Monkeypox, which mostly occurs in west and central Africa, is a rare viral infection similar to human smallpox, though milder WHO says coordinating with authorities over the outbreak; CDC confirms first US case MADRID/BOSTON: Spain and Portugal have detected over 40 suspected cases of monkeypox, while US authorities reported the country’s first confirmed case. Monkeypox, which mostly occurs in west and central Africa, is a rare viral infection similar to human smallpox, though milder. The virus causes fever symptoms as well as a distinctive bumpy rash. The outbreaks were concentrated in the Spanish and Portuguese capital cities, officials said Wednesday. The lone US case was detected in Massachusetts, with health officials saying the man found with the infection had recently traveled to Canada. The announcements came just days after British health authorities said they had detected seven cases so far this month, with the World Health Organization working with the government to investigate the outbreak. Health officials have noted some of these infections may be through sexual contact — in this instance among gay or bisexual men — which would be a new development in understanding how the virus is transmitted. In a statement, health authorities in the Madrid region said they had detected “23 possible cases of monkeypox,” indicating all of them were believed to have been transmitted through sexual activity. “In general, its transmission is via respiratory drops but the characteristics of the 23 suspected infections point to it being passed on through bodily fluids during sex relations,” the statement said, without giving further details. “All of them are young adult males and most of them are men who have sexual relations with other men, but not all of them,” Elena Andradas, head of public health in the Madrid region, told Cadena Ser radio. Another 20 suspected cases of monkeypox have been detected in the Lisbon region, Portugal’s health ministry said in a statement. “The cases were all among males, the majority of them young, who had ulcerated lesions,” it said. Symptoms of monkeypox in humans include a rash which often starts on the face then moves to other parts of the body, fever, muscle ache and chills. Most people recover from the illness within several weeks. Transmission is usually via close contact with infected animals such as rodents and monkeys, and is limited between people. It has only been fatal in rare cases. ALSO READ: EXPLAINER: Why monkeypox cases are rising in Europe The UK Health Security Agency (UKHSA), a public health protection body, on Monday said it had detected four new cases after registering three cases earlier in May. All four of the additional cases were men who have sex with men or self-identify as gay or bisexual, it said. None have known connections with the three earlier confirmed cases, the first of which was linked to travel from Nigeria, raising fears of community spread of the virus. In the US, the Massachusetts Department of Public Health said it was working with the Centers for Disease Control and Prevention (CDC) and relevant local boards of health to carry out contact tracing, adding that “the case poses no risk to the public, and the individual is hospitalized and in good condition.” The Public Health Agency of Canada late on Wednesday issued a statement saying it is aware of the monkeypox cases in Europe and is closely monitoring the current situation, adding no cases have been reported at this time. Monkeypox was first recorded in the Democratic Republic of Congo in the 1970s. The number of cases in West Africa has increased in the last decade. Symptoms include fever, headaches and skin rashes starting on the face and spreading to the rest of the body. The Massachusetts agency said the virus does not spread easily between people, but transmission can occur through contact with body fluids, monkeypox sores, items such as bedding or clothing that have been contaminated with fluids or sores, or through respiratory droplets following prolonged face-to-face contact. It said no monkeypox cases had previously been identified in the US this year. Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria. The CDC also said it is tracking multiple clusters of monkeypox reported in Europe within the past two weeks.