HEADLINE: MONKEYPOX DISEASE: As of June 12, 2022-1,285 laboratory confirmed cases of Monkeypox reported to WHO from 28 countries – WHO

Cases of monkeypox in countries where monkeypox is not usually or had not previously been reported, 13 May to 8 June 2022, 5 PM CEST

As of 8 June, 1285 laboratory confirmed cases and one probable case have been reported to WHO from 28 countries in four WHO Regions where monkeypox is not usual or had not previously been reported.

This represents an increase of 505 laboratory confirmed cases since the previous Disease Outbreak News on 4 June 2022 when 780 cases were reported.

As of 8 June 2022, there have been no associated reported deaths in these four Regions.

Of the cases reported in these regions, the majority (87%) of confirmed cases are from the WHO European Region (1112).

Confirmed cases have also been reported from the Region of the Americas (153), Eastern Mediterranean Region (14) and Western Pacific Region (6).

The case count fluctuates as more information is reported and becomes available daily and data is verified under the International Health Regulations (IHR 2005) (Table 1).

To date, the clinical presentation of monkeypox cases associated with this outbreak has been variable.

Many cases in this outbreak are not presenting with the classically described clinical picture for monkeypox (fever, swollen lymph nodes, followed by rash concentrated on the face and extremities).

Atypical features described include: presentation of only a few lesions or even just a single lesion; lesions that begin in the genital or perineal/perianal area and do not spread further; lesions appearing at different (asynchronous) stages of development; and the appearance of lesions before the onset of swollen lymph nodes, fever, malaise or other symptoms.

The modes of transmission during sexual contact remain unknown; while it is known that close physical contact can lead to transmission, it is not clear what role sexual bodily fluids, including semen and vaginal fluids, play in the transmission of monkeypox.

The situation is evolving and WHO expects that there will be more cases of monkeypox identified as surveillance expands in all regions and countries.

In addition to the cases reported from or identified in newly affected countries, WHO continued to receive updates on the status of ongoing monkeypox outbreaks and newly reported cases in countries in the African Region through established surveillance mechanisms (including Integrated Disease Surveillance and Response).

Since the beginning of 2022, 1536 suspected cases with 72 deaths were reported from eight countries as of 8 June 2022; 59 confirmed cases were reported from six countries during this same period.

This now includes cases from Ghana that had not previously reported human cases. Although an outbreak of monkeypox in the United States of America in 2003 was linked to small mammals which been imported from Ghana.

Laboratory strengthening in countries that have long experienced monkeypox is a priority to enable confirmation of suspected cases.

The case fatality ratio seen in the African Region underlines the need for support for all elements of the response including but not limited to, awareness-raising, risk communication, surveillance, diagnostic and laboratory support, and research and analysis in the Region.

WHO is providing guidance and reporting forms to countries that have long experienced monkeypox as well as countries that have newly been affected. WHO

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