The WHO says monkeypox is not a global public health emergency

The World Health Organization said on Saturday that the global monkeypox epidemic is not currently a public health emergency of international importance.

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

“The Emergency Committee has shared serious concerns about the scale and speed of the current epidemic,” WHO Director-General Tedros Adhanom Gebreyesus said in a statement.

“Overall, the report advised me that at this point, the event is not an emergency for public health of international importance, which is the highest level of concern that the WHO can issue,” he added.

The WHO said in another statement that the director general agreed with the commission’s board, although several members of the commission “expressed different views”.

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

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

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

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

The Director-General of the World Health Organization, Tedros Adanom Gebrejesus, at a press conference at the WHO headquarters in December 2021 in Geneva. Fabrice Coffrini / AFP via Getty Images file

“The Commission noted that many aspects of the current epidemic in several countries are unusual, such as the occurrence of cases in countries where the circulation of the monkeypox virus has not been previously documented, and the fact that the majority of cases occur. among men who have sex with young men, “the WHO said on Saturday.

Some members of the commission said there was a risk of “further, prolonged transmission to the general population”, the WHO added, given the low levels of immunity of the population.

Tedros said the commission could meet again “in the coming days and weeks” depending on how the outbreak develops. The Committee recommended that the outbreak be re-examined in a few weeks in order to observe major changes, such as a significant increase in the number of cases or evidence of a more severe or transmissible disease.

What do 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. Last week, Tedros said 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 in the recent outbreak, many people “present with atypical symptoms”, including a localized rash with only one lesion.

Traditionally, patients with monkeypox develop flu-like symptoms such as fever and body aches, followed by a widespread rash, including on the face, hands and arms. But some recent patients report small bumps that look like a pimple or blister as the first or only symptom. Some patients develop flu-like symptoms later, while others do not.

Many recent cases have developed rashes around the genitals or anus, along with painful, swollen lymph nodes. CDC officials said last week that some patients in the United States reported pain in or around the anus and rectum, rectal bleeding, inflammation of the lining of the rectum, or a feeling that they needed bowel movements even though their bowels were empty.

Cases of monkeypox can look like chickenpox, herpes, or syphilis, so the CDC recommends that anyone who develops symptoms associated with these diseases be screened for monkeypox.

The virus appears to be spread mainly through sexual activity among 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 lesions or rashes, as well as through respiratory droplets and contaminated items such as 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 the affected groups, which will further hamper response efforts.”

What vaccines and treatments are there?

Smallpox and smallpox are orthopoxviruses, so smallpox vaccines can be used to prevent smallpox. In particular, an injection called Jynneos is specifically approved for use against monkeypox in Canada and the United States and is approved for off-label use in Europe.

The WHO does not currently recommend mass vaccination against monkeypox. Instead, he advises states 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 opened a clinic on Thursday to vaccinate people who may have recently been exposed to monkeypox, including any gay, bisexual or other men who have sex with men “who have had multiple or anonymous sexual partners in the past 14 years.” days “. UK health officials also said earlier this week that doctors there could consider vaccinating some gay or bisexual men who are at higher risk of exposure, including men with multiple partners or who engage in group sex. .

“By extending the supply of vaccines to those at higher risk, we hope to break the transmission chain and help control the outbreak,” said Dr Mary Ramsey, head of immunization at the Health Security Agency. United Kingdom.

Doctors can also use antiviral drugs against smallpox and supportive care for monkeypox patients. Symptoms usually resolve after two to four weeks, although the lesions may leave scars.

The WHO advises infected people to isolate themselves until the scabs from any lesions “fall off and a new layer of skin forms.” He also recommended the use of condoms “to reduce the potential transmission of monkeypox, the risk of which is not yet known.”

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