2022–2023 mpox outbreak in europe 2022–2023 mpox outbreak in europe the 2022–2023 mpox outbreak in europe is a part of the outbreak of human mpox caused by the west african clade of the monkeypox virus. the outbreak reached europe on 6 may 2022 when the united kingdom reported their first case of mpox. as of 13 july 2022, 35 european countries and territories have confirmed cases. this article is about the outbreak on the continent. for an overview of the outbreak for the entire world, see 2022–2023 mpox outbreak. 2022–2023 mpox outbreak in europediseasempoxvirus strainmonkeypox virus (west african clade)index caselondon, englandarrival date6 may 2022 (1 year and 1 week ago)confirmed cases22,640suspected cases‡82deaths1territories35‡suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out. background these paragraphs are an excerpt from mpox. mpox (pronounced /ˈɛmpɒks/ em-poks, formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. the time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. there may be mild symptoms, and it may occur without any symptoms being apparent. cases may be severe, especially in children, pregnant women or people with suppressed immune systems. the disease is caused by the monkeypox virus, a zoonotic virus in the genus orthopoxvirus. the variola virus, the causative agent of smallpox, is also in this genus. it may spread from infected animals by handling infected meat or via bites or scratches. human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route. people can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted. diagnosis can be confirmed by testing a lesion for the virus's dna. there is no known cure. a study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease. a newer smallpox and mpox vaccine based on modified vaccinia ankara has been approved, but with limited availability. other measures include regular hand washing and avoiding sick people and animals. antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks. the illness is usually mild and most of those infected will recover within a few weeks without treatment. estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of mpox have been recorded since 2017. 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. 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. timeline arrival main articles: 2022–2023 mpox outbreak in germany, 2022–2023 mpox outbreak in the united kingdom, and 2022–2023 mpox outbreak in the netherlands an index case was imported into the united kingdom in late april 2022, by a man who had travelled to nigeria, where the disease is endemic. he had already showed symptoms since 29 april, and was admitted to hospital in london on 6 may. on 12 may, the man was confirmed to have contracted mpox. the following day, another mpox case was confirmed, and the united kingdom reported these cases to the world health organization (who). 18 may main articles: 2022–2023 mpox outbreak in spain and 2022–2023 mpox outbreak in portugal on 18 may, spain and portugal both confirmed their first cases of mpox following the confirmation of mpox in the united kingdom starting an outbreak in the countries. it is unknown how it was contracted, but most likely via travel or skin-to-skin contact abroad. 19 may on 19 may, belgium confirmed its first cases of mpox in two belgian men, it was later confirmed by reuters that the men had gone to the same party. later, italy confirmed its first case of mpox in an italian man in rome, the man was isolated at the spallanzani hospital. the disease was likely contracted from a stay in the canary islands. there were 2 suspected cases, which later became confirmed cases. sweden then confirmed its first case of mpox in stockholm, the swedish health agency confirmed it later. the person was not reported to be a woman or a man, but it was most likely a man. it is unknown how it was contracted, but likely via travel or skin-to-skin contact abroad. 20 may main articles: 2022–2023 mpox outbreak in france, 2022–2023 mpox outbreak in germany, and 2022–2023 mpox outbreak in the netherlands on 20 may, france reported their first case of mpox. the patient had no travel history, meaning he didn't contract the disease abroad. on the same day, germany and the netherlands reported their first cases of mpox. it was unknown how it was contracted in both stories, but likely via travel or skin-to-skin contact abroad. 21 may on 21 may, switzerland confirmed its first case of mpox. it was in a person of undisclosed gender, contracted through "close physical contact" abroad, according to reuters. 22 may on 22 may, austria confirmed its first case of mpox. it is unknown how it was contracted or who contracted it, but likely via travel or skin-to-skin contact abroad. 23 may on 23 may, denmark detected its first mpox infection. it was in an adult male, likely contracted from a trip to spain, according to reuters. no cases of mpox were detected in greenland, a danish constituent country in north america. 24 may on 24 may, the czech republic registered its first case of mpox in a woman, likely picked up from a festival in belgium, according to reuters. on the same day, slovenia also registered its first case of mpox. it was in a traveller of undisclosed gender who likely contracted mpox from a trip to the canary islands, according to reuters. 27 may on 27 may, ireland confirmed its first case of mpox in the east of the country. the health protection surveillance centre (hpsc) commenced publication of a weekly report on the epidemiology of human mpox in ireland on 9 june. on the same day, finland also confirmed its first case of mpox. it was in a man who likely had contracted the disease from a trip to another european country, according to reuters. 28 may on 28 may, malta registered its first case of mpox. it was in an adult male, who most likely picked up the disease abroad from one of the countries affected by the outbreak, according to the malta times. 31 may on 31 may, hungary confirmed its first case of mpox, in an adult male. it is still being investigated whether or not he recently travelled, though it is unknown how the man contracted the disease. on the same day, norway confirmed its first case of mpox. it was in a person of undisclosed gender who most likely contracted the disease from travelling abroad. the case was linked to the ongoing outbreak in europe, meaning that the patient may have travelled to a european country that was affected by the outbreak. 1 june on 1 june, gibraltar, a british overseas territory, registered its first case of mpox in a spanish resident of undisclosed gender working in gibraltar. the patient likely contracted the disease from close contact with another spanish national also working in gibraltar. 3 june on 3 june, latvia confirmed its first mpox infection. it was in an elderly person of undisclosed gender who most likely contracted the disease abroad. 8 june on 8 june, greece confirmed the country's first mpox case. it was in a person of undisclosed gender who likely contracted the disease from a trip to portugal. 9 june on 9 june, iceland confirmed its first mpox case. it was in two men who most likely contracted the disease from a trip to europe. 10 june on 10 june, poland confirmed its first mpox case. it is unknown who the patient is or how it was contracted, but it is possible it was picked up via travel or skin-to-skin contact. 13 june on 13 june, romania confirmed its first monkempoxypox infection. it was in an adult male who most likely contracted the disease from his partner who travelled in several different european countries that have been affected by mpox at the time. 15 june on 15 june, luxembourg confirmed its first mpox case. it is unknown how it was contracted, though it is being investigated. the disease was likely picked up via travelling abroad or skin-to-skin contact. on the same day, georgia also confirmed its first case of mpox. it was in a patient of undisclosed gender who likely contracted the disease from a trip to europe. 17 june on 17 june, serbia confirmed its first case of mpox. it was in a patient of undisclosed gender. it was revealed that it was an "imported case", meaning that the patient may have contracted the disease abroad. 23 june on 23 june, bulgaria confirmed its first mpox case. it was in two men who most likely contracted the disease from a trip to spain and the united kingdom but don't reckon any contact with infected persons. on the same day, croatia also received its first case of mpox. it was in an adult man who most likely contracted the disease from a stay in italy and spain. 28 june on 28 june, estonia confirmed its first case of mpox. it was in a middle-aged man who most likely contracted the disease abroad. he had no close contacts with anyone in estonia. 2 july on 2 july, andorra registered its first mpox case in a woman of unknown age. it is unknown how it was contracted, but it may likely have been picked up either abroad via travel or via skin-to-skin contact. 7 july on july 7, slovakia received its first case of mpox. it was in a person of undisclosed gender in the 20-59 age group who most likely contracted the disease abroad. 12 july on 12 july, russia confirmed its first case of mpox. it was in a man probably in his 20-25 age group who likely contracted the disease from a trip to europe where the outbreak had started. the man then tested positive for the virus and was isolated in a hospital, most likely in saint petersburg. 13 july on 13 july, bosnia and herzegovina registered its first mpox case. it is unknown how it was contracted, although the disease was likely picked up abroad via travel or skin-to-skin contact. 22 july on 22 july, monaco confirmed its first case of mpox, in a man who most likely had travelled to france where the disease was spreading. the princess grace hospital centre later reported that the first case of the disease had been confirmed in the residential area of la colle. 15 september on 15 september, ukraine's ministry of health reported the country's first case of mpox. the ministry noted that the patient, who did not travel abroad, was experiencing "mild symptoms" and undergoing hospital treatment. the region where the case was reported was not disclosed. responses world health organization (who) on 20 may, the who convened an emergency meeting of independent advisers to