Situation to Date
Since September 2017, Nigeria has routinely reported cases of monkeypox. Ongoing monkeypox transmission in Nigeria has increased the likelihood of sporadic travel-related cases appearing in other countries.
In early May, the UK confirmed monkeypox in a person who recently traveled to Nigeria. Shortly later, over a dozen new cases were identified in the UK, but these individuals had no history of travel and no link to the initial traveler, suggesting monkeypox is spreading locally between people. The majority of the monkeypox patients in the UK identify as men who are gay, bisexual, or men who have sex with men (MSM). Following confirmation of the initial UK case, monkeypox cases have been identified in other countries including in Europe, North America, and Australia, predominantly in men who identify as MSM. It is currently unknown why this population demographic is experiencing the majority of cases, but epidemiological investigations are ongoing.
Some of the recently identified cases were discovered in clinics that specialize in sexually transmitted infections. Even though monkeypox has not historically been regarded as a sexually transmitted infection, that possibility cannot be ruled out. This is because monkeypox can be passed between people by direct contact with skin lesions during sex or close contact, respiratory droplets, or other contact with contaminated clothing or linens. Given the demographics of early cases in this outbreak, monkeypox may be spreading in MSM networks, but not exclusively in them. Any prolonged close contact with an infected person can be an opportunity for transmission.