Recently, several European countries have reported outbreaks of monkeypox following the first case (index case) reported in the United Kingdom on May 7, 2022, linked to a traveler from Nigeria. Monkeypox belongs to a family of other pox-like viruses and is a rare viral disease characterized by flu-like symptoms and a blistering rash that typically begins on the face and spreads to other areas of the body. Monkeypox, as with all zoonotic diseases, originated from an animal reservoir (experts speculate it to be rodents) and has mutated to infect humans.

The first case in 1958 was identified in primates being used for research, and the first human infection was reported in the Democratic Republic of Congo in 1970. Monkeypox has since been observed to be primarily localized to Western and Central Africa. Australia and Canada have also identified several infected individuals, and as of June 2, 2022, there have been 21 confirmed positives in ten states across the United States. Globally, this constitutes more than 550 cases at the time of writing. Surprisingly, the spread of the disease has neither been linked to the first case in the U.K. nor direct travel from endemic areas. As such, it is not yet clear how or why the incidence of monkeypox is increasing and what hidden factors might be driving transmission, prompting the World Health Organization (WHO) and international public health officials to employ contract tracing strategies to seek connections between those who have tested positive.

What is currently known is that monkeypox is transmitted primarily through close contact with skin lesions, bodily fluids, and respiratory droplets. Men aged between 20 and 50 years, many of whom have sex with other men (MSM), are notably included in a majority of the cluster cases, thereby indicating that sexual contact may be a significant route of transmission. The correlation with sexual activity does not corroborate increased contamination or virulence; it simply highlights that close contact and skin lesions may allow for monkeypox to spread most effectively. Anne Rimoin, professor of epidemiology at the University of California, Los Angeles, suggests that the virus may have coincidentally been introduced to the MSM community and spread from there. She implores the public to avoid stigmatization, especially during a crucial time where more information is needed to grasp the entirety of the situation.

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