2022 monkeypox outbreak in North America

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This article is about the outbreak on the continent. For an overview of the outbreak for the entire world, see 2022 monkeypox outbreak.

2022 monkeypox outbreak in North America
DiseaseMonkeypox
Virus strainMonkeypox virus (West African clade)
Index caseMassachusetts, United States[1]
Arrival date18 May 2022 (2 years, 2 months and 1 day ago)
Confirmed cases17,608
Suspected cases‡224
Deaths
3:
Territories
20
Government website
[Response Website]
‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The 2022 monkeypox outbreak in North America is a part of the outbreak of human monkeypox caused by the West African clade of the monkeypox virus. The outbreak reached North America on 18 May 2022 when the United States reported their first case of monkeypox. As of 23 August 2022, 20 North American countries and territories have confirmed cases.

Background

These paragraphs are an excerpt from Monkeypox and 2022 monkeypox outbreak.

Monkeypox is an infectious viral disease that can occur in humans and some other animals.[4] Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over.[4] The time from exposure to onset of symptoms ranges from five to twenty-one days.[5][6] The duration of symptoms is typically two to four weeks.[6] There may be mild symptoms, and it may occur without any symptoms being known.[5][7] The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common to all outbreaks.[4][8] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[9]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus.[10] The variola virus, the causative agent of smallpox, is also in this genus.[11] Of the two types in humans, clade II (formerly West African clade)[12] causes a less severe disease than the Central African (Congo basin) type.[13] It may spread from infected animals by handling infected meat or via bites or scratches.[14] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.[4][14] People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted.[13] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[15]

There is no known cure.[16] A study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease.[17] A newer smallpox and monkeypox vaccine based on modified vaccinia Ankara has been approved, but with limited availability.[5] Other measures include regular hand washing and avoiding sick people and animals.[18] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[19][20] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[20] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of monkeypox have been recorded since 2017.[21]

An ongoing outbreak of monkeypox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with monkeypox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak.[22] The origin of several of the cases of monkeypox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[23] but it has been suggested that cases were already spreading in Europe in the previous months.[24]

Transmission

Stages of lesion development. Picture taken by Dr O.O. Afuye on 15 September 2019.

A large portion of those infected were believed to have not recently traveled to areas of Africa where monkeypox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[25]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out monkeypox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[26]

Timeline

Arrival

Main article: 2022 monkeypox outbreak in the United States

An index case was imported into the United States on 18 May 2022, by a man who had recently travelled to Canada.[1] He was admitted to a hospital in Massachusetts, likely on 17 May. The day after, the man was confirmed to have contracted monkeypox. The following day, another monkeypox case was confirmed,[27] and the United States reported these cases to the World Health Organization (WHO)[28] and the Centers for Disease Control and Prevention (CDC).[29]

Cases transited through North America

May

19 May
Main article: 2022 monkeypox outbreak in Canada

On 19 May, Canada confirmed the first two cases of monkeypox. Health officials revealed that there was a link between the U.S. case of monkeypox in Massachusetts and a few of the suspected cases in the Montreal region. The patient of unknown gender or age, may have been infected when recently traveling to Canada. The spread was likely through skin-to-skin contact picked up abroad.[30]

28 May

On 28 May, Mexico registered its first case of monkeypox. It was in a 50-year-old male who resides in the city of New York and is being treated at Mexico City. It was noted that he may have contracted the disease abroad, from the Netherlands, where there it had already been affected by monkeypox. It was likely picked up by skin-to-skin contact picked up abroad.[31]

June

29 June

On 29 June, Puerto Rico, a US Territory, confirmed its first case of monkeypox. It was likely in a male, age between 20 and 50 years old. It is unknown how it was contracted, but likely skin-to-skin contact picked up abroad.[32]

30 June

On 30 June, the Bahamas confirmed its first monkeypox case in a male visitor in his 40s who had most likely contracted the disease from a trip to London, UK, which had already been affected by the monkeypox outbreak on June 9. It was likely picked up from skin-to-skin contact abroad.[33]

July

5 July

On 5 July, Panama received its first monkeypox infection in a resident of unknown gender and age who most likely contracted the disease via contact with tourists from Europe, which had already been affected by the monkeypox outbreak. It was likely skin-to-skin contact rather than sexual contact.[34]

6 July

On 6 July, Jamaica registered its first monkeypox case. It was in a male of unknown age who had most likely contracted the disease from a trip to London, UK, which had already been affected by the monkeypox outbreak. It was likely picked up from skin-to-skin contact abroad.[35]

On the same day, the Dominican Republic also confirmed its first case of monkeypox. It was in a 25-year-old male who had most likely contracted the disease via contact with a person who was infected with monkeypox in the United States. It was likely skin-to-skin contact rather than sexual contact.[36]

16 July

On 16 July, Barbados confirmed its first monkeypox infection. It was in a Barbadian patient of unknown gender in his 30s. It is unknown how the patient contracted the disease, but likely via skin-to-skin contact abroad.[37]

17 July

On 17 July, Martinique, part of Overseas France and a Single territorial collectivity and an Overseas Department of France, received its first monkeypox case. It was in an adult of unknown exact age and gender who most likely contracted the disease from a trip to a country which had been affected by the monkeypox outbreak. It was likely picked up via skin-to-skin contact abroad.[38]

20 July

On 20 July, Costa Rica recorded its first monkeypox infection. It was in a 34-year-old male from the United States who resided in Costa Rica for 2 years. He most likely contracted it from a trip to the United States abroad and is considered an imported case. It was likely picked up via skin-to-skin contact.[39]

22 July

On 22 July, Bermuda, a British Overseas Territory, although technically part of North America, registered its first monkeypox case. It is unknown what the patient's gender and age is and how the patient contracted the disease, but it was likely via skin-to-skin contact abroad.[40]

25 July

On 25 July, Guadeloupe, part of Overseas France and an Overseas Department of France, confirmed its first case of monkeypox. It was in a patient of unknown gender or age who resides in Guadeloupe. The patient recently travelled to France and likely contracted the disease via contact with someone in France. It was likely skin-to-skin contact rather than sexual contact.[41]

August

1 August

On 1 August, Collectivity of Saint Martin, part of Overseas France, confirmed its first case of monkeypox. It was in a patient of unknown gender or age who's residence is unknown. It is unknown how it was contracted, however it may be likely that it was picked up via skin-to-skin contact abroad.[42]

3 August

On 3 August, Guatemala registered its first case of monkeypox. It was in a 31-year-old male who had likely contracted the disease via contact with foreigners/tourists from another country. It was likely skin-to-skin contact rather than sexual contact.[43]

9 August

On 9 August, Greenland reported its first two cases of monkeypox. It was in patients of unknown genders and ages who likely contracted the disease via skin-to-skin contact picked up abroad.[44]

12 August

On 12 August, Honduras reported its first case of monkeypox in an adult male under 50 years of age. It is unknown how the male contracted the disease, although it was likely picked up via contact with other infected abroad.[45]

19 August

On 19 August, Curacao confirmed its first case of monkeypox in a patient of unknown gender and age who likely contracted the disease abroad, via skin-to-skin contact or sexual contact with others.[46]

20 August

On 20 August, Cuba reported its first monkeypox infection. It was in a male Italian tourist of unknown gender. He most likely contracted the disease from a trip to Italy and other various destinations in the Caribbean. It is unknown how the disease was contracted, but likely via skin-to-skin contact rather than sexual contact.[47]

The man fell into cardiac arrest, likely on the same day he was diagnosed, which he recovered from, but remained in critical condition at the time. He later died on August 21st after rapidly deteriorating. This marked Cuba's first death, as well as North America's first death during the ongoing outbreak.[48]

22 August

On 22 August, Aruba reported its first case of monkeypox. It was in a patient of unknown age and gender who resides in Aruba. It is unknown how the patient contracted the disease, but likely contracted the disease abroad, via skin-to-skin contact or sexual contact with others.[49]

Responses

World Health Organization (WHO)

On 20 May, the WHO convened an emergency meeting of independent advisers to discuss the outbreak and assess the threat level.[50] Its European chief, Hans Kluge, expressed concern that infections could accelerate in Europe as people gather for parties and festivals over the summer.[51] On 14 June, the WHO announced plans to rename the monkeypox virus in order to combat stigma and racism surrounding the disease.[52] Another meeting convened on 23 June determined that the outbreak does not constitute a Public Health Emergency of International Concern for the time being.[53]

Countries

The majority of North American countries responded to the outbreak, and the responses of some are listed below.

  •  Canada: On 21 April, Public Services and Procurement Canada published a tender request seeking to stockpile doses of smallpox vaccine to be prepared in the event of a future accidental or intentional release of the virus.[54] The contract for 500,000 doses closed on 5 May, and was awarded to Bavarian Nordic.[55] On 24 May, the Public Health Agency of Canada stated that they were in the process of extracting Imvamune vaccines from their National Emergency Strategic Stockpile for deployment across the country, starting with the province of Quebec.[56] On 26 May, Quebec announced that Imvamune vaccines would be made available to those who have been in close contact with confirmed or suspected monkeypox cases.[57] On 7 June, PHAC announced that travellers returning to Canada may be subject to a mandatory quarantine period if they become ill with monkeypox, and warned that quarantined travellers may have restricted access to health care and delays returning home.[58]
  •  Dominican Republic: In May, the Ministry of Public Health of the Dominican Republic issued a preventive epidemiological alert after monkeypox was reported in several countries.[59][60]
  •  Guatemala: On 26 May, the Minister of Health of Guatemala, Francisco Coma, informed that the Ministry declared an epidemiological alert on the borders of the Central American country, with the objective of detecting possible cases of Monkeypox.[61] The minister also mentioned that one of the main transmissions of Monkeypox is from injuries and body fluids as well as contact with contaminated clothing.[62]
  •  Mexico: In May, Mexican health authorities have posted notices in clinics and hospitals for the purpose of identifying suspected cases in the country. In addition, the Ministry of Health has issued an epidemiological alert on 26 May 2022.[63]
  •  United States: On 22 May, President Joe Biden commented "they haven't told me the level of exposure yet but it is something that everybody should be concerned about". National security advisor Jake Sullivan told reporters the US has a vaccine that is relevant to treating monkeypox.[64] On 25 May, the CDC issued an alert for gay and bisexual men to be especially vigilant.[65][66] In addition, the CDC placed its monkeypox travel alert at "Level 2", following reports of cases in Australia and several countries in Europe.[67] Beginning 18 July 2022, Sonic Healthcare USA started testing for monkeypox using CDC's orthopoxvirus test, which includes monkeypox virus at Sonic Reference Laboratory in Austin, Texas.[68]

We were unable to record Overseas and Dependant territories' response to the outbreak.

Cases per country and territory

This is a table of confirmed and suspected monkeypox cases in North American countries during the ongoing 2022 monkeypox outbreak. It does not include countries where suspected cases were reported but later discarded. (As of 24 August 2022)

Cases of monkeypox by countries of North America (last updated on as of 24 August 2022)
Country Confirmed Suspected Total Deaths Last update First confirmed case First confirmed death Last confirmed case
 Aruba[a] 1 — 1 — 22 August 2022[49] 22 August 2022[49]
 Bahamas 2 — 2 — 22 August 2022[69] 30 June 2022[70]
 Barbados 1 — 1 — 16 July 2022[71] 16 July 2022[71]
 Bermuda[b] 1 — 1 — 22 July 2022[72] 22 July 2022[72]
Canada 1,198 45 1,243 — 19 August 2022[73] 19 May 2022[74]
 Collectivity of Saint Martin[c] 1 — 1 — 1 August 2022[75] 1 August 2022[75]
 Costa Rica 3 — 3 — 26 July 2022[76] 20 July 2022[77]
 Cuba 1 — 1 1[2] 20 August 2022[47] 20 August 2022[47] 21 August 2022[2]
 Curacao[a] 1 — 1 — 19 August 2022[46] 19 August 2022[46]
 Dominican Republic 6 — 6 — 17 August 2022[78] 6 July 2022[79]
 Greenland 2 — 2 — 9 August 2022[44] 9 August 2022[44]
 Guadeloupe[d][c] 1 — 1 — 25 July 2022[41] 25 July 2022[41]
 Guatemala 3 7 10 — 10 August 2022[80] 3 August 2022[81]
 Honduras 3 — 3 — 14 August 2022[82] 12 August 2022[45]
 Jamaica 4 — 4 — 10 August 2022[83] 6 July 2022[84]
Martinique[c][e] 2 — 2 — 11 August 2022[85] 17 July 2022[86]
Mexico 386 172 558 1[3] 23 August 2022[87] 28 May 2022[88] 23 August 2022[3]
 Panama 7 — 7 — 19 August 2022[89] 5 July 2022[90]
 Puerto Rico[f] 77 — 77 — 22 August 2022[91] 29 June 2022[92][93]
United States 15,909 — 15,909 — 23 August 2022[91] 18 May 2022[94][95]
 Total 17,608 224 17,832 24 August 2022 —
  1. ^ a b Constituent country of the Kingdom of the Netherlands
  2. ^ British Overseas Territory.
  3. ^ a b c Part of Overseas France
  4. ^ Sui generis collectivity of France
  5. ^ Single territorial collectivity and Overseas Department of France.
  6. ^ Unincorporated territory of the United States.

Timeline of first confirmed cases by country or territory

First confirmed monkeypox cases by country or territory
Date Countries / Territories
18 May 2022 United States
19 May 2022 Canada
28 May 2022  Mexico
29 June 2022  Puerto Rico[a]
30 June 2022  Bahamas
5 July 2022  Panama
6 July 2022  Jamaica ·  Dominican Republic
16 July 2022  Barbados
17 July 2022 Martinique[b][c]
20 July 2022  Costa Rica
22 July 2022  Bermuda[d]
25 July 2022  Guadeloupe[e][c]
1 August 2022  Collectivity of Saint Martin[c]
3 August 2022  Guatemala
9 August 2022  Greenland
12 August 2022  Honduras
19 August 2022  Curaçao[f]
20 August 2022  Cuba
22 August 2022  Aruba[f]
  1. ^ Unincorporated territory of the United States.
  2. ^ Single territorial collectivity and Overseas Department of France.
  3. ^ a b c Part of Overseas France
  4. ^ British Overseas Territory.
  5. ^ Sui generis collectivity of France
  6. ^ a b Constituent country of the Kingdom of the Netherlands

Timeline of suspected cases by country or territory

Countries listed below had only suspected cases at the time of reporting. Some countries reported confirmed cases after reporting suspected cases. Countries listed several times reported suspected cases again after they discarded suspected cases before.

Timeline of suspected monkeypox cases by country or territory
Date Countries / Territories
1 June 2022  Costa Rica (discounted on 4 June) •  Haiti (discounted on 5 July)[96]
2 June 2022  Cayman Islands[a] (discounted on 30 June)[97]
7 June 2022  Bahamas (confirmed cases reported on 30 June)
  1. ^ Single territorial collectivity and Overseas Department of France.

Timeline of first deaths by country or territory

Timeline of monkeypox deaths by country or territory
Date Countries / Territories
21 August 2022  Cuba
23 August 2022 Mexico
30 August 2022 United States

As of 22 August 2022, 20 North American countries and territories have been affected by the outbreak.

See also

Notes

References

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  2. ^ a b c "Italian tourist dies in Cuba's first case of monkeypox". Jacaranda FM. Retrieved 23 August 2022.
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  4. ^ a b c d "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization. 4 June 2022. Archived from the original on 6 June 2022. Retrieved 7 June 2022.
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  24. ^ Nsofor, Ifeanyi (2 June 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved 2 June 2022.{{cite web}}: CS1 maint: url-status (link)
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  27. ^ "US identifies second and third monkeypox cases".
  28. ^ "Monkeypox - United States of America". www.who.int. Retrieved 27 July 2022.
  29. ^ "2022 U.S. Monkeypox Outbreak". www.cdc.gov. Retrieved 28 July 2022.
  30. ^ "First case of monkeypox reported in Canada with 17 other suspected cases".
  31. ^ "First case of monkeypox registered in Mexico".
  32. ^ "First case of monkeypox registered in Puerto Rico, four additional cases under investigation".
  33. ^ "Bahamas confirms first case of monkeypox".
  34. ^ "Panama reports country's first monkeypox case".
  35. ^ "Jamaica announces its first case of monkeypox".
  36. ^ "Dominican Republic confirms first case of monkeypox".
  37. ^ "Barbados records first case of monkeypox".
  38. ^ "Monkeypox infection confirmed in Martinique".
  39. ^ "Costa Rica confirms first case of monkeypox".
  40. ^ "Bermuda confirms first case of monkeypox".
  41. ^ a b c "A case of monkeypox confirmed in Guadeloupe".
  42. ^ "First case of monkeypox identified in French Saint Martin".
  43. ^ "First case of monkeypox identified in Guatemala".
  44. ^ a b c "Grønland har også fået tilfælde af abekopper" [Greenland has also had cases of monkeypox]. nordjyske.dk. 9 August 2022. Retrieved 11 August 2022.
  45. ^ a b "Honduras registra primer caso de viruela del mono en hombre menor de 50 años". Swissinfo (in Spanish). Retrieved 13 August 2022.
  46. ^ a b c "Confirmed: First monkeypox infection registered on Curaçao". Curacao Chronicle. Retrieved 19 August 2022.
  47. ^ a b c "Cuba confirms first monkeypox case in visitor from Italy". Reuters. Retrieved 21 August 2022.
  48. ^ "Italian tourist dies after contracting monkeypox".
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  51. ^ Rigby, Jennifer; Grover, Natalie (20 May 2022). "WHO calls emergency meeting as monkeypox cases top 100 in Europe". Reuters. Archived from the original on 20 May 2022. Retrieved 21 May 2022.
  52. ^ "WHO Will Rename Monkeypox Virus to Minimize Stigma, Racism". Bloomberg.com. 13 June 2022. Retrieved 15 June 2022.
  53. ^ "Meeting of the International Health Regulations (2005) Emergency Committee regarding the multi-country monkeypox outbreak". who.int. WHO. Archived from the original on 28 June 2022. Retrieved 26 June 2022.
  54. ^ Public Services and Procurement Canada (21 April 2022). "Third Generation Smallpox Vaccine (6D024-215700/A)". Government of Canada. Archived from the original on 20 June 2022. Retrieved 20 June 2022.
  55. ^ Laura, Osman (20 May 2022). "Canada considering smallpox vaccine for monkeypox cases, says Dr. Theresa Tam". CTV News. Archived from the original on 20 June 2022. Retrieved 20 June 2022.
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  61. ^ "Ministerio de Salud envía alerta epidemiológica a las fronteras de Guatemala por la viruela de mono". Prensa Libre (in Spanish). 26 May 2022. Archived from the original on 27 May 2022. Retrieved 28 May 2022.
  62. ^ Mutz, Viviana. "Sistema de Salud de Guatemala en alerta por viruela del mono". República.gt (in Spanish). Archived from the original on 31 May 2022. Retrieved 28 May 2022.
  63. ^ Camhaji, Elías (26 May 2022). "México emite una alerta epidemiológica para identificar casos de la viruela del mono". El País México (in Spanish). Archived from the original on 28 May 2022. Retrieved 28 May 2022.
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  69. ^ "Factbox: Monkeypox cases and deaths around the world". Reuters. Retrieved 22 August 2022.
  70. ^ "The Bahamas confirms first case of monkeypox". Loop Caribbean News. Retrieved 30 June 2022.
  71. ^ a b "Health Ministry confirms first case of Monkeypox in Barbados". Barbados Today. 16 July 2022. Retrieved 16 July 2022.
  72. ^ a b "Bermuda confirms first case of monkeypox". news.knowledia.com. Retrieved 22 July 2022.
  73. ^ Canada cases can be aggregated from the following sources:
  74. ^ Phil Tsekouras Toronto investigating first suspected case of monkeypox Archived 24 May 2022 at the Wayback Machine 21 May 2022 www.cp24.com, accessed 23 May 2022
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External links

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