What is monkeypox and what do we know about the cases in the U.K. and Europe? : Goats and Soda The cases point to possible sexual transmission of this cousin of smallpox — a previously unknown method of spread for monkeypox.

Rare monkeypox outbreak in U.K., Europe and U.S.: What is it and should we worry?

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Scientists across Europe and North America have identified an outbreak of a rare disease called monkeypox. The outbreak is small but widespread. There are about a hundred cases in 11 countries which don't normally see the disease. As NPR's Michaeleen Doucleff reports, how it's spreading is a mystery.

MICHAELEEN DOUCLEFF, BYLINE: Anne Rimoin is an epidemiologist at the University of California, Los Angeles, and has spent her career studying monkeypox.

ANNE RIMOIN: For two decades, I've been working on monkeypox.

DOUCLEFF: During that entire time, she's never seen an outbreak like the one happening right now. There are dozens of suspected cases in Montreal, Lisbon, Madrid, London and Paris.

RIMOIN: Well, it's very unusual because we've never seen this kind of large clustering of cases occur in Europe and North America. It, you know, has never happened.

DOUCLEFF: In all these countries, scientists don't know yet where people are catching monkeypox.

RIMOIN: How exactly is this being transmitted? Is this close contact? Is this sexual transmission? Is it because of a contact with a product that potentially has been contaminated with monkeypox?

DOUCLEFF: Although this version of monkeypox isn't usually deadly, it can cause a nasty illness that lasts for several weeks. Typically, people have a fever, muscle aches and then a rash on their face, mouth, hands and possibly genitals. Boghuma Titanji is an infectious disease doctor at Emory University. She says the rash looks a lot like the chicken pox.

BOGHUMA TITANJI: Over time, as the rash progresses, the lesions can become pustules, so filled with pus. And then eventually they rupture and become encrusted.

DOUCLEFF: In the past, almost all outbreaks of monkeypox have occurred in West and Central Africa, where the virus circulates in rodents and primates. People catch the virus from an animal bite or scratch, then the virus spreads only to a handful of other people.

TITANJI: These outbreaks have been small in the past because humans are not the traditional hosts of the virus, so the transmission between humans has not been quite efficient.

DOUCLEFF: But in this new outbreak, she says, the transmission between people looks a bit more efficient, more widespread. Most of the infected people haven't traveled to Africa, and some haven't had contact with other cases. This means the virus is spreading cryptically or undetected in several major cities in Europe and Canada.

TITANJI: Which is making epidemiologists worry about the possibility of local transmission outside of an environment where the virus traditionally is endemic. And that makes you wonder, how is it spreading, and how was it introduced?

DOUCLEFF: And to wonder how many more cases are out there - for that reason, the U.S. Centers for Disease Control and Prevention is asking health care workers to be on the lookout for monkeypox in patients, regardless of their travel history.

Michaeleen Doucleff, NPR News.

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