2022–2023 mpox outbreak in Israel
DiseaseMpox
Virus strainMonkeypox virus (West African clade)
LocationIsrael
Index caseIchilov General Hospital, Tel Aviv
Date20 May 2022 – ongoing (1 year, 7 months, and 21 days)
Confirmed cases121
Suspected cases‡0
Deaths
0
Government website
Ministry of Health (Israel)
‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The 2022–2023 mpox outbreak in Israel is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was first reported in Israel on 20 May 2022 when the Health Ministry announced a suspected case which was confirmed on 21 May 2022. One month later, on 21 June, the first locally transmitted case was reported.

Currently, Israel is the most affected country in Asia and the 14th most affected country in the world. Israel was also the first in Asia to report a case.

Background

Mpox (formerly known as monkeypox)[1] is an infectious viral disease that can occur in humans and some other animals.[2] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes.[2] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[3] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks.[4] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[5]

The disease is caused by the monkeypox virus,[lower-alpha 1] a zoonotic virus in the genus Orthopoxvirus. The variola virus, the causative agent of the disease smallpox, is also in this genus.[2] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[2] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[5] It may spread from infected animals by handling infected meat or via bites or scratches.[5] Diagnosis can be confirmed by PCR testing a lesion for the virus' DNA.[2]

An outbreak of mpox, a viral disease then commonly known as "monkeypox", was confirmed in May 2022.[6] The initial cluster of cases was found in the United Kingdom,[7] where the first case was detected in London on 6 May 2022[8] in a patient with a recent travel history from Nigeria (where the disease is endemic).[9] On 16 May, the UK Health Security Agency (UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic.[8] Subsequently, cases have been reported from many countries and regions.[10] The outbreak marked the first time mpox had spread widely outside Central and West Africa. There is evidence that the disease had been circulating and evolving in human hosts over a number of years prior to the outbreak.[11]

On 23 July 2022, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, declared the outbreak a public health emergency of international concern (PHEIC), stating that "we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little".[12] A global response to the outbreak included public awareness campaigns in order to reduce spread of the disease, and repurposing of smallpox vaccines.[13][14] In May 2023, the World Health Organization declared an end to the PHEIC, citing steady progress in controlling the spread of the disease.[15]

Transmission

Stages of lesion development.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[16]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[17]

History

Imported case before the outbreak

In 2018, an imported case was detected in Israel. A 38-year-old man came from Rivers State, Nigeria in late September. He showed the symptoms of the disease on that month. Later on October the patient sought medical attention at Shaare-Zedek Medical Center in Jerusalem. He was confirmed to be infected with the West African Clade of monkeypox virus that month. All of the patient's contacts were traced and followed up but no virus transmission were detected.[18]

Arrival

Ichilov General Hospital (in the middle) in Tel Aviv Sourasky Medical Center, where the first case was isolated

As the outbreak was spreading in Europe in the middle of May 2022, the Israeli Health Ministry reported a suspected mpox case in the country on 20 May. The case was confirmed by testing on 21 May, becoming the first case in Israel during the outbreak.

The 30-year-old man returned from Western Europe and contracted the disease from there. The ministry reported that he was in isolation in the Ichilov General Hospital in Tel Aviv.[19][20]

Spread

The Ministry of Health reported the first case of community transmission on 21 June 2022.[21]

Timeline

Mpox cases in Israel  ()
     Deaths        Confirmed cases
MayMayJunJunJulJul
Last 15 daysLast 15 days
Date
Cases (rise)
Deaths (rise)
2022-05-21
1(n.a.)
2022-05-22
1(=)
2022-05-23
1(=)
2022-05-24
1(=)
2022-05-25
1(=)
2022-05-26
1(=)
2022-05-27
1(=)
2022-05-28
2(+1)
2022-05-29
2(=)
2022-05-30
2(=)
2022-05-31
2(=)
2022-06-01
2(=)
2022-06-02
2(=)
2022-06-03
2(=)
2022-06-04
2(=)
2022-06-05
2(=)
2022-06-06
2(=)
2022-06-07
3(+1)
2022-06-08
3(=)
2022-06-09
4(+1)
2022-06-10
4(=)
2022-06-11
4(=)
2022-06-12
4(=)
2022-06-13
4(=)
2022-06-14
4(=)
2022-06-15
5(+1)
2022-06-16
6(+1)
2022-06-17
6(=)
2022-06-18
6(=)
2022-06-19
6(=)
2022-06-20
9(+3)
2022-06-21
11(+2)
2022-06-22
13(+2)
2022-06-23
16(+3)
2022-06-24
16(=)
2022-06-25
16(=)
2022-06-26
18(+2)
2022-06-27
29(+11)
2022-06-28
33(+4)
2022-06-29
38(+5)
2022-06-30
42(+4)
2022-07-01
42(=)
2022-07-02
42(=)
2022-07-03
50(+8)
2022-07-04
52(+2)
2022-07-05
55(+3)
2022-07-06
55(=)
2022-07-07
59(+4)
2022-07-08
59(=)
2022-07-09
59(=)
2022-07-10
61(+2)
2022-07-11
66(+5)
2022-07-12
73(+7)
2022-07-13
80(+7)
2022-07-14
88(+8)
2022-07-15
90(+2)
2022-07-16
90(=)
2022-07-17
96(+6)
2022-07-18
96(=)
2022-07-19
102(+6)
2022-07-20
102(=)
2022-07-21
105(+3)
2022-07-22
105(=)
2022-07-23
105(=)
2022-07-24
114(+9)
2022-07-25
114(=)
2022-07-26
121(+7)
2022-07-27
121(=)

May 2022

June 2022

July 2022

Responses

Cases and Statistics

See also

Notes

  1. ↑ The World Health Organization (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), which is currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus".[1]

References

  1. 1 2 "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). November 28, 2022. Retrieved November 29, 2022.
  2. 1 2 3 4 5 "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). April 18, 2023. Archived from the original on April 21, 2022. Retrieved May 21, 2023.
  3. ↑ "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
  4. ↑ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). February 2, 2023. Archived from the original on May 21, 2023. Retrieved May 21, 2023.
  5. 1 2 3 "Mpox (monkeypox)". World Health Organization. May 12, 2023. Archived from the original on May 23, 2023. Retrieved May 24, 2023.
  6. ↑ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. May 21, 2022. Archived from the original on May 22, 2022. Retrieved May 25, 2022.
  7. ↑ "So, Have You Heard About Monkeypox?". The Atlantic. May 19, 2022. Archived from the original on June 23, 2022. Retrieved June 2, 2022.
  8. 1 2 "Monkeypox cases confirmed in England – latest updates". GOV.UK. September 6, 2022. Retrieved September 25, 2022.
  9. ↑ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. May 16, 2022. Archived from the original on May 17, 2022. Retrieved May 17, 2022.
  10. ↑ "2022 Mpox Outbreak Global Map | Mpox | Poxvirus | CDC". www.cdc.gov. September 12, 2023. Retrieved December 1, 2023.
  11. ↑ Sample, Ian (November 2, 2023). "Mpox circulated for five years before global explosion in 2022, research finds". The Guardian. ISSN 0261-3077. Retrieved December 1, 2023.
  12. ↑ "WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern". World Health Organization (WHO). July 23, 2022. Retrieved August 4, 2022.
  13. ↑ "Monkeypox – Campaign details". Department of Health and Social Care – Campaign Resource Centre. Archived from the original on May 28, 2023. Retrieved May 28, 2023.
  14. ↑ "Protecting you from mpox (monkeypox): information on the smallpox vaccination". GOV.UK. Archived from the original on May 28, 2023. Retrieved May 28, 2023.
  15. ↑ Kimball, Spencer (May 11, 2023). "WHO says mpox outbreak, the largest in history, no longer global health emergency". CNBC. Retrieved May 11, 2023.
  16. ↑ Vargas, Ramon Antonio (June 7, 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved June 9, 2022.
  17. ↑ "Monkeypox update: Where the outbreak stands now".
  18. ↑ Erez, Noam; Achdout, Hagit; Milrot, Elad; Schwartz, Yuval; Wiener-Well, Yonit; Paran, Nir; Politi, Boaz; Tamir, Hadas; Israely, Tomer; Weiss, Shay; Beth-Din, Adi; Shifman, Ohad; Israeli, Ofir; Yitzhaki, Shmuel; Shapira, Shmuel C.; Melamed, Sharon; Schwartz, Eli (May 25, 2019). "Diagnosis of Imported Monkeypox, Israel, 2018". Emerging Infectious Diseases. 25 (5): 980–983. doi:10.3201/eid2505.190076. PMC 6478227. PMID 30848724.
  19. ↑ Efrati, Ido. "Israel Confirms First Case of Monkeypox Virus". Haaretz. Retrieved July 11, 2022.
  20. ↑ "Israel, Switzerland report first monkeypox cases as virus spreads". Al Jazeera. Retrieved July 11, 2022.
  21. ↑ "שלושה גברים נוספים אובחנו בישראל כחולים באבעבועות הקוף" [Three other men diagnosed with monkeypox in Israel]. Ministry of Health (Israel) (in Hebrew). Retrieved July 11, 2022.
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