North America: Monkeypox (mpox) cases continue to be reported in North America in February /update 10 | CPT PPP Coverage

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Event

Public health officials continue to report monkeypox (mpox) cases across North America, with 922 additional cases identified Dec. 13, 2022-Feb. 28, 2023, bringing the total since May 18 to 35,349 confirmed cases. Data through Feb. 28 show 1,460 confirmed cases in Canada, 3,877 confirmed cases in Mexico, and 30,012 confirmed cases in the US. Additional cases will likely be identified in the coming weeks, despite decreasing disease activity, as disease surveillance and contact tracing continue. This represents the most updated information available as of March 6.

Context

The first confirmed cases of mpox in the US were reported on May 18, in Canada on May 19, and on May 28 in Mexico. These cases are associated with the widespread outbreak of mpox reported by individuals who attended one or more mass gatherings in May located in Antwerp, Belgium, as well as Madrid and Gran Canaria in Spain, or reported recent close contact with an attendee. Mass gatherings always present an elevated risk of infectious disease transmission. Human-to-human transmission occurs among people in close physical contact, with the increase in recent cases linked to sexual contact suggesting that the virus linked to the disease can be sexually transmitted. The current outbreak highlights the importance of vigilant safe sexual practices and suggests mpox can be transmitted while the infected person displays few or no symptoms; however, the risk is currently assessed as low for individuals not routinely engaging with multiple or anonymous sexual partners.

Mpox does not naturally occur in North America; most cases are reported in West and Central Africa, primarily in the DRC, Nigeria, and Cameroon, among individuals who report contact with wild primates or other mammals that may harbor the disease.

Mpox is caused by a virus belonging to the same family as the one that causes smallpox. However, mpox is not the same as smallpox and does not have the same capacity for rapid human-to-human transmission. Mpox is mainly transmitted to humans through direct contact with the bodily fluids of infected rodents or primates. Human-to-human transmission primarily occurs through close personal contact with an infected individual via respiratory droplets, direct contact with bodily fluids, or indirect contact with lesion material (e.g., contaminated clothing or bedding). Symptoms typically appear 6-16 days after exposure but can develop up to 21 days after exposure. Symptoms generally include fever, headache, muscle aches and backaches, swollen lymph nodes, chills, exhaustion, and a distinctive rash characterized by lesions that progress through several stages before falling off.

Advice

Practice basic health precautions, including frequent handwashing with soap and water, covering the nose and mouth when coughing, and avoiding obviously ill individuals. Avoid overcrowded areas such as nightclubs and consider using safe sexual practices such as physical barriers (condoms) in countries reporting mpox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas, especially if you have had one or more new sexual partners. Vaccines are available but limited.

Resources

US CDC: Monkeypox Factsheet