2022–2023 Mpox Outbreak In Europe
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The 2022–2023 mpox outbreak in Europe is a part of the outbreak of human mpox caused by the West African clade of the
monkeypox virus ''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the ''orthopoxvirus'' genus, making it closely related to the ...
. The outbreak reached
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
on 6 May 2022 when the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
reported their first case of mpox. 35 European countries and territories have confirmed cases.


Background


Transmission

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 Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
, the
Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
as well as
central Central is an adjective usually referring to being in the center of some place or (mathematical) object. Central may also refer to: Directions and generalised locations * Central Africa, a region in the centre of Africa continent, also known as ...
and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with
lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classifi ...
s 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. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced
proctitis Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Signs and symptoms A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have const ...
, 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 Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
, gonorrhea, chlamydia, and herpes.


Timeline


Arrival

An index case was imported into the United Kingdom in late April 2022, by a man who had travelled to Nigeria, where the disease is endemic. He had already showed symptoms since 29 April, and was admitted to hospital in
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
on 6 May. On 12 May, the man was confirmed to have contracted mpox. The following day, another mpox case was confirmed, and the United Kingdom reported these cases to the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO).


Cases transited through Europe


May


= 18 May

= On 18 May, Spain and Portugal both confirmed their first cases of mpox following the confirmation of mpox in the United Kingdom starting an outbreak in the countries. It is unknown how it was contracted, but most likely via travel or skin-to-skin contact abroad.


= 19 May

= On 19 May, Belgium confirmed its first cases of mpox in two Belgian men, it was later confirmed by Reuters that the men had gone to the same party. Later,
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical re ...
confirmed its first case of mpox in an Italian man in Rome, the man was isolated at the
Spallanzani Hospital The Lazzaro Spallanzani National Institute for Infectious Diseases (Italian: ''Istituto nazionale per le malattie infettive "L. Spallanzani"'') is an infectious disease hospital in the Italian city of Rome. The institute is named for the eighteenth- ...
. The disease was likely contracted from a stay in the Canary Islands. There were 2 suspected cases, which later became confirmed cases.
Sweden Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
then confirmed its first case of mpox in
Stockholm Stockholm () is the Capital city, capital and List of urban areas in Sweden by population, largest city of Sweden as well as the List of urban areas in the Nordic countries, largest urban area in Scandinavia. Approximately 980,000 people liv ...
, the Swedish Health Agency confirmed it later. The person was not reported to be a woman or a man, but it was most likely a man. It is unknown how it was contracted, but likely via travel or skin-to-skin contact abroad.


= 20 May

= On 20 May, France reported their first case of mpox. The patient had no travel history, meaning he didn't contract the disease abroad. On the same day, Germany and the Netherlands reported their first cases of mpox. It was unknown how it was contracted in both stories, but likely via travel or skin-to-skin contact abroad.


= 21 May

= On 21 May, Switzerland confirmed its first case of mpox. It was in a person of undisclosed gender, contracted through "close physical contact" abroad, according to Reuters.


= 22 May

= On 22 May, Austria confirmed its first case of mpox. It is unknown how it was contracted or who contracted it, but likely via travel or skin-to-skin contact abroad.


= 23 May

= On 23 May, Denmark detected its first mpox infection. It was in an adult male, likely contracted from a trip to Spain, according to Reuters. No cases of mpox were detected in
Greenland Greenland ( kl, Kalaallit Nunaat, ; da, Grønland, ) is an island country in North America that is part of the Kingdom of Denmark. It is located between the Arctic and Atlantic oceans, east of the Canadian Arctic Archipelago. Greenland is t ...
, a Danish constituent country in North America.


= 24 May

= On 24 May, the Czech Republic registered its first case of mpox in a woman, likely picked up from a festival in Belgium, according to Reuters. On the same day, Slovenia also registered its first case of mpox. It was in a traveller of undisclosed gender who likely contracted mpox from a trip to the Canary Islands, according to Reuters.


= 27 May

= On 27 May, Ireland confirmed its first case of mpox in the east of the country. The Health Protection Surveillance Centre (HPSC) commenced publication of a weekly report on the epidemiology of human mpox in Ireland on 9 June. On the same day, Finland also confirmed its first case of mpox. It was in a man who likely had contracted the disease from a trip to another European country, according to Reuters.


= 28 May

= On 28 May, Malta registered its first case of mpox. It was in an adult male, who most likely picked up the disease abroad from one of the countries affected by the outbreak, according to the Malta Times.


= 31 May

= On 31 May, Hungary confirmed its first case of mpox, in an adult male. It is still being investigated whether or not he recently travelled, though it is unknown how the man contracted the disease. On the same day, Norway confirmed its first case of mpox. It was in a person of undisclosed gender who most likely contracted the disease from travelling abroad. The case was linked to the ongoing outbreak in Europe, meaning that the patient may have travelled to a European country that was affected by the outbreak.


June


= 1 June

= On 1 June, Gibraltar, a
British Overseas Territory The British Overseas Territories (BOTs), also known as the United Kingdom Overseas Territories (UKOTs), are fourteen dependent territory, territories with a constitutional and historical link with the United Kingdom. They are the last remna ...
, registered its first case of mpox in a Spanish resident of undisclosed gender working in Gibraltar. The patient likely contracted the disease from close contact with another Spanish national also working in Gibraltar.


= 3 June

= On 3 June, Latvia confirmed its first mpox infection. It was in an elderly person of undisclosed gender who most likely contracted the disease abroad.


= 8 June

= On 8 June, Greece confirmed the country's first mpox case. It was in a person of undisclosed gender who likely contracted the disease from a trip to Portugal.


= 9 June

= On 9 June, Iceland confirmed its first mpox case. It was in two men who most likely contracted the disease from a trip to Europe.


= 10 June

= On 10 June, Poland confirmed its first mpox case. It is unknown who the patient is or how it was contracted, but it is possible it was picked up via travel or skin-to-skin contact.


= 13 June

= On 13 June, Romania confirmed its first monkempoxypox infection. It was in an adult male who most likely contracted the disease from his partner who travelled in several different European countries that have been affected by mpox at the time.


= 15 June

= On 15 June, Luxembourg confirmed its first mpox case. It is unknown how it was contracted, though it is being investigated. The disease was likely picked up via travelling abroad or skin-to-skin contact. On the same day, Georgia also confirmed its first case of mpox. It was in a patient of undisclosed gender who likely contracted the disease from a trip to Europe.


= 17 June

= On 17 June, Serbia confirmed its first case of mpox. It was in a patient of undisclosed gender. It was revealed that it was an "imported case", meaning that the patient may have contracted the disease abroad.


= 23 June

= On 23 June, Bulgaria confirmed its first mpox case. It was in two men who most likely contracted the disease from a trip to Spain and the United Kingdom but don't reckon any contact with infected persons. On the same day, Croatia also received its first case of mpox. It was in an adult man who most likely contracted the disease from a stay in Italy and Spain.


= 28 June

= On 28 June, Estonia confirmed its first case of mpox. It was in a middle-aged man who most likely contracted the disease abroad. He had no close contacts with anyone in Estonia.


July


= 2 July

= On 2 July, Andorra registered its first mpox case in a woman of unknown age. It is unknown how it was contracted, but it may likely have been picked up either abroad via travel or via skin-to-skin contact.


= 7 July

= On July 7, Slovakia received its first case of mpox. It was in a person of undisclosed gender in the 20-59 age group who most likely contracted the disease abroad.


= 12 July

= On 12 July, Russia confirmed its first case of mpox. It was in a man probably in his 20-25 age group who likely contracted the disease from a trip to
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
where the outbreak had started. The man then tested positive for the virus and was isolated in a hospital, most likely in
Saint Petersburg Saint Petersburg ( rus, links=no, Санкт-Петербург, a=Ru-Sankt Peterburg Leningrad Petrograd Piter.ogg, r=Sankt-Peterburg, p=ˈsankt pʲɪtʲɪrˈburk), formerly known as Petrograd (1914–1924) and later Leningrad (1924–1991), i ...
.


= 13 July

= On 13 July, Bosnia and Herzegovina registered its first mpox case. It is unknown how it was contracted, although the disease was likely picked up abroad via travel or skin-to-skin contact.


= 22 July

=


September


= 15 September

= On 15 September, Ukraine's Ministry of Health reported the country's first case of mpox. The Ministry noted that the patient, who did not travel abroad, was experiencing "mild symptoms" and undergoing hospital treatment. The region where the case was reported was not disclosed.


Responses


World Health Organization (WHO)

On 20 May, the WHO convened an emergency meeting of independent advisers to discuss the outbreak and assess the threat level. Its European chief,
Hans Kluge Hans Henri Marcel Paul Kluge (born 29 November 1968, (Roeselare) is a Belgian medical doctor and public health expert with more than 25 years of experience spanning three continents. , he served as the World Health Organization Regional Director ...
, expressed concern that infections could accelerate in Europe as people gather for parties and festivals over the summer. On 14 June, the WHO announced plans to rename the disease from ''monkeypox'' to ''mpox'' in order to combat stigma and racism surrounding the disease. Another meeting convened on 23 June determined that the outbreak does not constitute a Public Health Emergency of International Concern for the time being.


Countries

The majority of European countries responded to the outbreak, and the responses of some are listed below. *: The Risk Assessment Group (RAG) and health authorities declared that those infected with mpox must self-isolate for 21 days. *:
Fabian Leendertz Fabian Hubertus Leendertz (born 11 November 1972 in Krefeld) is a German biologist, veterinarian, and expert on zoonosis, specialising his research on primates, studying leprosy and anthrax in chimpanzees since 2014. In 2020, he was appointed t ...
of the
Robert Koch Institute The Robert Koch Institute (RKI) is a German federal government agency and research institute responsible for disease control and prevention. It is located in Berlin and Wernigerode. As an upper federal agency, it is subordinate to the Federal ...
described the outbreak as an epidemic that will not last long: "The cases can be well isolated via contact tracing and there are also drugs and effective vaccines that can be used if necessary." *: The Health Service Executive (HSE) has set up a multidisciplinary incident management team to prepare for the possible arrival of mpox, and infectious diseases experts are on alert for patients with symptoms of the virus. *: On 23 May, the Ministry of Health and the National Public Health Institute, have drafted a document of recommendations and measures to help prevent the spread of the disease. In a press statement, healthcare authorities have declared that the situation is being closely monitored. *: On 21 May, the Ministry of Health said that they are monitoring the situation with its Europe. he National Infectious Diseases Department of the HLC and refrain from close contact activities until the infection has resolved. *: On 22 May, Education Secretary Nadhim Zahawi said "we're taking it very, very seriously" and that the UK government had already started purchasing smallpox vaccines. The
Terrence Higgins Trust Terrence Higgins Trust is a British charity that campaigns about and provides services relating to HIV and sexual health. In particular, the charity aims to end the transmission of HIV in the UK; to support and empower people living with HIV, to ...
and British Association for Sexual Health and HIV (BASHH) expressed concern about the impact on sexual health services in the United Kingdom.


Dependent territories

*: On 31 May, a Strategic Coordination Group met to discuss Gibraltar's state of preparedness in the eventuality that a case of mpox was confirmed in the territory amid the rapid rise of cases in the United Kingdom and Spain.


Cases per country and territory

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


Timeline of first confirmed cases by country or territory


Timeline of suspected cases by country or territory

''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.'' 33 European countries and territories have been affected by the pandemic.


See also

*
Mpox Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild ...
*
Monkeypox virus ''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the ''orthopoxvirus'' genus, making it closely related to the ...
* Mpox in Nigeria * Mpox in the Democratic Republic of the Congo *
2022–2023 mpox outbreak An outbreak of mpox, a viral disease then commonly known as "monkeypox", was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient w ...
* Timeline of the 2022–2023 mpox outbreak * 2022–2023 mpox outbreak in Asia * 2022–2023 mpox outbreak in Canada * 2022–2023 mpox outbreak in Germany * 2022–2023 mpox outbreak in the Netherlands * 2022–2023 mpox outbreak in Portugal * 2022–2023 mpox outbreak in Spain * 2022–2023 mpox outbreak in the United Kingdom * 2022–2023 mpox outbreak in the United States


Notes


References


External links

{{DEFAULTSORT:2022-2023 mpox outbreak in Europe
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
Monkeypox Monkeypox (also called mpox by the WHO) is an infectious viral disease that can occur in humans and some other animals. Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over. The time from exposure to ...