The World Health Organization warned on Friday that urgent measures are needed to contain the spread of monkeypox in Europe, as cases have tripled in the past two weeks.
According to the WHO, Europe is the center of a global outbreak of the virus with 90% of confirmed cases of monkeypox there. New infections have tripled since June 15 with 4,500 confirmed cases in 31 European nations.
Henri Kluge, the head of WHO in Europe, called on governments to intensify efforts to prevent monkeypox from settling on the continent, warning that time is of the essence.
“Urgent and coordinated action is essential if we are to turn a corner in the race to reverse the spread of this disease,” Kluge said.
The World Health Organization on Saturday refused to declare the monkey’s smallpox a public health emergency of international interest, its highest alert level. However, the head of WHO, Tedros Adhanom Ghebreyesus, said smallpox of the monkey is an evolving health threat. Tedros called on governments to intensify surveillance, contact tracing and ensure that people at high risk have access to vaccines and antivirals.
Kluge said the WHO will likely reconsider whether smallpox is a global health emergency soon, given the “rapid evolution and emergency nature of the event.” He said 99% of monkeypox patients in Europe are men between 21 and 40 years old. Most patients who provided demographic information identified themselves as men who have sex with men, he said.
Smallpox smallpox is spread mainly through close physical contact with much of the transmission in the current outbreak that occurs through sex. However, a small number of cases have now been reported in which patients did not catch the virus during sexual contact, Kluge said. Relatives of infected individuals, heterosexual contacts and children have also infected the virus, he said.
Among patients where information about their condition was available, nearly 10 percent were hospitalized for treatment or isolation and one patient ended up in an intensive care unit, Kluge said. No one in Europe has died so far from the virus, he said.
“There is simply no room for complacency, especially here in the European region with its rapid outbreak that with every hour, day and week is extending its reach to previously unaffected areas,” Kluge said.
The stigmatization of men who have sex with men in some countries has made it difficult to get a full picture of the outbreak, Kluge said. Some people with monkeypox symptoms may avoid going to health care professionals for a diagnosis because they are afraid of the consequences if someone finds out they are gay or bisexual, Kluge said. However, clearly communicating the reality of the current outbreak is also crucial, he added.
“We know from our lessons about HIV treatment how stigma further fuels outbreaks and epidemics, but allowing our fear of creating stigma to prevent us from acting can be just as damaging,” Kluge said.
Kluge said public health authorities in Europe need to quickly step up surveillance for monkeypox and its ability to diagnose the disease and sequence samples. Contacts from people who have monkeypox to stop spreading should also be quickly identified, he said.
Public health authorities also need to spread the word among high-risk communities and the general public about what precautions to take when attending mass meetings this summer, Kluge said. And vaccines should be distributed equitably by focusing on those most at risk, he added.
Monkeypox is spread mainly through close physical contact with an infected person or contaminated material, such as shared clothing or sheets. The virus can spread through the respiratory droplets if an infected person has lesions in the throat or mouth. This requires, however, sustained face-to-face contact. Monkeypox is not thought to spread through aerosol particles such as Covid-19.
Respiratory drops fall to the ground quickly, while aerosol particles get lost in the air over 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 specific medical treatment.
Monkeypox often begins with flu-like symptoms such as fever, headache, high throat, body aches, chills, exhaustion, diarrhea, and swollen lymph nodes. Then a rash appears that looks like pimples or blisters on the body. People are more infectious when they have the rash.
Kluge said the vast majority of patients in Europe had a rash and about three-quarters reported flu-like symptoms.
Some patients in the current outbreak have developed a rash only in the genitals or anus before showing flu-like symptoms, according to the U.S. Centers for Disease Control and Prevention. In other cases, patients developed the rash without any flu-like symptoms.