Almost a month after the World Health Organization called for coordinated action to stop the spread of the monkeypox virus, the WHO took the unusual step on July 23 of declaring the infectious disease a global health emergency as the number of cases has grown quickly and spread to dozens of countries.

This is the seventh such infectious disease warning from the organization since 2007, according to the New York Times, and the first since it declared the novel coronavirus an international public health emergency in January 2020.

Monkeypox has hitherto been found almost exclusively in tropical regions of Africa. Cases of the rarely fatal infection have largely been linked to men who have had intimate contact with other men. However, it’s not considered a sexually transmitted virus because it can be easily transmitted though other types of close contact with an infected person, or even from infected objects like clothing and bedsheets.

To determine the countries with the most monkeypox cases, 24/7 Tempo reviewed data from Global.health, a collaborative resource of real-time infectious disease data maintained by technologists and researchers from international institutions. Countries are ordered by the number of cumulative monkeypox cases as of July 26, 2022. Population data comes from the World Bank.

The 20 countries with the highest number of confirmed monkeypox cases range from Mexico, with 52 cases, to Spain with 3,125 cases – with a total of 16,318 cases worldwide since the first one was confirmed in Nigeria on May 4. (These are nations fighting outbreaks of diseases other than COVID.)

Four countries, including the United States, with the world’s second-highest rate of infection, currently have more than 2,000 cases. The earliest confirmed cases among these four countries occurred on May 6 in the United Kingdom, underscoring how quickly instances of the disease have increased since then. (In America, these are the states with the most monkeypox cases.)

Click here to see the countries with the most monkeypox cases

Population size isn’t necessarily a factor in the number of cases by country. Sweden and Belgium have similarly sized populations and both reported their first cases on May 22, but Belgium has four times the number of cases than Sweden.