Four Monkeypox Deaths Reported Outside of Africa as Outbreak Expands

Four Monkeypox Deaths Reported Outside of Africa as Outbreak Expands
A protest in San Francisco on July 18, 2022. (Photo: Haven Daley, AP)

The global monkeypox outbreak has now caused its first fatalities outside of Africa. Over the weekend, Brazil reported a monkeypox-related death, while Spain reported two. On Monday, India reported a death as well.

The death in Brazil involved a 41-year-old man with lymphoma and weakened immunity who went into septic shock, health officials said Friday. In Spain, the AP reported, both deaths involved young men. And in India, health officials said that a 22-year-old man died while on ventilator support, three days after he was admitted to a private hospital with fever.

Monkeypox has been known to occasionally cause human outbreaks in some parts of Africa since at least the 1970s, usually spreading to humans from animals, with rodents being a common reservoir of the virus. So far in 2022, there have been more than 1,400 confirmed or suspected cases and around 70 confirmed or suspected monkeypox deaths in Africa. But the bulk of these cases and deaths appear to be linked to more severe strains of the virus than the strains that have spread around the world. The latest deaths are the first reported outside Africa during the larger global outbreak this year. Overall, there have been more than 22,000 cases so far documented worldwide in non-endemic areas this year.

Unlike in past outbreaks, the virus is now primarily spreading through human-to-human transmission. A large majority of cases with known information have been linked to prolonged close contact during sex, and most sufferers so far have been men who have sex with men. Monkeypox can be transmitted through any form of close contact between people, however, and could theoretically be spread via respiratory droplets as well. And there have been reports of family members, including children, contracting the virus from people in their household.

Monkeypox symptoms include flu-like illness along with distinctive, painful, and contagious rashes that can take a month to fall off. Most cases have been relatively mild, with 10% of people needing hospitalisation, usually to help manage their pain, according to the World Health Organisation. But the infection can cause life-threatening illness, and it’s historically been more dangerous for pregnant women, children, and others with weakened immune systems.

“The notification of deaths due to monkeypox does not change our assessment of the outbreak in Europe. We know that although the disease is self-limiting in most cases, monkeypox can cause severe complications,” Catherine Smallwood, Senior Emergency Officer at WHO Europe, told the AP. “With the continued spread of monkeypox in Europe, we will expect to see more deaths. Our goal needs to be on interrupting transmission quickly in Europe and stopping this outbreak.”

There are vaccines and antiviral drugs available for monkeypox, though their supply has been constrained so far. Late last month, the WHO declared a public health emergency over the monkeypox outbreak. Last week, San Francisco and New York City — the areas in the U.S. with the most cases to date — followed suit.