Global Outbreak Update: Confirmed case of monkeypox in Dallas, USA

The IHR National Focal Point for the USA notified PAHO/WHO of the imported case. As of 27 July 2021 the patient is hospitalized.

• Update Date: 27 July 2021
   
• Time frame and cases: The case-patient travelled from the USA to Lagos State, Nigeria on 25 June, visiting Ibadan, Oyo State, from 29 June to 3 July. He returned to the USA on 9 July. The case-patient developed a facial rash on 10 July. On 13 July, the patient attended a local hospital, and he was immediately placed under isolation. Sample of a skin lesion was taken, and on 14 July, an Orthopoxvirus was confirmed. On 15 July, the patient’s skin samples tested positive for the West African clade of monkeypoxvirus via RT-PCR conducted at the US CDC. On 17 July, the IHR National Focal Point for the USA notified PAHO/WHO of the imported case. As of 27 July 2021 the patient is hospitalized.
   
• Regions: The case-patient is hospitalized in Dallas, Texas. This is the first time that human monkeypox has been detected in a traveller to the USA, and the first case reported in the USA since the outbreak in 2003. During the 2003 outbreak in the USA, exposure was traced to contact with pet prairie dogs that had been co-housed with monkeypoxvirus-infected African rodents, imported from Ghana.
   
• Background: An outbreak occurred in Nigeria from 2017 to 2019, with cases still being reported in 2021. Most recently, two cases were previously reported in 2021 in the UK from travellers to Nigeria. You can check our Global Disease Update on those cases here.
   
• Virus / Vector / Disease Information: Monkeypox is a sylvatic zoonosis with incidental human infections that usually occur sporadically in forested parts of Central and West Africa. It is caused by the monkeypox virus and belongs to the Orthopoxvirus family.
• Response:

1. Isolation and treatment of the patient. 
2. The US CDC and state and local health departments are monitoring possible community and health care contacts with the case-patient. 
3. The US CDC is working with the airline and state and local health officials to contact airline passengers who shared a common seating area with the patient during his travel from Nigeria and within the USA.
4. Health personnel involved in the patient’s care have been wearing appropriate personal protective equipment.

• Recommendations:

1. Any illness during travel in an endemic area or upon return should be reported to a health professional. 
2. Residents and travellers to endemic countries should avoid contact with sick, dead or live animals that could harbor monkeypox virus (rodents, marsupials, primates) and should refrain from eating or handling wild game (bush meat). 
3. The importance of hand hygiene using soap and water, or alcohol-based sanitizer should be emphasized.
4. A patient with monkeypox should be isolated during the infectious period, just prior to and including the rash stage of the infection until all lesions have crusted and fallen off.
5. Health workers caring for patients with suspected or confirmed monkeypox should implement standard, contact and droplet infection control precautions.
6. WHO does not recommend any restriction for travel to, or trade with, Nigeria or the USA based on available information at this time.

More information on this update here. For more information about the disease,including latest news, research, fact sheets and training, please visit the dedicated WHO Monkeypox Portal.

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This section gives our users short updates from the World Health Organization’s Disease Outbreak News (DONs). They provide a glimpse into the day-to-day workings and importance of the overlaps amongst international public health cooperation, epidemiology, and national health systems.
For more information, please visit the WHO’s Disease Outbreak News