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America has detected its ninth case of monkeypox in a person in Virginia, health chiefs have revealed amid warnings the virus has started spreading inside the country.
The disease has now been spotted in seven states with the vast majority of infections detected among gay and bisexual men, the Centers for Disease Control and Prevention (CDC) said in a briefing Thursday.
It was not clear how many cases were linked to international travel, but top officials warned they were now assuming there was ‘some community spread’.
On Monday, they said all cases had been traced back to travel abroad — mainly Europe — where the outbreak is believed to have been sparked by unsafe sex at two mass events in Spain and Belgium.
A total of nine cases have been detected in the U.S. to date, with two in Florida and Utah and one each in California, Massachusetts, New York City, Virginia and Washington.
The CDC has warned Americans to take ‘enhanced precautions’ when travelling abroad to protect themselves against the virus.
Globally, more than 200 cases have now been detected in 23 countries including the UK, France, Italy, Israel and Australia.
Experts — including Dr Romulus Breban, a researcher at the Pasteur Institute in Paris, France — have been warning for years that an outbreak of the virus was bound to happen because so many people no longer have immunity to its closely-related cousin smallpox.
Utah yesterday revealed its two reported cases of monkeypox had been confirmed, raising the tally to three confirmed cases. There are six suspected cases in the country
The above map shows which countries have detected monkeypox where it is not native. Cases have been disproportionately detected among gay and bisexual men
The CDC’s travel advisory applies to all international travel outside the U.S.
It told those outside the U.S. to avoid sick people and animals, not to eat game meat, and not to use any creams, powders or lotions made from wild animals.
Anyone who experiences an unexplained rash — a common symptom of the virus — was urged to seek immediate medical attention.
Explaining the decision to activate Level 2, the CDC said: ‘None of [the cases] reported having recently been in Central or West African countries where monkeypox usually occurs, including the Democratic Republic of Congo and Nigeria, among others.’
A spokesman for the Salt Lake County Department of Health — in Utah — yesterday revealed the CDC tests had come back positive for the virus.
The two adults — who have not been named — live in the same house and came down with a ‘mild illness’ after returning from abroad.
They have been isolating at home since Wednesday, with local health chiefs saying there is ‘no risk’ of wider transmission.
It was not revealed where the individuals had returned from, except that it was an area ‘currently experiencing monkeypox cases’.
The CDC is currently carrying out tests to confirm the two cases in Florida, and one each in California, Washington and New York City. A case was confirmed in Massachusetts early in the outbreak.
The cases are all in men who have recently returned from travel abroad, the CDC said in a statement Wednesday.
At least 200 people are being monitored for possible infection after being exposed to someone who had the virus.
But health chiefs advise that the risk of transmission is low because the virus is ‘very difficult’ to spread.
It normally requires sustained skin-to-skin contact with infectious lesions, but can also be spread in droplets expelled by an infected person.
Infections begin with a fever and ‘flu-like’ symptoms up to 21 days after catching the virus.
These then progress into a rash that appears on the face before spreading across the rest of the body. Painful skin lesions also appear.
Health chiefs say that in the current outbreak these skin lesions are more commonly appearing on the genital area, driving theories it is being spread through sex.
Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)
Most cases clear up on their own within four weeks, but about one in 100 people who catch the currently circulating strain of the virus die from the infection.
People who are exposed to the virus are offered smallpox vaccines — which also work against this virus as the two are closely related — to bolster their immunity. Patients are also given antibiotics to help curb the illness.
It comes after experts warned yesterday that the outbreak was ‘inevitable’ because so many people now do not have protection against smallpox.
Americans were routinely jabbed against this virus until the early 1970s, when the scheme was deemed no longer necessary because the virus had been beaten into submission. Similar programs were wound down globally.
Scientists say waning immunity from the mammoth inoculation programs may help explain why monkeypox outbreaks are becoming more common across the world.
Dr Romulus Breban, a researcher at the Pasteur Institute in Paris, said the current global outbreak was ‘waiting to happen’ because of the world’s ‘almost zero’ immunity level. Nineteen countries have detected cases in the past month, which has sparked alarm because infections usually only occur in west and central Africa.
Vet who caught monkeypox from prairie dog in 2003 outbreak says he suffered ‘flu-like’ symptoms and feared he would lose his thumb
Dr Kurt Zaeske, who is now retired and living in Wisconsin, said he caught the virus in 2003
A veterinarian who caught monkeypox in America’s biggest ever outbreak nearly two decades ago says he suffered ‘flu-like’ symptoms and feared he’d lose his thumb after lesions erupted all over his body.
Dr Kurt Zaeske, who is now retired and living in Wisconsin, caught the virus in 2003 after tending to sick prairie dogs at a breeding farm.
The illness initially left him with a fever and feeling dizzy, nauseous and very tired all the time. Within a few days, small lesions erupted across his body, and a ‘very painful’ blister appeared on his thumb — leaving him fearing it could be amputated.
Doctors administered Zaeske with antibiotics after a positive test for monkeypox and he was put in self-isolation. The illness cleared up within a few weeks.
Zaeske detailed his harrowing experience to NBC, saying that suffering the tropical disease was ‘scary’ initially, but also ‘fascinating’ to be part of the outbreak.
Monkeypox is now sweeping the western world, with more than 221 cases detected in 24 countries — mostly in Europe — including up to eight in the United States.
But experts warn the outbreak of the disease — which is endemic to West Africa — was just waiting to happen as the end of smallpox vaccination drives in the 1970s have left people less than 50 years old with no protection against the virus.
How DO you catch monkeypox and what are the symptoms? EVERYTHING you need to know about tropical virus
How do you catch monkeypox?
Until this worldwide outbreak, monkeypox was usually caught from infected animals in west and central Africa.
The tropical virus is thought to be spread by rodents, including rats, mice and even squirrels.
Humans can catch the illness — which comes from the same family as smallpox — if they’re bitten by infected animals, or touch their blood, bodily fluids, or scabs.
Consuming contaminated wild game or bush meat can also spread the virus.
The orthopoxvirus can enter the body through broken skin — even if it’s not visible, as well as the eyes, nose and mouth.
Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people.
However, health chiefs insist it is very rare.
Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus’ tell-tale scabs.
The virus can also spread through coughs and sneezes.
In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.
How deadly is it?
Monkeypox is usually mild, with most patients recovering within a few weeks without treatment.
Yet, the disease kills up to 10 per cent of cases. But this high rate is thought to be in part due to a historic lack of testing meaning that a tenth of known cases have died rather than a tenth of all infections.
However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.
The UK cases all had the West African version of the virus, which is mild compared to the Central African strain.
It is thought that cases in Portugal and Spain also have the milder version, though tests are underway.
How is it tested for?
It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox.
Monkeypox is confirmed by a clinical assessment by a health professional and a test in the UK’s specialist lab – the UKHSA’s Rare and Imported Pathogens Laboratory.
The test involves taking samples from skin lesions, such as part of the scab, fluid from the lesions or pieces of dry crusts.
What are the symptoms?
It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.
Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.
But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
People who are infected with monkeypox often suffer from severe rashes, skin lesions and flu like symptoms. The virus kills around one-in-ten people it infects, though there is belief that the current strain making its way around the world has a mortality rate of one percent
How long is someone contagious?
An individual is contagious from the point their rash appears until all the scabs have fallen off and there is intact skin underneath.
The scabs may also contain infectious virus material.
The infectious period is thought to last for three weeks but may vary between individuals.
What do I do if I have symptoms?
Anyone with an unusual rash or lesions on any part of their body, especially their genitalia, should contact NHS 111 or call a sexual health service.
Britons are asked to contact clinics ahead of their visit and avoid close contact with others until they have been seen by a medic.
Gay and bisexual men have been asked to be especially alert to the symptoms as most of the cases have been detected in men who have sex with men.
What even is monkeypox?
Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.
Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent.
The UK, US, Israel and Singapore are the only countries which had detected the virus before May 2022.
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