May 31, 2022 – The CDC has updated its travel advisory for monkeypox as global cases continue to increase.

The risk to the public is still considered low, the CDC said, but travelers should “practice enhanced precautions” and avoid close contact with sick people.

The travel advisory shifted from level 1, where travelers are advised to “watch” and “practice usual precautions.” Now at level 2, travelers should be on “alert.” The next and final advisory level, or level 3, would reach a “warning” stage and encourage people to “avoid nonessential travel.”

For now, the CDC recommends that travelers remain vigilant and seek medical care if they have an unexplained skin rash.

As of Monday, the U.S. has confirmed 15 cases of monkeypox or orthopoxvirus, which is a family of viruses that includes monkeypox, according to the latest CDC data.

California and Florida have three cases each, followed by two cases each in Colorado, New York, and Utah. One case has been identified each in Massachusetts, Virginia, and Washington.

Globally, 23 countries have reported 257 confirmed monkeypox cases, along with 127 suspected cases, according to a World Health Organization update on Sunday. In non-endemic countries, no deaths have been linked to the virus so far.

The U.K. continues to have the most severe outbreak, with 106 cases. Portugal has reported 49 cases, followed by Canada with 26 confirmed cases and 35 suspected cases.

Most cases don’t have any travel links to Central or West Africa, where monkeypox is endemic. Instead, most have been identified at primary care offices and sexual health services when patients report an unexplained rash, the WHO said.

“The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area is atypical,” it said. “One case of monkeypox in a non-endemic country is considered an outbreak.”

With the “sudden appearance” of dozens of outbreaks in several non-endemic countries at the same time, undetected transmission may have been happening for some time but become amplified in recent weeks, the agency said.

Early WHO investigations have found that cases are being reported among gay, bisexual, and other men who have sex with men. The WHO urged public health authorities to focus on providing accurate information to the groups who face the highest risks and protecting front-line health care workers who may become exposed.

More monkeypox cases are also being reported in countries where the virus is endemic, the WHO said. So far this year, the Democratic Republic of the Congo has confirmed 1,284 cases and 58 deaths, followed by Nigeria with 46 cases and no deaths, and Cameroon with 25 cases and nine deaths. In recent weeks, the Central African Republic has reported eight cases and two deaths, and the Republic of the Congo has reported two cases and no deaths.

“The situation is evolving rapidly and WHO expects that there will be more cases identified as surveillance expands in non-endemic countries, as well as in countries known to be endemic who have not recently been reporting cases,” the WHO said.

At the same time, WHO officials said Monday that they don’t believe the monkeypox outbreak will turn into a wide-ranging pandemic, according to CBS News.

“We are not concerned of a global pandemic,” Rosamund Lewis, who leads the smallpox secretariat of the WHO’s Emergencies Program, told the news outlet.

But WHO officials want to know more about recent monkeypox transmission, she said.

“We are concerned that individuals may acquire this infection through high-risk exposure if they don’t have the information they need to protect themselves,” she said. “We are concerned that because the global population is not immune to orthopoxviruses since the end of smallpox eradication, that the virus may attempt to exploit a niche and spread more easily between people. But we don’t have the answer to this question yet.”