As monkey pox cases continue to rise worldwide, health officials are investigating reports of several new deaths, including the first batch of deaths reported from countries outside where the virus is endemic to animals.
The global number of cases is now over 25,000, with over 6,000 in the US. The global death toll is now at least 10. Earlier, officials reported three deaths from Nigeria and two from the Central African Republic, both of which have reported cases of monkeypox overflow in the past. On Monday, Ghana, which has also had cases in the past, reported its first death. At the same time, four new deaths have been reported in Spain (2), Brazil (1) and India (1). World Health Organization officials are still waiting for more clinical information on the cases.
Initial media reports suggest the death in Brazil was a 41-year-old man who had lymphoma and was immunocompromised and therefore at higher risk for serious illness.
The other three cases reportedly died of encephalitis — inflammation of the brain — which is a known potential complication of monkey pox. In India, officials said a 22-year-old man died after returning from a trip to the United Arab Emirates, where he initially tested positive for the virus. He delayed treatment while in the UAE but then deteriorated on his return to India and died in hospital after being placed on a ventilator. Officials there told reporters that he had also tested positive for the Epstein-Barr virus, the cause of infectious mononucleosis, and that they were investigating other possible underlying health conditions.
In Spain, a 31-year-old and a 44-year-old reportedly died of monkeypox-associated encephalitis. Reports to date suggest that both were previously healthy and not immunocompromised.
The monkeypox virus clade spreading during the multinational outbreak has historically had a fatality rate of up to 3 percent in endemic countries. While deaths remain rare in the current multinational outbreak, health officials say they see a broader spectrum of diseases.
New clinical data
“We’re seeing new manifestations of disease,” Rosamund Lewis, WHO’s technical lead for monkey pox, said in a question-and-answer video on Tuesday. Those new manifestations include conditions “that can be extremely painful and require medical attention, such as secondary infections or such as inflammation or swelling of the rectum,” she said.
Lewis went on to note the reports of deaths, including cases of encephalitis. “This is very tragic; it’s not entirely surprising,” she said. The WHO will release more information about the cases as it comes out of countries, she said.
More disease data and possible deaths may come in as the outbreak continues to grow. Some countries, such as Germany and the UK, are seeing plateaus or possibly slow declines. But others, such as the US, Peru and Brazil, are still seeing dramatic increases.
In the US, the number of cases is now up to 6,326, the largest number in the world, according to the Centers for Disease Control and Prevention. The US confirmed its first case on May 18 and added more than 2,500 cases in the past week. Cases have now been reported in every state except Wyoming and Montana. So far, no deaths have been reported.
On Monday, the governors of California and Illinois declared a state of emergency over the outbreak. The New York governor declared a state of emergency on Friday. The statements are intended to mobilize resources and efforts to combat the public health threat, which is largely spreading among men who have sex with men. It is unclear whether federal officials will declare a public health emergency during the outbreak. But on Tuesday, the White House announced that President Biden had appointed two longtime FEMA operatives to lead the country’s response.
The WHO declared the multinational monkeypox outbreak a Public Health Emergency of International Concern (PHEIC) on July 23. It is the agency’s highest alert level.