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The global tally of monkeypox cases has surpassed 200 and continues to increase daily, reaching across 21 countries, according to the latest report from the European Centre for Disease Prevention and Control.

On Wednesday, the agency reported 219 confirmed cases worldwide, including 9 in the U.S. and 71 in the U.K. Later that day, does nifedipine cause hair loss the U.K. reported 7 more cases, bringing the global total to 226.

“If anyone suspects they might have rashes or lesions on any part of their body, particularly if they have recently had a new sexual partner, they should limit their contact with others and contact … their local sexual health service as soon as possible,” Susan Hopkins, the chief medical adviser for the U.K. Health Security Agency, said in a statement.

In the European Union, 12 countries have reported at least one case, with the highest total so far in Spain with 51 cases, followed by Portugal with 37 cases.

Most of the 118 cases in Europe have been detected in young men, particularly those who identify as gay, bisexual or men who have sex with men, the European CDC said.

In many of these cases, patients have sought medical care for a rash on or around the genital area, which has suggested that transmission of the virus is happening during close physical contact during sex. Monkeypox isn’t a sexually transmitted infection — meaning that the virus doesn’t transmit through seminal or vaginal fluids — but viral droplets can spread during close contact.

Before May, the cases outside of endemic countries were isolated and occurred among people who had recently traveled.

“This is the first time that chains of transmission are reported in Europe without known epidemiological links to West or Central Africa, where this disease is endemic,” the European CDC wrote. “These are also the first cases worldwide reported among MSM.”

So far, no deaths have been reported among the European cases, and infections have been mild.

Public health officials across the world are bracing for more positive cases as more suspected samples arrive at testing labs for genetic sequencing. Canada has confirmed 11 more cases in Quebec this week, bringing its total to 16.

“We expect more cases to be confirmed in the coming days,” Jean-Yves Duclos, the health minister at the Public Health Agency of Canada, said in a statement.

Jynneos, a smallpox vaccine, is about 85% effective against monkeypox, according to CDC data. The manufacturer, Bavarian Nordic, announced Wednesday that it signed the first supply contract with an unidentified country for the vaccine. The company also said it is “currently in dialogue” with several countries that want to buy the vaccine.

In the U.S., public health officials are in the process of releasing the two-dose vaccine from the Strategic National Stockpile to protect some high-risk Americans who have been in contact with current monkeypox patients.

Canada, Spain, and the U.K. are also offering the vaccine to close contacts.

Sources

European Centre for Disease Prevention and Control: “Epidemiological update: Monkeypox multi-country outbreak, May 25, 2022.”

U.K. Health Security Agency: “Monkeypox cases confirmed in England – latest updates, May 25, 2022.”

Public Health Agency of Canada: “Statement from the Minister of Health on Canada’s Response to Monkeypox, May 24, 2022.”

CDC: “Monkeypox and Smallpox Vaccine Guidance.”

Bavarian Nordic: “Bavarian Nordic enters first larger vaccine contract with government in response to monkeypox outbreak.”

WebMD: “U.S. Releasing Monkeypox Vaccine from National Stockpile.”

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