WASHINGTON (REUTERS, AFP) - US health officials on Friday (June 3) urged doctors to test for monkeypox if they suspect cases, saying there may be community-level spread but that the overall public health risk remained low.  

So far, there have been 21 cases of the disease in at least 11 states. Affected patients are isolating to help prevent spreading the virus, US Centre for Disease Control and Prevention (CDC) officials told reporters in a conference call. 

Sixteen of the first 17 cases were among people who identify as men who have sex with men, according to a new CDC report, and 14 were thought to be travel associated.

All patients are in recovery or have recovered, and no cases have been fatal.

"There have also been some cases in the United States that we know are linked to known cases," Jennifer McQuiston, deputy director of the CDC's Division of High Consequence Pathogens and Pathology, told reporters on a call.

"We also have at least one case in the United States that does not have a travel link or know how they acquired their infection."

In many of the cases the monkeypox rash started in the genital area, which could lead some doctors to diagnose it as a more common sexually transmitted infection such as herpes or syphilis.  

Health officials believe community transmission is likely, which is why they want doctors to test patients if they have any reason to suspect monkeypox.  

The CDC stressed that monkeypox is transmitted by close contact with someone who has the virus and to monkeypox sores. 

“Anyone can get monkeypox and we are carefully monitoring for monkeypox that may be spreading in any population, including those who are not identifying as men who have sex with men,” Ms McQuiston said.

So far, the United States has run 120 tests for monkeypox.  Officials said the government has the capacity to run 1,000 tests per day.

Monkeypox is a rare disease that is related to but less severe than smallpox, causing a rash that spreads, fever, chills, and aches, among other symptoms.

Generally confined to western and central Africa, cases have been reported in Europe since May and the number of countries affected has grown since.

Though its new spread may be linked to particular gay festivals in Europe, it is not thought to be a sexually transmitted disease, with the main risk factor being close skin-to-skin contact with someone who has monkey pox sores.

A person is contagious until all the sores have scabbed and new skin is formed.

Raj Panjabi, senior director for the White House's global health security and biodefence division, added that 1,200 vaccines and 100 treatment courses had been delivered to US states, where they were offered to close contacts of those infected.

There are currently two authorised vaccines: ACAM2000 and JYNNEOS, which were originally developed against smallpox. Though smallpox has been eliminated, the US retains the vaccines in a strategic national reserve in case it is deployed as a biological weapon.

JYNNEOS is the more modern of the two, with fewer side effects.

"We continue to have more than enough vaccine available," Dawn O'Connell, assistant secretary for preparedness and response in the Department of Health and Human Services, told reporters.

In late May, the CDC said it had 100 million doses of ACAM200 and 1,000 doses of JYNNEOS available, but O'Connell said on Friday the figures had shifted, though she could not divulge precise numbers for strategic reasons.

The CDC has also authorised two antivirals used to treat smallpox, TPOXX and Cidofovir, to be repurposed to treat monkeypox.

"Anyone can get monkeypox and we are carefully monitoring for monkeypox that may be spreading in any population, including those who are not identifying as men who have sex with men," said McQuiston.

That being said, the CDC is undertaking special outreach in the LGBT community, she added.

A suspected case "should be anyone with a new characteristic rash," or who meet the criteria for high suspicion such as relevant travel, close contact, or being a man who has sex with men.