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2. Cases outside of Africa

Mpox cases have sporadically occurred in other places. In 2003, rats imported from Ghana infected prairie dogs, spreading the virus around the American midwest, leading to more than 50 human cases. Cases of people traveling to Africa and getting infected were reported in 2018, 2019, and 2021. According to the World Health Organization, cases of mpox outside Africa, particularly in North America and Europe have [citation href="https://www.who.int/emergencies/situations/monkeypox-oubreak-2022" WHO" title="Mpox (monkeypox) outbreak" desc="Mpox (Monkeypox)"] outbreak spread significantly since May 2022 when infections in Nigeria set off an outbreak. In 2022, there were 30,000 cases in the U.S. alone. In 2023, this figure dropped to 1,700 cases, but the virus may be making a comeback.

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