Caribbean: Officials report confirmed monkeypox (mpox) cases in multiple locations into December /update 4

Event

Health officials continue to identify monkeypox (mpox) cases in the Caribbean, with 165 additional confirmed cases reported from Sept. 19-Dec. 12, bringing the total confirmed case count to 355 since July 1. Most cases have been reported in Puerto Rico (207 confirmed). Cases have also been reported in the Dominican Republic (52 confirmed, one probable), Jamaica (18 confirmed), Cuba (8 confirmed, one death), Aruba (three confirmed cases), Curacao (three confirmed cases), Bahamas (two confirmed cases), Guyana (two confirmed cases), Barbados (one confirmed case), Bermuda (one confirmed case), Martinique (one confirmed case), Guadeloupe (one confirmed case), and Saint Martin (one confirmed case). Officials will likely identify additional cases in the coming weeks as disease surveillance, and contact tracing continues. This data represents the most updated information as of Dec. 14.

Context

The first confirmed cases of mpox in the Caribbean were reported July 1 in Puerto Rico. The cases are associated with the widespread outbreak of mpox reported by individuals who attended one or more mass gatherings in May located in Antwerp, Belgium, as well as Madrid and Gran Canaria in Spain, or reported recent close contact with an attendee. Mass gatherings always present an elevated risk of infectious disease transmission. 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 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 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.

Mpox is caused by a virus belonging to the same family as the one 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, such as nightclubs, 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.