China: Confirmed monkeypox (mpox) cases reported in several provinces in September

Event

Health officials have reported elevated monkeypox (mpox) activity in multiple areas in China, with more than 1,260 cases reported July 3-Sept. 12. Beijing remains most affected, with cases also reported in 14 other provinces. As disease surveillance and contact tracing continue, officials will likely identify additional cases in the coming weeks. This report represents the most up-to-date information as of Sept. 20.

Context

The first confirmed cases of mpox in China were reported on Sept. 2, 2022 in Chongqing. The first confirmed cases reported in 2022 were associated with overseas travel; however, all 2023 cases were due to local transmission. Human-to-human transmission occurs among people in close physical contact, with an increase in recent cases linked to sexual contact. The current outbreak highlights the importance of vigilant safe sexual practices, and mpox 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.

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

Mpox is caused by a virus that belongs to the same family as the virus that causes smallpox. However, mpox is not the same as smallpox and does not have the same capacity for rapid human-to-human transmission. Mpox 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 and consider using safe sexual practices, such as physical barriers (condoms), in countries reporting mpox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas. Vaccines are available but limited.