Unconventional Spread of Monkeypox
What makes the 2022 monkeypox outbreak different from others is clear evidence of community transmission. According to worldwide data from the CDC, as of June 9, 2022, there were 1,356 confirmed cases in 31 countries, including 44 cases in the United States. This means that person-to-person spread of the monkeypox virus is occurring among individuals who have not traveled outside of their own country. The clinical presentation of monkeypox cases in the current outbreak also differs from that of previous outbreaks. In the past, monkeypox rashes often morphed from a macule to a pustule and commonly affected the face, hands, feet, and trunk, with some patients harboring as many as 200 lesions at once. That pattern still occurs, but increasingly, the presentation is characterized by a more localized spread, especially in the genital region, which experts describe as unusual and not an area traditionally thought of in the past as a focus for monkeypox. Also, affected individuals in the current outbreak may develop fewer lesions, sometimes between 1 and 5 instead of up to 200.