Experts at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health say the current monkeypox outbreak is more common than previous outbreaks outside of Africa, and all physicians should pay attention to the possibility that patients with fever and rash may be infected.
In their new guidance, Center experts note that a significant number of new cases have occurred among nontraditional men, although the cause is unclear, according to a statement published in Annals of Internal Medicine.
Several dozen cases of monkeypox have now been reported in Europe, Britain and North America, raising concerns among epidemiologists and public health experts worldwide.
What distinguishes these cases is that they all occur outside the endemic region of virus distribution, the virus is transmitted from person to person, and most cases do not appear to involve travel from an endemic country, but multiple, hitherto unrelated clusters emerge.
Since smallpox belongs to the orthopoxvirus family, of which smallpox is a member, it is possible that the increase in monkeypox outbreaks in recent years is related to a decline in population immunity to smallpox over time. Vaccination against smallpox can prevent the disease, and smallpox antivirals can also treat monkeypox.
Typically, monkeypox presents with fever and a rash that begins in the mouth, then progresses to the face and then to the extremities, including the palms and soles. Primary care physicians, emergency physicians, emergency room physicians, dermatologists, and those who work in clinics treating STD patients may be most likely to identify new patients with monkeypox if they keep showing up. Clinicians who suspect monkeypox should alert state health officials to start testing, experts said in a statement.