Triple case in Europe, urgent action needed to contain spread

The World Health Organization warned on Friday that urgent action is needed to contain the spread of monkeypox in Europe as the number of cases has tripled in the past two weeks.

Europe is the center of the global outbreak of the virus, with 90% of confirmed monkeypox cases reported by the WHO. Since June 15, the number of new infections has tripled, with 4,500 confirmed cases in 31 European countries.

Henri Kluge, head of the WHO in Europe, urged governments to step up efforts to prevent the spread of monkeypox on the continent, warning that time is of the essence.

“Urgent and coordinated action is needed if we are to turn the tide of the race and reverse the ongoing spread of this disease,” Kluge said.

World Health Organization on Saturday refused to declare monkeypox a public health emergency of international concern., the highest warning level. However, WHO chief Tedros Adhanom Ghebreyesus said monkeypox was a growing health threat. Tedros urged governments to step up surveillance, trace contacts and ensure that people in high-risk groups have access to vaccines and antivirals.

Kluge said the WHO would likely soon reconsider whether monkeypox is a global health emergency, given the “rapid evolution and extraordinary nature of the event.” He said that 99% of monkeypox patients in Europe are men between the ages of 21 and 40. Most patients who provided demographic information identified themselves as men who have sex with men, he said.

Monkeypox is primarily spread through close physical contact, with most of the transmission in the current outbreak occurring through sexual contact. However, a small number of cases have now been reported in which patients did not contract the virus during sexual contact, Kluge said. According to him, family members of those infected, heterosexual contacts, and children also became infected.

Of the patients who had information about their condition available, Kluge said, nearly 10% were admitted to hospital for treatment or isolation, and one patient ended up in the intensive care unit. No one has yet died from the virus in Europe, he said.

“There is no room for complacency – especially here in the European Region, where the outbreak is rapidly spreading, with every hour, day and week spreading to previously unaffected areas,” Kluge said.

The stigmatization of men who have sex with men in some countries makes it difficult to get a full picture of the outbreak, Kluge said. Some people with monkeypox symptoms may avoid going to healthcare providers for a diagnosis because they fear the consequences if someone finds out they are gay or bisexual, Kluge said. However, he added that communicating clearly about the reality of the current outbreak is also critical.

“We know from our HIV lessons how stigma further fuels outbreaks and epidemics, but letting our fear of stigma stop us from acting can be just as devastating,” Kluge said.

Kluge said public health authorities in Europe must rapidly strengthen monkeypox surveillance and their ability to diagnose the disease and sequence specimens. It also needs to quickly identify contacts of people infected with monkeypox to stop the spread, he said.

Public health authorities also need to educate high-risk communities and the general public about the precautions to take when attending mass gatherings this summer, Kluge said. He added that vaccines need to be distributed fairly, with particular attention to those most at risk.

Monkeypox is primarily spread through close physical contact with an infected person or through contaminated materials such as shared clothing or sheets. The virus can be spread through the air if an infected person has lesions in their throat or mouth. However, this requires constant face-to-face contact. Monkeypox is not believed to be spread through aerosol particles such as Covid-19.

Respiratory droplets fall to the ground quickly, and aerosol particles linger in the air for a longer period of time, which is one of the reasons Covid is so contagious.

Monkeypox belongs to the same family of viruses as smallpox, but has milder symptoms. Most people recover in two to four weeks without special treatment.

Monkeypox often begins with flu-like symptoms such as fever, headache, sore throat, body aches, chills, exhaustion, diarrhea, and swollen lymph nodes. Then a rash appears on the body that looks like pimples or blisters. People are most contagious when they have a rash.

Kluge said the vast majority of patients in Europe had a rash, and about three-quarters reported flu-like symptoms.

According to the U.S. Centers for Disease Control and Prevention, some patients during the current outbreak only developed a rash on their genitals or anus before they developed any flu-like symptoms. In other cases, patients developed a rash without any flu-like symptoms at all.