As cases rise, surveillance expanded in nations not associated with disease

The World Health Organization said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox had been reported from 12 member states where the virus is not endemic, the UN agency said, adding it will provide further guidance and recommendations in the coming days for countries on how to mitigate the spread of monkeypox.

"Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic", the agency said.

Symptoms of monkeypox are usually mild and include headache, aching muscles, and exhaustion. The disease can also cause unsightly skin lesions that are susceptible to infection.

The United Kingdom is braced for a sharp rise in monkeypox cases as an outbreak of the once-rare disease ramps up.

Britain is seeing daily infections of the monkeypox virus that are unconnected to any travel to West Africa, where the disease is endemic, Susan Hopkins, chief medical adviser of the UK Health Security Agency said on Sunday.

UK-based scientists said more infected people will be traced in the coming days, to add to the 20 found in the country so far.

Claire Dewsnap, president of the British Association for Sexual Health and HIV, told Sky News: "There is going to be more diagnoses over the next week. How many is hard to say. What worries me the most is there are infections across Europe, so this has already spread."

And she said it will be "a massive job" for the authorities to now trace everyone who has been in contact with someone who has the disease.

The UK was the first country to identify cases in an outbreak that is now known to be impacting the European mainland, the United States, and Australia. In the past, monkeypox had been contained to central and western Africa.

Hans Kluge, the WHO's regional director for Europe, said the organization expects many more cases throughout the summer.

Charlotte Hammer, a Cambridge University expert on emerging diseases, told The Guardian newspaper: "I am certain that we are going to see more cases. First, health authorities are now－very actively－looking for cases, so we are more likely to spot people with mild versions that we might previously have missed or misdiagnosed. In addition, monkeypox has an incubation period of between one and three weeks, so it is likely we will see new infections among those who were in early contact with the outbreak's first cases."

David Heymann, an infectious disease specialist at the WHO, told the BBC it looks as if the virus is currently spreading through sexual contact.

However, the fact that it has popped up simultaneously in far-flung corners of the world has been puzzling doctors. One theory as to why that is happening is that fewer people are being vaccinated against smallpox; a jab that offers some protection against monkeypox.

Developing advice

Heymann said the WHO is developing advice on how nations should treat and attempt to contain the disease, which will be released in the coming days.

Switzerland and Israel reported their first cases on the weekend, with Australia, Belgium, Canada, France, Italy, Portugal, Spain, and Sweden all reporting initial cases last week.

US President Joe Biden said on Sunday that recent cases of monkeypox that have been identified in Europe and the United States were something "to be concerned about".

In his first public comments on the disease, Biden said: "It is a concern in that if it were to spread it would be consequential."

The Bangladeshi government has declared a health alert amid the outbreak of the monkeypox virus in some parts of the world, although no cases have been reported in the country, an official said on Sunday.

Agencies and Xinhua contributed to this story.