1st probable case of monkeypox found in Michigan; what is it and where is it spreading

Associated Press

London — European and American health authorities have identified a number of cases monkeypox, mostly in young men. It's a surprising outbreak of disease that rarely appears outside Africa.

Health officials around the world are keeping watch for more cases because, for the first time, the disease appears to be spreading among people who didn’t travel to Africa. They stress, however, that the risk to the general population is low.

On Wednesday, the Michigan Department of Heath and Human Services announced that it had identified the first probable monkeypox case in the state.

The case involves an Oakland County resident, according to the state health department.

This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak.

Here's what to know about monkeypox:

What is monkeypox?

Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic.

The illness was first identified by scientists in 1958 when there were two outbreaks of a “pox-like” disease in research monkeys — thus the name monkeypox. The first known human infection was in 1970, in a 9-year-old boy in a remote part of Congo.

What are the symptoms?

Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.

Most patients only experience fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.

The incubation period is from about five days to three weeks. Most people recover within about two to four weeks without needing to be hospitalized.

This 1997 image provided by U.S. Centers for Disease Control and Prevention shows the right arm and torso of a patient, whose skin displayed a number of lesions due to what had been an active case of monkeypox.

How is monkeypox treated?

Monkeypox can be fatal for up to one in 10 people and is thought to be more severe in children.

People exposed to the virus are often given one of several smallpox vaccines, which have been shown to be effective against monkeypox. Anti-viral drugs are also being developed.

U.S. health officials on Tuesday expanded the group of people recommended to get vaccinated against the monkeypox virus.

They also said they are providing more monkeypox vaccine, working to expand testing, and taking other steps to try to get ahead of the outbreak.

How many monkeypox cases are there typically?

The World Health Organization estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6,000 cases annually, and Nigeria, with about 3,000 cases a year.

Patchy health monitoring systems mean many infected people are likely missed, experts say.

Isolated cases of monkeypox are occasionally spotted outside Africa, including in the U.S. and Britain. The cases are typically associated with travel to Africa or contact with animals from areas where the disease is more common.

In 2003, 47 people in six U.S. states had confirmed or probable cases. They caught the virus from pet prairie dogs that been housed near imported small mammals from Ghana.

Where has monkeypox been identified in the U.S.?

As of Wednesday, the U.S. had identified 351 cases in 27 states and the District of Columbia, according to the CDC. Since the beginning of a global outbreak, 5,115 monkeypox cases have been confirmed in 51 countries.

Case count by state:

Arizona 1
California 80
Colorado 7
District Of Columbia 21
Florida 35
Georgia 8
Hawaii 6
Illinois 46
Indiana 2
Kentucky 1
Maryland 5
Massachusetts 15
Minnesota 2
Missouri 2
Nebraska 1
Nevada 2
New Jersey 4
New York 72
North Carolina 2
Ohio 3
Oklahoma 2
Oregon 1
Pennsylvania 8
Rhode Island 1
Texas 8
Utah 5
Virginia 3
Washington 6

What's different about these cases?

It's the first time monkeypox appears to be spreading among people who didn't travel to Africa.

In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden. Most of the cases involve men who have had sex with men.

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Britain's Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening.

The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.

Is monkeypox being spread through sex?

It's possible, but it's unclear at the moment.

Monkeypox has not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people, their body fluids and their clothing or bedsheets.

Michael Skinner, a virologist at Imperial College London, said it's still too early to determine how the men in the U.K. were infected.

“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person’s sexual orientation and irrespective of the mode of transmission," Skinner said.

Francois Balloux of University College London said monkeypox said sex qualifies as the kind of close contact needed to transmit the disease.

The U.K. cases "do not necessarily imply any recent change in the virus’ route of transmission,” Balloux said.