A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022

Author:

Vaughan Aisling M1ORCID,Cenciarelli Orlando2,Colombe Soledad341ORCID,Alves de Sousa Luís2,Fischer Natalie41,Gossner Celine M2,Pires Jeff1,Scardina Giuditta2,Aspelund Gudrun5,Avercenko Margarita6,Bengtsson Sara7,Blomquist Paula8,Caraglia Anna9,Chazelle Emilie10,Cohen Orna11,Diaz Asuncion12,Dillon Christina13,Dontsenko Irina14,Kotkavaara Katja15,Fafangel Mario16,Ferraro Federica9,Firth Richard17,Fonager Jannik18,Frank Christina19,Carrasco Mireia G20,Gkolfinopoulou Kassiani21,Grenersen Marte Petrikke22,Guzmán Herrador Bernardo R23,Henczkó Judit24,Hoornenborg Elske25,Igoe Derval13,Ilić Maja26,Jansen Klaus19,Janță Denisa-Georgiana27,Johansen Tone Bjordal22,Kasradze Ana28,Koch Anders29,Kyncl Jan30,Martins João Vieira31,McAuley Andrew32,Mellou Kassiani33,Molnár Zsuzsanna34,Mor Zohar3536,Mossong Joël37,Novacek Alina38,Orlikova Hana30,Pem Novosel Iva26,Rossi Maria K32,Sadkowska-Todys Malgorzata39,Sawyer Clare40,Schmid Daniela38,Sîrbu Anca27,Sondén Klara7,Tarantola Arnaud41,Tavares Margarida424344,Thordardottir Marianna5,Učakar Veronika16,Van Ewijk Catharina4546,Varjas Juta14,Vergison Anne37,Vivancos Roberto8,Zakrzewska Karolina39,Pebody Richard1ORCID,Haussig Joana M2ORCID

Affiliation:

1. World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark

2. European Centre for Disease Prevention and Control (ECDC), Solna, Sweden

3. Outbreak Research Team, Institute of Tropical Medicine, Antwerp, Belgium

4. Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland

5. Centre for Health Security and Communicable Disease Control, The Directorate of Health, Reykjavik, Iceland

6. Infectious Disease Prevention and Control Unit, Department of Infectious Risks Analysis and Prevention, Centre for Disease Prevention and Control of Latvia, Riga, Latvia

7. Unit for Diagnostics Preparedness of Notifiable and High Consequence Pathogens, Public Health Agency of Sweden, Solna, Sweden

8. Field Services, United Kingdom Health Security Agency, London, United Kingdom

9. Directorate General of Health Prevention, Ministry of Health, Rome, Italy

10. Santé publique France, the French National Public Health Agency, Saint-Maurice, France

11. Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel

12. National Centre of Epidemiology, Carlos III Health Institute, CIBER in Infectious Diseases (CIBERINFEC), Madrid, Spain

13. Health Services Executive, Health Protection Surveillance Centre, Dublin, Ireland

14. Department of Communicable Diseases, Health Board, Tallinn, Estonia

15. Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland

16. Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia

17. Public Health Wales, Cardiff, United Kingdom

18. Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark

19. Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany

20. Ministry of Health, Government of Andorra, Andorra la Vella, Andorra

21. Surveillance Coordination Department. Hellenic National Public Health Organization (EODY), Athens, Greece

22. The Norwegian Institute of Public Health, Oslo, Norway

23. Coordinating Centre for Health Alerts and Emergencies (CCAES), Directorate General of Public Health, Ministry of Health, Madrid, Spain

24. Department of Microbiological Reference Laboratory, National Public Health Center, Budapest, Hungary

25. Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands

26. Croatian Institute of Public Health, Zagreb, Croatia

27. National Centre of Surveillance and Control of Communicable Disease, National Institute of Public Health Romania, Bucharest, Romania

28. Head of Public Health Emergency Preparedness and Response Division, National Center for Disease Control and Public Health, Tbilisi, Georgia

29. Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark

30. Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic

31. Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal

32. Public Health Scotland, Edinburgh, Scotland, United Kingdom

33. Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, Hellenic National Public Health Organization (EODY), Athens, Greece

34. Department of Communicable Disease Epidemiology and Infection Control, National Public Health Center, Budapest, Hungary

35. School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel

36. Public Health Services, Ministry of Health, Jerusalem, Israel

37. Health Directorate, Luxembourg, Luxembourg

38. Austrian Agency for Health and Food Safety (AGES), Vienna, Austria

39. National Institute of Public Health (NIH) - National Research Institute, Warsaw, Poland

40. Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, United Kingdom

41. Santé publique France Regional Office, Saint-Denis, Île-de-France, France

42. National Program for Sexually Transmitted Infections and HIV Infection, Directorate-General of Health, Lisbon, Portugal

43. Laboratory for Integrative and Translational Research in Population Health (ITR), and EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal

44. Emerging Infectious Diseases Unit, Department of Infectious Diseases, Centro Hospitalar Universitário de São João, Porto, Portugal

45. ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden

46. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands

Abstract

Following the report of a non-travel-associated cluster of monkeypox cases by the United Kingdom in May 2022, 41 countries across the WHO European Region have reported 21,098 cases and two deaths by 23 August 2022. Nowcasting suggests a plateauing in case notifications. Most cases (97%) are MSM, with atypical rash-illness presentation. Spread is mainly through close contact during sexual activities. Few cases are reported among women and children. Targeted interventions of at-risk groups are needed to stop further transmission.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

Reference31 articles.

1. World Health Organization (WHO). 2022 Monkeypox Outbreak: Global Trends. Geneva: WHO. [Accessed: 5 Sep 2022]. Available from: https://worldhealthorg.shinyapps.io/mpx_global

2. World Health Organization (WHO). Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox. Geneva: WHO

3. 2022. Accessed: Available from: https://www.who.int/news/item/23-07-2022-second-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of-monkeypox

4. United Kingdom Health Security Agency (UKHSA). Monkeypox cases confirmed in England – latest updates. London: UKHSA; 2022. Available from: https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates

5. Community transmission of monkeypox in the United Kingdom, April to May 2022.;Vivancos;Euro Surveill,2022

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