The new monkeypox outbreak in the UK, Europe, and the US was not communicated through conventional scientific channels or the UK Health Security Agency (UKHSA), but via the social networking site, Twitter. As each suspected case was reported and infectious disease experts shared their theories in real time, Kraemer became increasingly concerned.
He says that the outbreak was unusual in its geographic expansion, with some clusters not linked to travel. In the past, cases of monkeypox could be traced back to countries where the virus is common. Not this time. Kraemer created the Monkeypox Tracker to keep up with the spread of the virus. It is this tool that makes it easy to see what is unusual about the new outbreak.
Monkeypox is endemic in West and Central Africa, but it is not known for being transmissible. It was first found in monkeys in 1958, but rodents and other small mammals are thought to be the main animal host, and the virus is most commonly transmitted through close contact between these creatures and humans.
It can be spread through respiratory droplets or the body fluids of aninfecting person, but this is less common as monkeypox is not contagious until a person is displaying symptoms. Some of the longest transmission chains documented for the virus are only six person-to-person.
The Monkeypox Tracker shows that clusters of cases are suddenly appearing around the globe without clear links back to endemic countries. The UK has the most confirmed cases at 57, along with clusters in Portugal and Spain, but cases have also emerged as far away as Canada and Australia.
What is going on? Some scientists thought that a new, more transmissible form of monkeypox might have emerged, but now the first viral genomic sequence from the outbreak are being published and appear to suggest otherwise. Scientists at the Institute of Tropical Medicine in Antwerp, Belgium, published a sequence from a 30-year-old patient that suggests the monkeypox currently in circulation is similar to the one seen in an outbreak last year. The Portuguese patient's sequence appears to be similar to the one detected in the year.
If the virus genomes are similar to earlier ones, we would be more confident that there hasn't been a jump in transmissibility.
It seems more likely that the outbreak is the result of a flare in cases within parts of Africa, combined with a spike in air travel following the end of Pandemic restrictions, and waning immunity against orthopoxviruses. Jamie Lloyd-Smith, a University of California, Los Angeles professor who has been studying monkeypox for more than a decade, says immunity against this family of viruses has been declining in humans since 1980.
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