![]() Investigations have been unable to link that case to any of the other cases detected to date, suggesting that there have been multiple introductions of the virus into the United Kingdom and other countries, with cases potentially having gone undetected till now. Clinicians confirmed that the patient had monkeypox three days later. The first case in the current outbreak was a traveller who returned to the United Kingdom from Nigeria, a monkeypox endemic area, on 4th May 2022. Genital lesions have previously been uncommon and reflect a unique aspect of this outbreak. ![]() Possible transmission between sexual partners may occur due to contact during sex with infectious skin and mucosal (including oral) lesions, as sexual transmission of monkeypox has not yet been proven. Additional symptoms include rash, fever, painful lymph nodes, and oral ulcers. Most cases are mild and present with lesions on the genitalia or peri-genital areas. Of the cases with available information, males accounted for more than 70%, mostly aged between 20-55 years, and have been detected through sexual health services. Since then, 15 countries have collectively reported more than 140 cases (see table). On 15th May, four additional laboratory-confirmed cases were reported amongst sexual health services attendees presenting with a vesicular rash illness in men practising sex with men. On 13th May 2022, the World Health Organization (WHO) was notified of two laboratory-confirmed cases and one probable case of monkeypox, from the same household, in the United Kingdom. The National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, confirms that there are currently no monkeypox cases in South Africa.
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