Canada among 10 countries reporting highest cumulative mpox cases, WHO reports

As an mpox outbreak continues to spread globally, the World Health Organization says Canada is among the top 10 countries reporting the highest cumulative cases to date.

From Jan. 1, 2022 to Aug. 9, 2023, the WHO has noted a total of 89,308 laboratory-confirmed cases of mpox, or monkeypox, reported globally, according to a status report published on Monday.

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While not the most affected of countries, Canada finds itself among the top 10 nations grappling with the illness.

As of July 28, 2023, the government of Canada has received detailed case reports on 1,440 confirmed cases of mpox in the country, and is reporting a total of 1,503 confirmed cases on its dashboard.

That differs slightly from the World Health Organization's figure of 1,496 confirmed Canadian cases, which the WHO says is expected and due "to different inclusion criteria and different data cut-off times."

With the 1,496 Canadian cases as reported by the WHO, the country is tenth in highest cumulative cases worldwide.

The U.S. has the highest number with 30,446 total cases, followed by Brazil with 10,967 and Spain at 7,560. Colombia (4,090), Mexico (4,045), Peru (3,812), the U.K. (3,771) and Germany (3,694) are also among the top ten countries.

Together, these countries account for about 82 per cent of the total cases reported globally since last January, the WHO said.

The WHO says the disease continues to spread.

In the last month, there were 1,020 new cases globally, which is a 1.2 per cent increase in total cases. The Western Pacific Region contributed a significant majority, with 77.2 per cent of the cases, according to the report, "driven by sustained community transmission in China."

The number of weekly cases reported globally declined by 58.9 per cent in the first week of August compared to the previous week, but the WHO noted this could be in part because of data from China that includes 491 new cases not yet accounted for in the current analysis.

The mpox outbreak is currently affecting 113 countries, areas and territories. Some countries have sporadic cases while others have high community transmission.

One new country was added to the outbreak list in this report; Trinidad and Tobago reported its first three mpox cases.

China and Portugal, along with six other countries, reported a significant increase in cases from June 28 to Aug. 8. China had a 140 per cent increase while Portugal reported a 201 per cent increase.

Globally, there have been 152 confirmed deaths, with three recent ones reported in the U.S.

WHO IS BEING AFFECTED?

The report states as of Aug. 9, an overwhelming majority of cases (96.3 per cent) are men between the ages of 29 and 41.

Of the cases with available age data, the majority of minors diagnosed with mpox live in the Americas Region.

Around half of the cases with available information have been reported among individuals living with HIV. However, this proportion drops to 29 per cent for cases reported within the last 12 weeks, indicating a potential shift in the demographic of affected individuals.

According to the report, health workers are shown to be the most affected by the mpox outbreak, making up 4.8 per cent of cases. This is in part because they are closely interacting with infected patients, WHO said.

HOW IS MPOX BEING TRANSMITTED?

Since the start of the outbreak, the most prominent mode of transmission reported has been skin and mucosal contact during sex, making up 82.1 per cent, or 16,587, of 20,209 cases, health officials say.

The next most common method of transmission is by person-to-person non-sexual contact. However, there is not a comprehensive understanding of transmission due to a lack of detailed information, especially from the WHO African Region, officials behind Tuesday's report said.

In terms of exposure settings, parties with sexual contact are the most reported, accounting for 66 per cent of the documented cases over the duration of the outbreak.

Looking only at the past 12 weeks, the most common reported exposure setting has been classified as "other" (44 per cent), followed by party settings with sexual contact (25 per cent), households (1 per cent), workplaces (4 per cent), large events with sexual contact (4 per cent), and large events with no sexual contact (2 per cent).

WHAT ARE THE SYMPTOMS?

Among the symptoms reported, nine-in-10 people confirmed to have mpox have experienced a rash.

The second most common symptom has been fever, which more than half of patients experienced, followed by a systemic rash or genital rash with 54 per cent and 47.6 per cent respectively.

Health officials say not everyone experiences all of the symptoms simultaneously.

The next WHO mpox situation report will be published in the second week of September.