The World Health Organization has declared monkeypox a global health emergency, its highest-level warning, and Biden officials are weighing a similar declaration, as experts worry that the virus may gain a permanent foothold in the United States and other countries where it is not traditionally found.

What to know about monkeypox symptoms, treatments and protection

Monkeypox symptoms, More than 22,000 cases of monkeypox have been reported in 79 countries this year, most of those in countries that don’t typically see the virus. In the United States, more than 4,900 cases were confirmed as of July 29 by the Centers for Disease Control and Prevention, but that is probably a significant undercount. Normally, the virus is found mostly in central and western Africa where it is endemic in some animals that pass it to people. What worries global health experts about this outbreak is that it is spreading person to person, primarily among networks of men who have sex with men. Scientists are trying to figure out whether recent mutations to the virus are helping it spread in ways they don’t yet fully understand.

Here’s what you need to know about monkeypox, and how to protect yourself. Monkeypox infections typically last two to four weeks, the CDC says, and begin with flu-like symptoms including fever, headaches, muscle aches and exhaustion. Eventually, fluid-filled bumps or “pox” spread across the skin. Health officials have noted that the latest monkeypox cases often involve genital rashes that can be confused with syphilis or herpes. Monkeypox can be deadly, but two major strains of the virus pose different risks. A Congo Basin strain has been found to be fatal to about 1 in 10 people infected with it, according to the WHO, while a West African strain appears to be less severe, becoming fatal for about 1 in 100 infected people. That milder strain appears to be the one currently infecting people around the world, including Europe and the United States. The first known monkeypox deaths outside Africa in the current outbreak were reported on July 29 and July 30, with two fatalities in Spain and one in Brazil. Five people have died in Africa, according to the WHO

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