African Reserves

WHO declares monkeypox a public health emergency

The World Health Organization announced on Saturday that the global outbreak of monkeypox does not currently constitute a public health emergency of international concern.

The WHO convened an emergency committee on Thursday to discuss whether the designation, which has only been given to six outbreaks since 2007, was appropriate for monkeypox.

“The emergency committee shared serious concerns about the scale and speed of the current outbreak,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement.

“Overall, in the report, they informed me that at this time the event does not constitute a public health emergency of international concern, which is the highest level of alert WHO can issue” , he added.

The WHO said in a separate statement that the director-general agreed with the committee’s advice, although a few committee members “expressed different views”.

The WHO reserves this type of emergency alert for “serious, sudden, unusual or unexpected” events that pose a health risk to more than one country and may require an immediate and coordinated international response. The organization has previously given the designation to Covid-19, as well as Ebola, Zika, H1N1 flu and poliomyelitis.

More than 4,000 cases of monkeypox have been reported worldwide in 47 countries and territories since the start of May, according to the Centers for Disease Control and Prevention. The United States alone had recorded more than 200 cases in 25 states and Washington, DC as of Friday.

Previously, monkeypox was largely confined to Africa, where it is endemic in 11 countries. Most monkeypox infections have been recorded in the Democratic Republic of Congo, which recorded more than 1,200 cases from January to May, according to the WHO.

The version of the virus that spreads internationally, the West African strain, has a mortality rate of 1%. No deaths outside of Africa have been reported in connection with the current outbreak. The other, the Congo Basin strain, has a mortality rate of 10%.

World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus during a press conference at WHO headquarters in December 2021 in Geneva. Fabrice Coffrini / AFP via Getty Images file

“The committee noted that many aspects of the current outbreak in several countries are unusual, such as the occurrence of cases in countries where monkeypox virus circulation had not previously been documented, and the fact that the vast majority cases are seen in men who have sex with men at a young age,” the WHO said on Saturday.

Some committee members said there was a risk of “additional and sustained transmission in the wider population”, the WHO added, given low levels of population immunity.

Tedros said the committee could meet again “in the coming days and weeks” depending on how the outbreak evolves. The committee recommended reviewing the outbreak in a few weeks to observe any major changes, such as a significant increase in the number of cases or evidence of a more severe or communicable disease.

What the Symptoms of Monkeypox Look Like

The name monkeypox is misleading: although the virus was first discovered in laboratory monkeys in Denmark in 1958, it is much more common in small rodents.

Earlier this month, an international group of scientists called for the virus to be renamed to avoid discriminatory associations. Tedros said last week that the WHO was working with experts to change the name of the virus, its strains and the disease it causes.

The organization also said that during the recent outbreak, many people were “showing atypical symptoms”, including a localized rash with as little as a lesion.

Traditionally, patients with monkeypox have developed flu-like symptoms such as fever and body aches, followed by a generalized rash, especially on the face, arms and hands. But some recent patients have reported tiny bumps that look like a pimple or blister as their first or only symptom. Some patients later develop flu-like symptoms, others do not.

Many recent cases have developed rashes around the genitals or anus, as well as painful and swollen lymph nodes. CDC officials said last week that some US patients have reported pain in or around the anus and rectum, rectal bleeding, inflammation of the lining of the rectum, or the feeling of needing to go to stool even if the intestines are empty.

Cases of monkeypox can resemble chickenpox, herpes, or syphilis. The CDC therefore recommends that anyone who develops symptoms associated with these illnesses get tested for monkeypox.

The virus appears to be spread primarily through sexual activity in men who have sex with men, but some cases have been reported in women. Anyone who has close physical contact with an infected person’s sores or rashes, as well as through respiratory droplets and contaminated items like clothing or bedding, can become infected.

The WHO said on Saturday that the emergency committee was concerned about “the rights to privacy, non-discrimination, physical and mental health of affected population groups, which would further hamper response efforts”. .

What vaccines and treatments are available?

Both monkeypox and smallpox are orthopoxviruses, so smallpox vaccines can be used to prevent monkeypox. One vaccine in particular, called Jynneos, is specifically approved for use against monkeypox in Canada and the United States, and has been approved for off-label use against the disease in Europe.

WHO does not recommend mass vaccination against monkeypox at this time. Instead, it advises countries to vaccinate close contacts of infected people, ideally within four days of exposure, which can prevent the onset of symptoms and disease. The WHO also recommends vaccines for healthcare workers who have been exposed to monkeypox and laboratory personnel who perform diagnostic tests for the virus.

New York City opened a clinic on Thursday to vaccinate people who may have recently been exposed to monkeypox, including all gay, bisexual or other men who have sex with men “who have had multiple sexual partners or anonymous in the last 14 days”. British health officials also said earlier this week that doctors there may consider vaccinating certain gay or bisexual men who are at higher risk of exposure, including men with multiple partners or who participate in sex parties. group sex.

“By expanding the supply of vaccines to those most at risk, we hope to break the chains of transmission and help contain the outbreak,” said Dr Mary Ramsay, Head of Immunization at the UK Health Security Agency. , in a press release.

Doctors may also give smallpox antivirals and supportive care to patients with monkeypox. Symptoms usually disappear after two to four weeks, although the lesions may leave scars.

The WHO advises those infected to self-isolate until the scabs from any lesions “have fallen off and a new layer of skin has formed”. It also recommends using condoms “to reduce the potential transmission of monkeypox, the risk of which is not yet known.”