By MARIA CHENG

LONDON (AP) — Scientists who have monitored numerous outbreaks of monkeypox in Africa say they are baffled by the disease’s recent spread in Europe and North America.

Cases of the smallpox-related disease have previously been seen only among people with links to central and West Africa. But in the past week, Britain, Spain, Portugal, Italy, U.S., Sweden and Canada all reported infections, mostly in young men who hadn’t previously traveled to Africa.

France, Germany, Belgium and Australia confirmed their first cases of monkeypox on Friday.

“I’m stunned by this. Every day I wake up and there are more countries infected,” said Oyewale Tomori, a virologist who formerly headed the Nigerian Academy of Science and who sits on several World Health Organization advisory boards.

“This is not the kind of spread we’ve seen in West Africa, so there may be something new happening in the West,” he said.

Monkeypox typically causes fever, chills, a rash and lesions on the face or genitals. WHO estimates the disease is fatal for up to one in 10 people, but smallpox vaccines are protective and some antiviral drugs are also being developed.

One of the theories British health officials are exploring is whether the disease is being sexually transmitted. Health officials have asked doctors and nurses to be on alert for potential cases, but said the risk to the general population is low.

Nigeria reports about 3,000 monkeypox cases a year, WHO said. Outbreaks are usually in rural areas, where people have close contact with infected rats and squirrels, Tomori said. He said many cases are likely missed.

Tomori hoped the appearance of monkeypox cases across Europe and other countries would further scientific understanding of the disease.

The WHO’s lead on emergency response, Dr. Ibrahima Soce Fall, acknowledged this week that there were still “so many unknowns in terms of the dynamics of transmission, the clinical features (and) the epidemiology.”

On Friday, Britain’s Health Security Agency reported 11 new monkeypox cases, saying that “a notable proportion” of the most recent infections in the U.K. and Europe have been in young men with no history of travel to Africa who were gay, bisexual or had sex with men.

Authorities in Spain and Portugal also said their cases were in young men who mostly had sex with other men and said those cases were picked up when the men turned up with lesions at sexual health clinics.

Experts have stressed they do not know if the disease is being spread through sex or other close contact related to sex.

Nigeria hasn’t seen sexual transmission, Tomori said, but he noted that viruses that hadn’t initially been known to transmit via sex, like Ebola, were later proven to do so after bigger epidemics showed different patterns of spread.

The same could be true of monkeypox, Tomori said.

In Germany, Health Minister Karl Lauterbach said the government was confident the outbreak could be contained. He said the virus was being sequenced to see if there were any genetic changes that might have made it more infectious.

Rolf Gustafson, an infectious diseases professor, told Swedish broadcaster SVT that it was “very difficult” to imagine the situation might worsen.

“We will certainly find some further cases in Sweden, but I do not think there will be an epidemic in any way,” Gustafson said. “There is nothing to suggest that at present.”

Scientists said that while it’s possible the outbreak’s first patient caught the disease while in Africa, what’s happening now is exceptional.

“We’ve never seen anything like what’s happening in Europe,” said Christian Happi, director of the African Centre of Excellence for Genomics of Infectious Diseases. “We haven’t seen anything to say that the transmission patterns of monkeypox have been changing in Africa. So if something different is happening in Europe, then Europe needs to investigate that.”

Happi also pointed out that the suspension of smallpox vaccination campaigns after the disease was eradicated in 1980 might inadvertently be helping monkeypox spread. Smallpox vaccines also protect against monkeypox, but mass immunization was stopped decades ago.

“Aside from people in west and Central Africa who may have some immunity to monkeypox from past exposure, not having any smallpox vaccination means nobody has any kind of immunity to monkeypox,” Happi said.

Shabir Mahdi, a professor of vaccinology at the University of Witwatersrand in Johannesburg, said a detailed investigation of the outbreak in Europe, including determining who the first patients were, was now critical.

“We need to really understand how this first started and why the virus is now gaining traction,” he said. “In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If that’s now changing, we really need to understand why.”

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Geir Moulson in Berlin, Jan M. Olsen in Copenhagen and AP reporters across Europe contributed to this report.

NEW YORK (AP) — Wall Street headed for more losses at the open following the previous day’s rout amid persistently high inflation and its potential effect on corporate profits and consumer spending.

Futures for the S&P 500 and Dow Jones Industrial Average slid 0.9% Thursday before the bell.

Shares in Europe and Asia fell sharply following plunging U.S. markets.

Germany’s DAX was down 1.6% at midday, while the CAC 40 in Paris declined 1.7% and Britain’s FTSE 100 shed 2.1%.

On Wednesday, the Dow sank more than 1,100 points, or 3.6%. The S&P 500 had its biggest drop in nearly two years, shedding 4%, and the tech-heavy Nasdaq fell 4.7%.

The benchmark index is now down more than 18% from the record high it reached at the beginning of the year. That’s just shy of the 20% decline that’s considered a bear market.

“The sentiment in the market is highly negative as traders and investors are largely concerned about an economic downturn and soaring inflation,” Naeem Aslam of Avatrade said.

Rising interest rates, high inflation, the war in Ukraine and a slowdown in China’s economy have caused investors to reconsider the prices they’re willing to pay for a wide range of stocks, from high-flying tech companies to traditional automakers.

The last bear market happened just two years ago, but this would still be a first for those investors that got their start trading on their phones during the pandemic. For years, thanks in large part to extraordinary actions by the Federal Reserve, stocks often seemed to go in only one direction: up. Now, the familiar rallying cry to “buy the dip” after every market wobble is giving way to fear that the dip is turning into a crater.

The Federal Reserve is trying to temper the impact from the highest inflation in four decades by raising interest rates. Many other central banks are on a similar track. But the Bank of Japan has stuck to its low interest rate policy and the gap between those benchmark rates of the world’s largest and third-largest economies has pushed the dollar’s value up against the Japanese yen.

Japan reported a trade deficit for April as its imports ballooned 28%. The shift reflects surging energy costs amid the war in Ukraine and a weakening of the yen against the U.S. dollar.

The Nikkei 225 in Tokyo lost 1.9% to 26,402.84 and the Hang Seng in Hong Kong dropped 2.5% to 20,120.60. In South Korea, the Kospi shed 1.3% to 2,592.34, while Australia’s S&P/ASX 200 gave up 1.7% to 7,064.50.

The Shanghai Composite index reversed earlier losses, gaining 0.4% to 3.096.96.

On Wednesday, retailer Target lost a quarter of its value after reporting earnings that fell far short of analysts’ forecasts. Inflation, especially for shipping costs, dragged its operating margin for the first quarter to 5.3%. It had been expecting 8% or higher.

The company warned that its costs for freight this year would be $1 billion higher than it estimated just three months ago.

The report comes a day after Walmart said its profit took a hit from higher costs. The nation’s largest retailer fell 6.8%, adding to its losses from Tuesday.

Target and Walmart each provided anecdotal evidence that inflation is weighing on consumers, saying they held back on purchasing big-ticket items and changed from national brands to less expensive store brands.

The weak reports stoked concerns that stubbornly rising inflation is putting a tighter squeeze on a wide range of businesses and could cut deeper into their profits.

Other big retailers also have racked up hefty losses.

The data are not entirely consistent. On Tuesday, the market cheered an encouraging report from the Commerce Department that showed retail sales rose in April, driven by higher sales of cars, electronics, and more spending at restaurants.

Investors worry the Fed could trigger a recession if it raises interest rates too high or too quickly. Worries persist about global growth as Russia’s invasion of Ukraine puts even more pressure on prices for oil and food while lockdowns in China to stem COVID-19 cases worsens supply chain problems.

In other trading, benchmark U.S. crude oil declined $1.27 to $108.32 per barrel in electronic trading on the New York Mercantile Exchange. It dropped $2.81 to $109.59 on Wednesday.

Brent crude, the basis for pricing for international trading, slipped 71 cents to $108.40 per barrel.

The dollar fell to 127.92 Japanese yen from 128.20 yen late Wednesday. The euro strengthened to $1.0514 from $1.0464.