Monkeypox classed as a global public health emergency

GENEVA — The World Health Organization has declared that the multicountry monkeypox outbreak outside the traditional endemic areas in Africa has turned into a public health emergency of international concern.

After reconvening the WHO Emergency Committee on Thursday concerning the outbreak, the WHO Director-General, Tedros Adhanom Ghebreyesus, announced the decision on Saturday to sound the highest level of alert that the global health authority can issue for the time being, even without a consensus of the committee.

“So in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations,” Tedros said.

“For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern.”

He gave five reasons for the decision. First, the information provided by countries shows that the virus has spread rapidly to many countries in which it has not appeared before; second, the three criteria for declaring a public health emergency of international concern under the International Health Regulations have been met; third, the advice of the Emergency Committee, even without a consensus; fourth, scientific principles, evidence and other information that are insufficient and leave many unknowns; and fifth, the risk to human health, international spread, and the potential for interference with international traffic.

Tedros first convened the WHO Emergency Committee late last month, after which the latter advised him that the event had not constituted a public health emergency of international concern. The outbreak has continued to grow, with more than 16,000 cases in 75 countries and territories reported to the WHO, including five deaths, Tedros said on Saturday.

Many clusters of the monkeypox virus have been reported within the past few weeks in several European countries and North America, which are regions where the virus is not normally found.

Endemic monkeypox disease is normally geographically limited to West and Central Africa, the WHO has said. The identification of confirmed and suspected cases of monkeypox without any travel history to an endemic area in multiple countries is atypical.

Viral infection

Monkeypox, a viral infection resembling smallpox and first detected in humans in 1970, is less dangerous and contagious than smallpox, which was eradicated in 1980.

The European Union’s drug watchdog on Friday recommended for approval the use of Imvanex, a smallpox vaccine, to treat monkeypox. The vaccine, developed by the Danish drugmaker Bavarian Nordic, has been approved in the EU since 2013 for the prevention of smallpox.

It was also considered a potential vaccine for monkeypox because of the similarity between the monkeypox virus and the smallpox virus.

The first symptoms of monkeypox are fever, headaches, muscle pain and back pain over five days.

Rashes subsequently appear on the face, the palms of hands and the soles of the feet, followed by lesions, spots and finally scabs.

The United States may see more cases of monkeypox before the numbers go down, Director of the Centers for Disease Control and Prevention Rochelle Walensky said on Friday. “With the scale-up of testing, with the scale-up of information, we anticipate that there will be more cases before there are less,” Walensky told The Washington Post.

The director noted that the United States on Friday detected two monkeypox cases in children for the first time. The two cases are unrelated and are probably the result of household transmission, the CDC said in a statement.

India reported the fourth monkeypox case, and the first case in the capital New Delhi, on Sunday. The first three cases were reported from the state of Kerala on July 14, July 18 and July 22.