2022–2023 mpox outbreak in South America

The 2022–2023 mpox outbreak in South America is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak reached South America on 27 May 2022 when Argentina reported their first case of mpox. As of 14 August 2022, 8 South American countries and territories have confirmed cases.

2022–2023 mpox outbreak in South America
DiseaseMpox
Virus strainMonkeypox virus (West African clade)
Index caseBuenos Aires, Argentina
Arrival date27 May 2022 (2 years, 6 months and 6 days ago)
Confirmed cases22,293
Suspected cases1,900
Deaths
44
Territories
8
Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

Background

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Mpox (/ˈɛmpɒks/, EM-poks; formerly known as monkeypox)[1] is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most infected individuals recover within a few weeks without treatment. The time from exposure to the onset of symptoms ranges from three to seventeen days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.[2][3][4]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus. The variola virus, which causes smallpox, is also in this genus.[5] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[5] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[2] The virus may spread from infected animals through handling infected meat or via bites or scratches.[2] Diagnosis can be confirmed by polymerase chain reaction (PCR) testing a lesion for the virus's DNA.[5]

Vaccination is recommended for those at high risk of infection.[5] No vaccine has been developed specifically against mpox, but smallpox vaccines have been found to be effective.[6] There is no specific treatment for the disease, so the aim of treatment is to manage the symptoms and prevent complications.[5][7] Antiviral drugs such as tecovirimat can be used to treat mpox,[5] although their effectiveness has not been proved.[8]

An ongoing outbreak of mpox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak.[9] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[10] but it has been suggested that cases were already spreading in Europe in the previous months.[11]

Transmission

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Stages of lesion development. Picture taken by Dr O.O. Afuye on 15 September 2019.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[12]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[13]

Timeline

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Arrival

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An index case was imported into Argentina on 27 May. It was unknown how the disease was contracted, but likely abroad in mpox-affected countries. The patient had likely showed symptoms since 25 May, and was admitted to a hospital on 26 May. The next day, the patient was confirmed to have contracted mpox. The following day, another mpox case was confirmed, and Argentina reported these cases to Reliefweb.[14]

Cases transited through South America

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June

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9 June
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On 9 June, Brazil confirmed its first case of mpox. It was in a 41-year-old male who may have been infected from recently traveling to Spain and Portugal, which had already been affected by the mpox outbreak. It was likely contracted via skin-to-skin contact.[15]

12 June
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On 12 June, Venezuela registered its first case of mpox. It was in a male of unknown age who had likely contracted the disease via skin-to-skin contact in Madrid, Spain which had already been affected by the mpox outbreak.[16]

17 June
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On 17 June, Chile confirmed its first mpox infection. It was in a young male of unknown specific age from the Metropolitan Region. It was likely contracted via skin-to-skin contact from a trip to Europe.[17]

23 June
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On 23 June, Colombia confirmed its first three cases of mpox in adults of unknown genders and ages. Two of the cases were found in the capital Bogota, and the third was found in Colombia's second city, Medellin. It was unknown how those cases were contracted, although it was likely skin-to-skin contact picked up abroad.[18]

26 June
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On 26 June, Peru reported its first case of mpox. It was in a foreign citizen of unknown gender or age who resides in Lima, Peru. The patient likely got infected via while being in contact with people from abroad. It was likely skin-to-skin contact rather than sexual contact.[19]

July

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6 July
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On 6 July, Ecuador reported its first mpox infection. It was in a 30-year-old male who resides in the Southwest coastal province of Guayas, Ecuador. It is unknown how the patient contracted the disease, but likely skin-to-skin contact picked up abroad.[citation needed]

29 July
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On 29 July, Uruguay registered its first case of mpox. It was in a patient of unknown age and gender. It is unknown how the disease was contracted, but likely skin-to-skin contact abroad.[20]

August

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1 August
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On 1 August, Bolivia confirmed its first case of mpox. It was in a 38-year-old male. It is unknown how the disease was contracted, but likely skin-to-skin contact picked up abroad.[21]

Responses

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World Health Organization (WHO)

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On 20 May, the WHO convened an emergency meeting of independent advisers to discuss the outbreak and assess the threat level.[22] Its European chief, Hans Kluge, expressed concern that infections could accelerate in Europe as people gather for parties and festivals over the summer.[23] On 14 June, the WHO announced plans to rename disease from monkeypox to mpox in order to combat stigma and racism surrounding the disease.[24] Another meeting convened on 23 June determined that the outbreak does not constitute a Public Health Emergency of International Concern for the time being.[25]

Countries

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The majority of South American countries responded to the outbreak, and the responses of some are listed below.

  •   Brazil: The Brazilian Ministry of Health created groups of biologists to monitor monkeys and medical groups to monitor possible cases.[26] On August 8, 2022, during a podcast, the president of Brazil Jair Bolsonaro made homophobic jokes about the disease. When questioning the host about whether he would get a mpox vaccine, and the host says yes; Jair Bolsonaro replied: "I'm sure you want to get the vaccine. You don't fool me" followed by laughter. The host remains in his serious speech on the subject, Bolsonaro commented: "Don't you understand?" clarifying the homophobic tone of the comment.[27][28]
  •   Colombia: As of May, the Colombian Ministry of Health was taking follow-up and control measures. The Director of Epidemiology and Demography of the Ministry of Health, Claudia Cuellar, informed the Colombian population about how mpox is spread through people, and she spoke about the clinical presentation of the virus and international health regulations.[29] Health authorities in the Department of Norte de Santander have been on alert, since the department is a border area where people pass between Colombia and Venezuela.[30]

Cases per country and territory

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This is a table of confirmed and suspected mpox cases in South American countries during the ongoing 2022–2023 mpox outbreak. It does not include countries where suspected cases were reported but later discarded. (As of 31 July 2023)

Cases of mpox by countries of South America (last updated on as of 31 July 2023)
Country Confirmed Suspected Total Deaths Last update First confirmed case First confirmed death
  Argentina 1,129 1,129 2 25 April 2023[31] 27 May 2022[32]
  Bolivia 265 265 12 August 2022[33] 1 August 2022[34]
  Brazil 10,967 1,874 12,841 16 14 July 2023[35] 9 June 2022[36][37] 29 July 2022[38]
  Chile 1,442 26 1,468 3 29 June 2023[39] 17 June 2022[40]
  Colombia 4,090 4,090 31 July 2023 23 June 2022[41]
  Ecuador 557 557 3 11 August 2022[42] 6 July 2022[43] 8 August 2022
  Peru 3,812 3,812 20 12 July 2023[44] 26 June 2022[45] 1 August 2022[46]
  Uruguay 19 19 3 August 2022[47] 29 July 2022[48]
  Venezuela 12 12 12 June 2022[49] 12 June 2022[49]
 Total 22,293 1,900 24,193 44

Timeline of first confirmed cases by country or territory

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First confirmed mpox cases by country or territory
Date Countries / Territories
27 May 2022   Argentina
9 June 2022   Brazil
12 June 2022   Venezuela
17 June 2022   Chile
23 June 2022   Colombia
26 June 2022   Peru
6 July 2022   Ecuador
29 July 2022   Uruguay
1 August 2022   Bolivia
22 August 2022   Guyana
25 August 2022   Paraguay

Timeline of suspected cases by country or territory

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Countries listed below had only suspected cases at the time of reporting. Some countries reported confirmed cases after reporting suspected cases. Countries listed several times reported suspected cases again after they discarded suspected cases before.

Timeline of suspected mpox cases by country or territory
Date Countries / Territories
23 May 2022   French Guiana[a][b] (discounted on 1 June)
25 May 2022   Bolivia (discounted between 3 and 10 June)[50]
27 May 2022   Ecuador (discounted on 30 May)
30 May 2022   Peru (discounted on 2 June)  Brazil (confirmed cases reported on 9 June)
1 June 2022   Paraguay (discounted on 7 June)[51]
2 June 2022   Uruguay (confirmed cases reported on 29 July)
14 June 2022   Ecuador (discounted on 15 June)[52]

Timeline of first deaths by country or territory

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Timeline of mpox deaths by country or territory
Date Countries / Territories
29 July 2022   Brazil
1 August 2022   Peru
8 August 2022   Ecuador

See also

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Notes

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References

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  1. ^ "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). 28 November 2022. Archived from the original on 1 December 2022. Retrieved 29 November 2022.
  2. ^ a b c "Mpox". World Health Organization (WHO). 17 August 2024. Archived from the original on 19 August 2024. Retrieved 22 August 2024.
  3. ^ "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  4. ^ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). 15 March 2024. Archived from the original on 2 April 2024. Retrieved 22 August 2024.
  5. ^ a b c d e f "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  6. ^ Christodoulidou MM, Mabbott NA (1 January 2023). "Efficacy of smallpox vaccines against Mpox infections in humans". Immunotherapy Advances. 3 (1): ltad020. doi:10.1093/immadv/ltad020. PMC 10598838. PMID 37886620.
  7. ^ "Mpox (formerly Monkeypox)". NIH: National Institute of Allergy and Infectious Diseases. 6 December 2022. Archived from the original on 23 May 2023. Retrieved 24 May 2023.
  8. ^ "Patient's Guide to Mpox Treatment with Tecovirimat (TPOXX)". U.S. Centers for Disease Control and Prevention (CDC). 28 November 2022. Archived from the original on 24 May 2023. Retrieved 24 May 2023.
  9. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  10. ^ Pinkstone, Joe (17 May 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  11. ^ Nsofor, Ifeanyi (2 June 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved 2 June 2022.
  12. ^ Vargas, Ramon Antonio (7 June 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 9 June 2022.
  13. ^ "Monkeypox update: Where the outbreak stands now".
  14. ^ "Epidemiological Update: Monkeypox - 9 July 2022". www.reliefweb.int. Retrieved 9 July 2022.
  15. ^ "First case of monkeypox reported in Brazil". Reuters.
  16. ^ "Venezuela confirms first case of monkeypox". Reuters.
  17. ^ "Chile reports first case of monkeypox". Reuters.
  18. ^ "Colombia reports first cases of monkeypox". Reuters.
  19. ^ "Minsa confirms first case of monkeypox in Peru".
  20. ^ "Uruguay has first case of monkeypox confirmed".
  21. ^ "Bolivia has confirmed its first case of monkeypox".
  22. ^ Rigby, Jennifer (20 May 2022). "WHO to hold emergency meeting on monkeypox on Friday -sources". Reuters. Archived from the original on 20 May 2022. Retrieved 20 May 2022.
  23. ^ Rigby, Jennifer; Grover, Natalie (20 May 2022). "WHO calls emergency meeting as monkeypox cases top 100 in Europe". Reuters. Archived from the original on 20 May 2022. Retrieved 21 May 2022.
  24. ^ "WHO Will Rename Monkeypox Virus to Minimize Stigma, Racism". Bloomberg.com. 13 June 2022. Retrieved 15 June 2022.
  25. ^ "Meeting of the International Health Regulations (2005) Emergency Committee regarding the multi-country monkeypox outbreak". who.int. WHO. Archived from the original on 28 June 2022. Retrieved 26 June 2022.
  26. ^ "Governo cria grupo para monitorar varíola dos macacos e acompanha caso de brasileiro" [Government creates group to monitor monkeypox and follows up on Brazilian case]. CNN (in Brazilian Portuguese). 21 May 2022. Archived from the original on 24 May 2022. Retrieved 22 May 2022.
  27. ^ "Bolsonaro insinua que quem se vacinar contra monkeypox é gay" [Bolsonaro insinuates that anyone who gets vaccinated against monkeypox is gay]. Terra (in Brazilian Portuguese). Retrieved 9 August 2022.
  28. ^ Gouveia, Lais (9 August 2022). "Participação de Bolsonaro no Flow tem alerta de fake news e piada homofóbica com varíola dos macacos (vídeo)" [Bolsonaro's participation in Flow has fake news alert and homophobic joke with monkeypox (video)]. Brasil 247 (in Brazilian Portuguese). Retrieved 9 August 2022.
  29. ^ Ibarguen, Yorely (23 May 2022). "Viruela del mono: Colombia se declara en riesgo moderado por la propagación". Caracol Radio (in Spanish). Archived from the original on 5 June 2022. Retrieved 28 May 2022.
  30. ^ "Alerta en Norte de Santander por la viruela del mono". La Opinión (in Spanish). Archived from the original on 6 June 2022. Retrieved 28 May 2022.
  31. ^ "Boletín epidemiológico nacional | Semana epidemiológica 16 | Número 650 año 2023" [National epidemiological bulletin | Epidemiological week 16 | Number 650 year 2023] (PDF). Directorate of Epidemiology [es] (in Spanish). 29 April 2023. p. 10. Retrieved 1 August 2023.
  32. ^ "Salud informa que el resultado de la muestra PCR tomada por ANLIS Malbrán al primer caso sospechoso de viruela símica dio positivo" (in Spanish). 27 May 2022. Archived from the original on 27 May 2022. Retrieved 27 May 2022.
  33. ^ "Suman 11 casos de viruela del mono y hay 50 sospechosos". Página Siete (in Spanish). Retrieved 12 August 2022.
  34. ^ "Confirman primer caso de viruela del mono en Bolivia" [First case of monkeypox confirmed in Bolivia]. El Deber (in Spanish). 1 August 2022. Retrieved 1 August 2022.
  35. ^ "Card Situação Epidemiológica de Monkeypox no Brasil n° 26 SE 32 - 13-08-22". Ministry of Health (Brazil). Retrieved 14 August 2022.
  36. ^ "Man in Sao Paulo hospital with Brazil's first monkeypox case -officials". Reuters. 9 June 2022. Archived from the original on 9 June 2022. Retrieved 9 June 2022.
  37. ^ "São Paulo confirma 1º caso de varíola dos macacos no Brasil". 8 June 2022. Archived from the original on 9 June 2022. Retrieved 8 June 2022.
  38. ^ Fonseca, Pedro (29 July 2022). "Brazil reports first monkeypox death outside Africa in current outbreak". Reuters. Retrieved 29 July 2022.
  39. ^ "Informe ejecutivo | Viruela del mono | Chile, 30 de junio de 2023" [Executive report | Mpox | Chile, June 30, 2023] (PDF). Department of Epidemiology [es] (in Spanish). 11 July 2023. Retrieved 1 August 2023.
  40. ^ "MINSAL confirma el primer caso de Viruela del Mono en Chile" [MINSAL confirms the first case of Monkeypox in Chile]. Ministry of Health of Chile (in Spanish). 17 June 2022. Archived from the original on 17 June 2022. Retrieved 17 June 2022.
  41. ^ "Minsalud e INS confirman tres casos de viruela símica en Colombia". Ministry of Health and Social Protection (Colombia) (in Spanish). Archived from the original on 24 June 2022. Retrieved 24 June 2022.
  42. ^ "16 casos confirmados de viruela del mono en Ecuador". Teleamazonas (in Spanish). Retrieved 11 August 2022.
  43. ^ "Ecuador confirms first case of monkeypox". Xinhua News Agency. Retrieved 7 July 2022.
  44. ^ Peru cases can be aggregated from the following sources:
  45. ^ "MINSA confirma primer caso de la viruela del mono en el Perú" [MINSA confirms first case of monkeypox in Peru]. Ministry of Health of Peru (in Spanish). 26 June 2022. Retrieved 28 June 2022.
  46. ^ "Perú confirma la muerte de un paciente afectado por viruela del mono". MachalaMovil. Archived from the original on 9 August 2022. Retrieved 1 August 2022.
  47. ^ "2022 Monkeypox Outbreak Global Map". Centers for Disease Control and Prevention. Retrieved 9 August 2022.
  48. ^ "Primer caso importado de viruela símica en Uruguay" [First imported case of monkeypox in Uruguay]. Ministry of Health of Uruguay (in Spanish). 29 July 2022. Retrieved 29 July 2022.
  49. ^ a b "Venezuela confirms first case of monkeypox". Reuters. Archived from the original on 12 June 2022. Retrieved 12 June 2022.
  50. ^ "Los casos sospechosos de viruela del mono en Bolivia fueron 'totalmente descartados'" [The suspected cases of monkeypox in Bolivia were "totally discarded"]. La Razón (in Spanish). La Paz, Bolivia. 10 June 2022. Archived from the original on 10 June 2022. Retrieved 10 June 2022.
  51. ^ "Descartan en Paraguay primer caso de viruela del mono". Prensa Latina (in Spanish). 7 June 2022. Archived from the original on 9 June 2022. Retrieved 8 June 2022.
  52. ^ "Segundo caso sospechoso de viruela del mono en Ecuador es descartado". El Comercio (in Spanish). 15 June 2022. Archived from the original on 17 June 2022. Retrieved 17 June 2022.
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