A section of skin tissue, harvested from a lesion on the skin of a monkey, which had been infected with monkeypox virus, is seen at 50X magnification on day four of the rash developing skin in 1968. CDC/Handout via REUTERS

MADRID/LISBON, May 20 (Reuters) – (This May 20 story corrects official tallies in headline and first paragraph, and adds a line about the Extremadura case in fifth paragraph)

Spanish health authorities reported 23 new confirmed cases of monkeypox on Friday, mostly in the Madrid region where the regional government closed a sauna linked to the majority of infections.

The total tally in Spain has now reached 30, while 23 confirmed cases have now been identified in neighboring Portugal, where nine new cases were detected on Friday.

Madrid authorities have been working to trace the cases mainly from a single outbreak in a sauna, regional health chief Enrique Ruiz Escudero told reporters on Friday. The word sauna is used in Spain to describe establishments popular with gay men looking for sex rather than just a public bath.

“The Directorate of Public Health will carry out an even more detailed analysis (…) to control the contagion, cut the chains of transmission and try to mitigate the transmission of this virus as much as possible,” he said.

The Extremadura region confirmed its first case on Friday afternoon. It is under investigation by national health authorities and is therefore not yet included in the national tally.

Another 18 suspected cases are being investigated in Spain, 15 in the Madrid region, two in the Canary Islands and one in Andalusia, health authorities said.

More than 100 cases of viral infection more frequent in West and Central Africa have been reported in Europe. Read more

It’s usually a mild infection, with symptoms like fever, headache, and a characteristic bumpy rash. Read more

Twenty cases have been detected in Britain – where authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed. Read more

The UK Health Security Agency said a notable proportion of recent cases in Britain and Europe have been found in gay and bisexual men. Read more

Spain is evaluating different treatment options, such as antivirals and vaccines, but so far all cases have mild symptoms and therefore no specific ad hoc treatment has been needed, the minister told reporters on Friday. Spanish Health, Carolina Darias.

The Portuguese cases remain under clinical follow-up but none have been hospitalized as they are all stable, the health authority said.

Reporting by Emma Pinedo and Patricia Rua Editing by Andrei Khalip, Inti Landauro, Toby Chopra and Frances Kerry

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