system
Given the following post, respond as if you're commenting on Reddit:
human
USA currently represents 35% of Monkeypox cases in the world. While having 4% of the population. How is that possible?

Now I realize the US usually has a disproportionate percentage of viral outbreaks like with Covid but 35% seems unbelievable. 

Is Europe severely under testing currently? How else would you explain this disparity?
gpt
Not many good answers so far.

Why does US have 35% of cases (Vs 5% global pop) and is Europe undertesting?

 - A quick skim suggests that as of mid-August 2022, USA has about 14,000 confirmed cases and Europe about 16,000.  Total US population is about 330M and EU about 450M. **Therefore the difference in per capita monkeypox cases in US/EU is not large**. It is that these two areas have most of the recorded cases.
 - Moving away from statistics and into operational details: we know the US testing regime has not been very good for the standard US reasons of the disseminated health care system with weak federal control and sproadic public health funding at the local level.  So it is highly unlikely that the US is testing significantly better than other OECD nations.
 - It is true that the USA and Europe have recorded disproportionate monkeypox cases compared to their population vs rest of world.  This might be due to higher traffic with the source region, or that MSM social networks are relatively larger and stronger in US/EU and that is the primary spreading method right now, or it might be better testing, or a combination of all of the above.

Overall we don't know for certain why US/EU have most of the cases right now (or even if that's superficial observation is true), but we have a few guesses.