What is Monkeypox? Symptoms, Transmission and Why Cases are Rising in Europe

Few cases of monkeypox have now been reported or suspected in the United Kingdom, Portugal and Spain. Outbreaks are cause for concern because the disease occurs mostly in West and Central Africa, and only rarely spreads elsewhere. This is what scientists know so far.


Monkeypox is a virus that causes symptoms of fever as well as a characteristic bumpy rash. It is usually mild, although there are two main strains: the Congo strain, which is more severe – with a fatality rate of up to 10% – and the West African strain, which has a fatality rate of more than 1% of cases. Fewer UK cases have been reported as a West African strain.

“Historically, there have been very few cases that have been exported. It has only happened eight times in the past before this year,” said Jamie Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, who said it was “very unusual.”

Portugal has recorded five confirmed cases, and Spain is testing 23 probable cases. Neither country has reported cases before.


The virus spreads through close contact, both in its spread from host animals, and, less commonly, between humans. It was first found in monkeys in 1958, hence the name, although rodents are now considered the main source of transmission.

This time experts are baffled, because a number of cases in the UK – nine as of May 18 – have no known link to each other. Only the first case reported on May 6 had recently traveled to Nigeria.

As such, experts have warned of wider transmission if cases go unreported.

The UK Health Security Agency alert also highlighted that recent cases were mostly among men who self-identified as gay, bisexual or MSM, and advised these groups to exercise caution.
The World Health Organization (WHO) said this week that scientists will now send the virus back to see if it’s linked.

why now?

One possible scenario behind the increase in cases is increased travel as coronavirus restrictions are lifted.

“My working theory is that there’s a lot going on in West and Central Africa, and travel has been resumed, which is why we’re seeing more cases,” Whitworth said.

Monkeypox puts virologists on alert because it belongs to the smallpox family, although it causes less serious disease.

Smallpox was eradicated by vaccination in 1980, and the vaccine was phased out. But it also protects against monkeypox, so the end of vaccination campaigns has led to a jump in monkeypox cases, according to Anne Remoen, a professor of epidemiology at UCLA.

But experts urged people not to panic.

“This won’t cause a nationwide epidemic like COVID did, but it’s a serious outbreak of a dangerous disease — and we need to take it seriously,” Whitworth said.

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