By: Bernd Debusmann JR, BBC News
More than 3,800 monkeypox cases have been reported in the US, the most of any country around the globe, government health data shows.
The rising number of cases has reportedly prompted the Biden administration to mull declaring a national health emergency.
The virus has already been classified as a global health emergency by the World Health Organization (WHO).
To date, more than 18,000 cases have been reported in 75 countries.
According to data published online by the US Centers for Disease Control and Prevention (CDC), as of 25 July there were 3,846 confirmed or suspected monkeypox cases in the US.
The figure – which comes amid expanded testing in addition to the growing outbreak of the virus – is now ahead of that of Spain, where 3,105 cases have so far been reported.
Cases of monkeypox – a rare, little-known disease – are being investigated in European countries including the UK, as well as in the US, Canada and Australia.
In the UK there have been more than 2,000 confirmed cases in recent weeks.
Infections are usually mild and the risk to the general population is low, but the UK government has bought stocks of smallpox vaccine to guard against monkeypox.
How do you catch it?
Monkeypox can be spread when someone is in close contact with an infected person. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose or mouth.
It has not previously been described as a sexually transmitted infection, but it can be passed on by close contact.
Guidance is advising anyone with the virus to abstain from sex while they have symptoms.
It can also be spread by contact with infected animals such as monkeys, rats and squirrels, or by virus-contaminated objects, such as bedding and clothing.
What are the symptoms?
Initial symptoms include fever, headaches, swellings, back pain, aching muscles.
Once the fever breaks a rash can develop, often beginning on the face, then spreading to other parts of the body, most commonly the palms of the hands and soles of the feet.
The rash, which can be extremely itchy or painful, changes and goes through different stages before finally forming a scab, which later falls off. The lesions can cause scarring.
Are gay men at greater risk?
Although some of the cases have been seen in gay and bisexual men, anyone who comes into close contact with someone who has monkeypox could potentially get the virus.
The UK Health Security Agency (UKHSA) has said “a notable proportion” of the recent cases in the UK and Europe have been found in gay and bisexual men “so we are particularly encouraging them to be alert to the symptoms and seek help if concerned”.
The two other countries with the highest number of infections, Germany and the UK, have reported 2,352 and 2,208 cases, respectively.
With cases in the US rising, the Washington Post on 25 July reported that the Biden administration was considering declaring a public health emergency.
The measure would allow the government to use federal funds to combat the outbreak, raise public awareness and better collect relevant health data.
Additionally, the administration is reportedly preparing to name a coordinator to oversee the government’s response to monkeypox from the White House.
On July 21, 50 Democratic lawmakers sent an open letter to President Joe Biden, urging him to declare a public health emergency and send millions of vaccine doses to the US from manufacturing facilities overseas.
While officials have said that gay and bisexual men – as well as healthcare workers – have so far been most at risk, fears are mounting that the virus could spread to other segments of the population.
On 22 July, the US confirmed the first cases of monkeypox in children.
The US response to the virus has so far been plagued by vaccine shortages and a slow start to testing, leading some to compare the situation to the beginning of the Covid-19 pandemic in early 2020.
In Washington DC, for example, officials have warned that a “rapid increase in cases”, coupled with a “very limited” supply of vaccines, means that authorities must prioritise high-risk residents.
The city currently has the highest per capita total of infections, with 172 cases reported in the district.
Most monkeypox cases are mild, with initial symptoms including a high fever, swollen lymph nodes and a blistery, chickenpox-like rash or lesions.
So far, no deaths from the virus have been reported in the US.
Health protection teams are contacting people who’ve come into close contact with confirmed cases and are at high risk. They are offering advice and monitoring them.
They are advising anyone else who has been in close contact with someone infected by monkeypox to isolate at home for up to 21 days.
Sources: BBC News, UK Health Security Agency