WHO declares monkeypox outbreak a global health emergency

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The World Health Organization has activated the highest level of alert for the growing monkeypox outbreak, declaring the virus a Public Health Emergency of International Concern.

The rare designation means that the outbreak is now considered by the WHO to be a serious enough threat to global health that a coordinated international response is needed to prevent the virus from spreading further and potentially becoming a pandemic.

While the declaration does not place demands on national governments, it does serve as an urgent call to action. WHO can only give guidance and advice to its Member States, not mandates. Member States are required to report events that pose a threat to global health.

UN agency refused last month to declare a global emergency in response to monkeypox. But over the past few weeks, the number of infections has risen significantly, prompting WHO chief Tedros Adhanom Ghebreyesus to issue the highest alert.

More than 16,000 cases of monkeypox have been reported in 75 countries this year, according to the WHO, and the number of confirmed infections rose by 77% from late June to early July. Men who have sex with men are currently at the greatest risk of infection.

Africa has recorded five deaths from the virus this year. So far, no deaths have been reported outside of Africa.

According to the US Centers for Disease Control and Prevention, most people recover from monkeypox within two to four weeks. The virus causes a rash that can spread throughout the body. People who have contracted the virus say that the rash, which looks like pimples or blisters, can be very painful.

The current outbreak of monkeypox is very unusual as it is spreading widely in countries in North America and Europe where the virus is not normally found. Historically, monkeypox spread in small numbers in remote areas of West and Central Africa, where the virus was carried by rodents and other animals.

Europe is currently the global epicenter of the outbreak, with more than 80% of confirmed cases worldwide in 2022. The US has more than 2,000 cases in 43 states, Washington, DC, and Puerto Rico.

In early May, the United Kingdom reported a case of monkeypox in a man who had recently returned from a trip to Nigeria. A few days later, the UK reported three more cases of monkeypox in humans, which appeared to have been infected locally. Then other European countries, Canada and the US also began to confirm cases. It is not clear where the outbreak actually started.

The last time WHO released global health emergency in January 2020 in response to the Covid-19 outbreak and two months later declared it a pandemic. The WHO does not have a formal process for declaring a pandemic under its organizational laws, meaning that the term has a vague definition. In 2020, the agency declared Covid a pandemic to alert complacent governments to the “alarming levels of spread and severity” of the virus.

WHO Leading Monkeypox Expert Dr. Rosamund Lewis told reporters in May that the UN health agency not concerned that monkeypox is causing a global pandemic. She said public health authorities had the ability to contain the outbreak.

But infectious disease experts are concerned that public health authorities have failed to contain the outbreak, and monkeypox will take root forever in countries where the virus has not previously been detected, except in isolated travel-related cases.

Monkeypox is not a new virus

Unlike Covid-19, monkeypox is not a new virus. Scientists first detected monkeypox in 1958 in captive monkeys used for research in Denmark and confirmed the first human case of the virus in 1970 in the country of Zaire, now called the Democratic Republic of the Congo.

Monkeypox belongs to the same family of viruses as smallpox, although it causes milder disease. WHO and national health agencies have many years of experience in dealing with smallpox, which was declared eradicated in 1980. Successful smallpox control and treatments developed against it will provide public health officials with important knowledge for monkeypox control.

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In the past, transmission of monkeypox between humans was relatively rare, and the virus was usually transmitted from animals to humans. But now, monkeypox spreads more efficiently between people. The WHO said the international community had not invested enough resources in fighting monkeypox in Africa prior to the global outbreak.

“This transmission has been occurring in African countries in two specific areas for a large number of years, and we do not fully understand what drives the transmission in these countries,” the doctor said. Mike Ryan, WHO Health Emergencies Program Manager. “There is much more research to be done and much more investment to be made to understand this problem.”

Gays and bisexuals are most at risk

Monkeypox is mainly spread through skin-to-skin contact during sex. Men who have sex with men are currently most at risk, as most of the transmission has occurred in the gay community. However, the WHO and CDC emphasize that anyone can contract monkeypox regardless of sexual orientation.

Lewis, a WHO expert on monkeypox, said 99% of cases reported outside of Africa are in men, and 98% of infections occur in men who have sex with men, primarily those who have had multiple, recent anonymous or new sexual partners. The virus has been found outside of the gay community, but transmission has been low so far. On Friday, the CDC confirmed the presence of monkeypox in two children.

The WHO and CDC have repeatedly warned against stigmatization of gay and bisexual men, while emphasizing the importance of being informed about how the virus is currently spreading so that people in communities at highest risk can take steps to protect their health.

“People want information to know how to protect themselves, under what circumstances people might be at risk or infected,” Lewis said. It is critical for health care providers and community organizers to widely disseminate information on how to reduce the risk of infection ahead of major holidays and festivals this summer, she said.

Scientists in Spain as well as Italy found monkeypox virus DNA in the semen of positive patients, although it is still unclear whether the virus can be spread through semen during sex. Spanish scientists also found monkeypox DNA in it. saliva samples.

It is also unclear whether the virus can be spread when people are infected but have no symptoms, which is known as asymptomatic transmission.

Symptoms and Risk Factors

The U.S. Centers for Disease Control and Prevention recommends that people avoid intimate physical contact with people who have monkeypox-like rashes and consider minimizing sexual contact with multiple or anonymous partners. People should also avoid sex parties or other events where people don’t wear a lot of clothes.

Individuals who choose to have sex with a partner with monkeypox should follow CDC risk reduction guidelinesaccording to the health agency.

In the past, monkeypox typically started with flu-like symptoms, including fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. The disease then develops into a rash that can spread throughout the body. Patients are considered most contagious when the rash appears.

But in the current outbreak, the symptoms were atypical. Some people develop a rash first, while others develop a rash without any flu-like symptoms at all. Many patients develop a local rash on the genitals and anus.

CDC and WHO say rashes are easy confused with common sexually transmitted diseases. They told health care providers that they should not rule out monkeypox just because a patient tested positive for a sexually transmitted disease.

Although monkeypox can be spread through the air, the method requires prolonged personal contact, according to the CDC. Health officials do not believe that monkeypox is spread through small aerosol particles like Covid. Respiratory droplets are heavier so they don’t stay in the air for as long, while Covid is an airborne virus, which is one of the reasons it’s contagious.

Monkeypox can also be spread by contact with contaminated materials such as sheets and clothing.

“This disease is contagious, but not that contagious. This is a disease in which transmission can be limited,” Ryan said. “As we said in Covid, don’t be a person transmitting this disease.”

Vaccine

Since monkeypox is not a new virus, vaccines and antiviral drugs already exist to prevent and treat the disease it causes, although they are in short supply. USA tens of thousands of doses already distributed or a vaccine called Jynneos to quell the outbreak. The Food and Drug Administration approved a two-dose vaccine in 2019 for adults aged 18 and over who are at high risk of contracting monkeypox or smallpox.

Since May, the Biden administration has distributed more than 300,000 doses of Jynneos to states and cities, with another 786,000 doses being delivered to the US. The Department of Health and Human Services has ordered 5 million more doses through 2023.

CDC Director Dr. Rochelle Walensky said demand for monkeypox vaccines exceeds available supply in the US, leading to long queues in places like New York City, the epicenter of the outbreak.

Jynneos is produced bavarian northern, a biotechnology company based in Denmark. Bavarian Nordic now has up to 5 million doses available to the rest of the world, excluding the US, according to a company spokesperson. But Bavarian Nordic is capable of producing 40 million frozen liquids and 8 million freeze-dried doses a year, the spokesman said.

There are also more than 100 million doses of the old-generation smallpox vaccine, ACAM2000, manufactured in the United States. Emergent biosolutions, which is also likely effective in preventing monkeypox. But ACAM2000 can have serious side effects and is not recommended for people with weak immune systems, including HIV patients, people with certain skin conditions, and pregnant women.

ACAM2000 uses a weak strain of a virus from the same family as monkeypox and smallpox to confer immunity. But the mild strain used in the vaccine can reproduce, meaning that people receiving ACAM2000 must take precautions to make sure they don’t pass the virus on to others or spread the rash from the injection site to other parts of the body. The Jynneos vaccine does not carry this risk because it does not use a replicating strain of the virus.

According to the CDC, there is no data yet on the effectiveness of monkeypox vaccines in the current outbreak.

WHO does not currently recommend mass vaccination, and the US currently reserves vaccines in its stockpile for people who have confirmed or suspect exposure to monkeypox. Unlike Covid, smallpox and monkeypox vaccines can be given after infection due to the long incubation period of the viruses. But according to the CDC, vaccines must be given within four days of exposure for the best chance of preventing the onset of the disease.