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The World Health Organization has activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.
The rare designation means the WHO now considers the outbreak a significant enough threat to global health that a coordinated international response is needed to prevent the virus from spreading further and potentially escalating into a pandemic.
While the declaration does not impose requirements on national governments, it serves as an urgent call to action. WHO can only issue guidance and recommendations to its member states, not mandates. Member states must report events that pose a threat to global health.
The United Nations agency last month declined to declare a global emergency in response to monkeypox. But infections have risen substantially in recent weeks, prompting WHO chief Tedros Adhanom Ghebreyesus to issue the highest alert.
More than 16,000 cases of monkeypox have been reported in 75 countries so far this year, and the number of confirmed infections rose 77% from late June to early July, according to data from the WHO. Men who have sex with men are currently at the highest risk of infection.
Five deaths from the virus have been reported in Africa this year. So far, no deaths have been reported outside of Africa.
Most people recover from monkeypox in two to four weeks, according to the US Centers for Disease Control and Prevention. The virus causes a rash that can spread all over the body. People who have contracted the virus said the rash, which looks like pimples or blisters, can be very painful.
The current outbreak of monkeypox is highly unusual in that it is spreading widely in North American and European nations where the virus is not normally found. Historically, monkeypox has spread at low levels in remote parts of West and Central Africa, where rodents and other animals carried the virus.
Europe is currently the global epicenter of the outbreak, accounting for more than 80% of confirmed infections worldwide in 2022. The US has reported more than 2,000 cases in 43 states, Washington, DC and Puerto Rico.
In early May, the United Kingdom reported a case of smallpox in a person who recently returned from a trip to Nigeria. Several days later, the United Kingdom reported three more cases of monkeypox in people who appeared to have been infected locally. Other European nations, Canada and the United States also began to confirm cases. It is unclear where the outbreak actually began.
The WHO last issued a global health emergency in January 2020 in response to the Covid-19 outbreak and declared it a pandemic two months later. The WHO has no official process for declaring a pandemic under its organizational laws, meaning the term is loosely defined. In 2020, the agency declared Covid a pandemic in an effort to warn complacent governments about the “alarming levels of spread and severity” of the virus.
The WHO’s leading expert on monkeypox, Dr Rosamund Lewis, told reporters in May that the UN health agency was not concerned about monkeypox causing a global pandemic. He said public health authorities had a window of opportunity to contain the outbreak.
But infectious disease experts are concerned that health authorities have failed to contain the outbreak and that monkeypox will take permanent root in countries where the virus has not previously been found, except for isolated travel-related cases.
Monkeypox is not a new virus
Unlike Covid-19, monkeypox is not a new virus. Scientists first discovered monkeypox in 1958 in captive monkeys used for research in Denmark and confirmed the first case of a human infected with the virus in 1970 in the nation of Zaire, now called the Republic Democratic Republic of the Congo.
Monkeypox belongs to the same family of viruses as smallpox, although it causes a milder illness. WHO and national health agencies have decades of experience in the fight against smallpox, which was declared eradicated in 1980. The success of the fight against smallpox and the tools developed against it will provide officials with health workers important knowledge to fight smallpox.
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Transmission of monkeypox between people was relatively rare in the past, and the virus usually passed from animals to humans. But monkeypox is now spreading more efficiently between people. The WHO has said that the international community did not invest enough resources in the fight against monkeypox in Africa before the global outbreak.
“This transmission has occurred in African countries in two particular areas for a large number of years, and we don’t fully understand what is driving the transmission in those countries,” said Dr. Mike Ryan, head of the emergency program health of the WHO. “There’s a lot more research to be done and a lot more investment to understand this problem.”
Gay and bisexual men at higher risk
Monkey pox is spread primarily through skin-to-skin contact during sex. Men who have sex with men are at the highest risk right now, as most transmission has occurred in the gay community. However, WHO and CDC have emphasized that anyone can catch monkey pox regardless of sexual orientation.
Lewis, the WHO monkeypox expert, said 99% of reported cases outside Africa are among men and 98% of infections occur among men who have sex with men, mainly those who have had multiple anonymous or new recent sexual partners. The virus has been detected outside the gay community, but transmission has been low so far. The CDC confirmed chicken pox in two children on Friday.
The WHO and CDC have repeatedly warned against stigmatizing gay and bisexual men, while stressing the importance of communicating the reality of how the virus is currently spreading so that people in the most at-risk communities can take steps to protect your health.
“People want information to know how to protect themselves, under what circumstances people might be at risk or infected,” Lewis said. It’s crucial that health agencies and community organizers widely disseminate information about how to reduce the risk of infection ahead of this summer’s major celebrations and festivals, he said.
Scientists in Spain and Italy detected monkeypox virus DNA in the semen of positive patients, although it remains unclear whether the virus can be spread through semen during sex. Spanish scientists also detected monkeypox DNA in saliva samples.
It is also unclear whether the virus can spread when people are infected but have no symptoms, known as asymptomatic transmission.
Symptoms and risk factors
The US CDC recommends that people avoid intimate physical contact with people who have a rash that resembles monkeypox and consider minimizing sex with multiple or anonymous partners. People should also consider avoiding sex parties or other events where people don’t wear a lot of clothing.
According to the health agency, people who decide to have sex with a partner who has monkeypox should follow CDC guidelines to reduce their risk.
In the past, monkeypox usually started with flu-like symptoms, including fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. The disease then developed into a rash that can spread all over the body. Patients are considered more infectious when the rash develops.
But in the current outbreak the symptoms have been atypical. Some people develop a rash first, while others show a rash without any flu-like symptoms. Many patients have developed a localized rash on the genitals and anus.
The CDC and WHO have said the rash is easily mistaken for common sexually transmitted diseases. Health care providers have been told they should not rule out monkeypox just because a patient tests positive for a sexually transmitted disease.
Although monkeypox can be spread through respiratory droplets, this method requires prolonged face-to-face interaction, according to the CDC. Health officials do not believe that monkeypox is spreading through small aerosol particles like Covid. Respiratory droplets are heavier, so they don’t stay in the air as long, while Covid is an airborne virus, which is one of the reasons it’s so contagious.
Monkey pox can also be spread by contact with contaminated materials, such as bed linen and clothing.
“This disease is communicable, but it’s not that communicable. It’s a disease where transmission can be contained,” Ryan said. “As we said in Covid, don’t be the person who transmits this disease.”
vaccines
Because monkeypox is not a new virus, there are already vaccines and antivirals to prevent and treat the disease it causes, although they are scarce. The United States is already distributing tens of thousands of doses of a vaccine called Jynneos in an effort to quell the outbreak. The Food and Drug Administration approved the two-dose vaccine in 2019 for adults 18 and older who are at high risk for chickenpox or chickenpox.
The Biden administration has distributed more than 300,000 doses of Jynneos to states and cities since May, and another 786,000 doses are being delivered in the US. The Department of Health and Human Services has requested 5 million more doses through 2023.
CDC Director Dr. Rochelle Walensky said demand for monkeypox vaccines is outstripping the supply available in the US, leading to long lines in places like New York City, an epicenter of the outbreak .
Jynneos is manufactured by Bavarian Nordic, a biotechnology company based in Denmark. OK, Bavarian Nordic now has up to 5 million doses available for the rest of the world, excluding the US, a company spokesperson said. But Bavarian Nordic has the capacity to fill 40 million frozen liquids and 8 million freeze-dried doses a year, the spokesman said.
The US also has more than 100 million doses of an older-generation smallpox vaccine called ACAM2000, made by Emergent…