Caribbean: Officials report confirmed monkeypox cases in multiple regions in the Caribbean through September /update 2

Event

Health officials continue to identify monkeypox cases, with an additional 87 confirmed cases reported Aug. 18-Sept. 18, bringing the total case count to 170 since June 26. Most cases are reported from Puerto Rico (137 confirmed). Cases have also been reported in the Dominican Republic and Jamaica (seven confirmed); Martinique (seven confirmed); Bahamas and Cuba (two confirmed), and countries reporting one confirmed case (Barbados, Bermuda, Saint Martin). A suspected case was reported in the Cayman Islands. As disease surveillance and contact tracing continue, officials will likely identify additional cases in the coming weeks. This report represents the most updated information as of Sept. 18.

Context

In contrast to past sporadic cases linked to travel to endemic countries, health officials have not confirmed the source of infection for the current outbreak, which is primarily centered in Europe. Human-to-human transmission occurs among people in close physical contact, with the increase in recent cases linked to sexual contact, suggesting that the virus linked to the disease can be sexually transmitted. The current outbreak highlights the importance of vigilant safe sexual practices and suggests monkeypox can be transmitted while the infected person displays few or no symptoms; however, the risk is currently assessed as low for individuals not routinely engaging with multiple or anonymous sexual partners.

Monkeypox does not naturally occur in the Caribbean; most cases are reported in West and Central Africa, primarily in the DRC, Nigeria, and Cameroon, among individuals who report contact with wild primates or other mammals which may harbor the disease.

Monkeypox is caused by a virus belonging to the same family as the one that causes smallpox. However, monkeypox is not the same as smallpox, and it does not have the same capacity for rapid human-to-human transmission. Monkeypox is mainly transmitted to humans through direct contact with the bodily fluids of infected rodents or primates. Human-to-human transmission primarily occurs through close personal contact with an infected individual via respiratory droplets, direct contact with bodily fluids, or indirect contact with lesion material (e.g., contaminated clothing or bedding). Symptoms typically appear 6-16 days after exposure but can develop up to 21 days after exposure. Symptoms generally include fever, headache, muscle aches and backaches, swollen lymph nodes, chills, exhaustion, and a distinctive rash characterized by lesions that progress through several stages before falling off.

Advice

Practice basic health precautions, including frequent handwashing with soap and water, covering the nose and mouth when coughing, and avoiding obviously ill individuals. Avoid overcrowded areas, such as nightclubs, and consider using safe sexual practices, such as physical barriers (condoms), in countries reporting monkeypox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas. Vaccines are available but limited.