The World Health Organization (WHO) reported another 50 suspected cases were under investigation, without mentioning any countries, and warned that possibly there will be more infections.

The WHO is working on the hypothesis that the outbreak is caused by sexual contact, David Heymann, chair of the WHO’s Strategic and Technical Advisory Group on Infectious Hazards with Pandemic and Epidemic Potential, told Reuters.

“With several confirmed cases in the UK, Spain and Portugal, this is the largest and most widespread outbreak of monkeypox ever seen in Europe,” the German Armed Forces Medical Service said.

According to BBC health correspondent James Gallagher, it is a “unusual and unprecedented outbreak of monkeypox it took disease scientists completely by surprise.”

“It’s always a concern when a virus changes its behavior. Until now, monkeypox was pretty predictable,” he said.

However, this rare infection is usually mild and most people recover within weeks, according to health authorities. The virus does not spread easily from person to person and the risk to the general public is considered low.

Although there is no vaccine developed specifically for monkeypox, some countries use smallpox injection as it provides 85% protection as the two viruses are quite similar.

British authorities reported that they had purchased smallpox vaccines and started offering them to those who were “at higher risk” of monkeypox.

Other countries, such as Spain, are evaluating it. This European country presented this Saturday a protocol for infected people which provides for self-isolation at home – only going out to see a doctor – and wearing a mask.

Those in close contact with an infected person should not self-isolate, but are asked to minimize social interactions and get tested.

Monkeypox is caused by the virus of the same name, a member of the smallpox virus family.

“Monkey pox is a zoonosis – those diseases that are transmitted from animals to humans – of the jungle type, with incidental human infections, usually occurring sporadically in forested areas of West and Central Africa“, said the Pan American Health Organization (PAHO) disease prevention and control adviser, epidemiologist Enrique Pérez, during a press conference on Wednesday.

“It’s caused by a virus, the smallpox virus, and it belongs to a family of viruses which are the orthopoxviruses,” he said.

“It manifests as a pustular rash (pimples filled with pus) and is a systemic disease that can vary from a mild form…to a more serious and elusive disease. including death“, he added.

In Africa, case fatality rates range between 4% and 22% and the majority of patients are children.

“What do we recommend? Any illness that occurs while traveling or returning from an endemic area should be reported to healthcare professionals, including recent travel information and vaccination history. “

“People residing in or traveling to endemic countries should always avoid contact with sick animals, which may harbor the smallpox virus,” Pérez said.

Two of the patients infected in the UK came from Nigeria so it is likely they have the virus strain of West Africa, generally mild.

The third case was a healthcare worker who contracted the virus from one of the patients.

The following four cases, three in London and one in the North East of England, have no known link between them and no travel history.

The UK Health Security Agency has said anyone who fears they may be infected should seek medical advice.

Early symptoms include fever, headache, swelling, back pain, muscle aches and general listlessness.

After the fever has passed, a rash may develop, often starting on the face and then spreading to other parts of the body, most commonly the palms of the hands and the soles of the feet.

The rash, which can be very itchy, evolves and goes through different stages before finally forming a scab, which then falls off. Injuries can cause scarring.

The infection usually goes away on its own and lasts two to four weeks. Most cases are mild, sometimes similar to chickenpox.

Monkeypox can be spread when a person is in close contact with an infected person.

Pérez, from PAHO, said it is transmitted through large exhaled droplets. It can enter the body through broken skin, the respiratory tract, or the eyes, nose, or mouth, and has an incubation period of 6 to 13 days, although it can last up to 21 days.

Viral excretion through feces can also be a route of virus transmission.

Although it is called “monkey pox”, it is also transmitted by rodents, marsupials and other primates. PAHO noted that people “should avoid handling animals.”

It can also be spread through contact with infected animals or through objects contaminated with the virus, such as clothing.

The virus was first identified in a captive monkey and since 1970 sporadic outbreaks have been reported in 10 African countries.

In 2003 there was an outbreak in the United States, the first time the disease was seen outside of Africa.

The patients contracted the disease through close contact with rodents that had been infected by small mammals – rats, dormice and squirrels – imported from Africa.

A total of 81 cases have been reported, but none have resulted in death.

In 2017, Nigeria experienced its largest documented outbreak, some 40 years after the country had its last confirmed cases of monkeypox. There were 172 suspected cases and 75% of the victims were men between the ages of 21 and 40.

This year, Nigeria has recorded 46 suspected cases, of which 15 are confirmed, according to the WHO.

There is no cure for monkeypox, but outbreaks can be controlled by preventing infections.

In Africa yes. From 2016 to date, more cases have been detected than in the previous 40 years, according to Raúl Rivas González, professor of microbiology at the University of Salamanca (Spain), in an article published in The conversation.

Regarding the reason for this resurgence, Rivas González points to four reasons:

UK experts say they are not close to a local outbreak and, according to England’s Public Health Office, the risk to the public is low.

Jonathan Ball, professor of molecular virology at the University of Nottingham, said: “The fact that only one of the 50 contacts of the patient initially infected with monkeypox was infected shows how little infectious the virus is.”

Nick Phin, Deputy Director of the National Infection Service at England’s Public Health Office, added: “It is important to stress that monkeypox is not easily transmitted from person to person and the risk to the general public is very weak.”

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