The head of the World Health Organization said on Saturday that the monkeypox outbreak is a major emerging threat but does not currently constitute a global health emergency.
WHO Director-General Tedros Adhanom Ghebreyesus convened a committee of experts on Thursday to advise him on whether to sound the UN health agency’s alarm over the outbreak.
A surge in cases of monkeypox has been reported since early May outside West and Central Africa, where the disease has long been endemic.
Most of the new cases were in Western Europe. More than 3,200 confirmed cases and one death have been reported to WHO this year from over 50 countries.
“The Emergency Situations Committee has expressed serious concern about the scale and speed of the current outbreak,” Mr Tedros said, noting many unknowns about the spread and data gaps.
“They informed me that this event does not currently constitute a Public Health Emergency of International Concern (PHEIC), which is the WHO’s highest level of alert, but acknowledged that the very convening of the committee reflects growing concern about the international spread of simian smallpox.”
Mr Tedros said the outbreak is a “clearly evolving health threat” that requires immediate action to stop further spread using surveillance, contact tracing, isolation and patient care, and making vaccines and treatments available to groups risk.
“Intense Response” Needed
“The vast majority of cases occur among men who have sex with men at a young age,” mostly in urban areas, in “clustered social and sexual networks,” the WHO report from the meeting said.
Although several members expressed differing views, the committee decided by consensus to advise Mr Tedros that the outbreak was not a PHEIC at this stage.
“However, the committee unanimously recognized the extraordinary nature of the event and that controlling the further spread of the outbreak requires an intensive response.”
They are on standby to reassemble in the coming days and weeks depending on how the outbreak develops. The Committee recommended that countries improve diagnosis and risk communication.
He noted that many aspects of the outbreak were unusual, while some members suggested that there was a risk of sustained transmission due to low levels of population immunity against smallpox virus infection.
The committee that considered this issue is made up of 16 scientists and public health experts and is chaired by Jean-Marie Okwo-Bele, former director of WHO’s Department of Vaccines and Immunization.
Thursday’s five-hour private meeting was held in person at WHO headquarters in Geneva and via videoconference.
The committee discussed current observations of stabilization or a potential downward trend in the number of cases in some countries; contact tracing difficulties due to anonymous contacts, and “potential links to international LGBTQI+ Pride gatherings and events to help increase opportunities for exposure through intimate sexual encounters.”
They were also concerned that the potential stigmatization of affected groups could hinder response efforts.
According to them, there are gaps in knowledge about the routes of transmission, the infectious period, as well as access to vaccines and antiviral drugs and their effectiveness.
Normal initial symptoms of monkeypox include high fever, swollen lymph nodes, and a blister-like rash that resembles chickenpox.
The initial outbreaks were not epidemiologically linked to areas where monkeypox has historically been reported, suggesting that undetected transmission may have continued for some time.
To date, several people have been hospitalized, and 10 cases have been reported among healthcare workers.
The current WHO containment plan aims to raise awareness among affected populations and encourage safe behavior and protective measures.
There have been six PHEIC statements since 2009, the most recent being for COVID-19 in 2020, although the lackluster global response to the wake-up call is still worrisome at WHO headquarters.
The PHEIC was declared after the third meeting of the emergency committee on 30 January. But it wasn’t until March 11, when Mr Tedros called the rapidly deteriorating situation a pandemic, that many countries seemed to realize the danger.