Another case of monkeypox is under investigation in the United States, one of 12 nations seeing transmission of a virus strain linked to West Africa.

The latest case, reported Sunday in the U.S. state of Florida, is believed to be linked to international travel. The World Health Organization says confirmed cases around the globe are genetically similar to that seen in Cameroon, Gabon, and other West African nations where the virus is endemic. A separate case in Portugal is a close match to a monkeypox strain that originated in Nigeria in 2018 and 2019.

While exposure due to international travel historically has been the reason for rare cases of monkeypox outside of the African continent, health officials are now seeing community transmission within their own countries.

“The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area represents a highly unusual event,” said WHO in a statement issued Saturday.  “Surveillance to date in non-endemic areas has been limited, but is now expanding.  WHO expects that more cases in non-endemic areas will be reported.”

A number of infections in various countries have been linked to men who have sex with men, but Matthew Kavanagh, UNAIDS Deputy Executive Director, urges people to avoid drawing conclusions that stigmatize specific groups. Monkeypox can be transmitted among all people who are in close contact with anyone who carries the virus.

The symptoms include fever, rash, and swollen lymph nodes. Monkeypox can prove fatal in about 3% to 6% of cases. Tecovirimat, a drug approved for monkeypox treatment just this year, is not yet widely available, nor is a vaccine approved in 2019, according to WHO.

Image:  CDC United States