WHO observes global emergence of monkeypox; cases are increasing in Great Britain, elsewhere in Europe

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LONDON – The World Health Organization is considering whether to declare monkeypox an international emergency, a decision that could come as early as Friday. A declaration could escalate the global response as cases increase rapidly in Britain despite efforts to contain it. Britain, where nearly 800 cases of the virus have been recorded in the past month, has the highest number of infections reported outside of Central and West Africa – and case trends here are troubling experts across Europe, epicenter of the outbreak, which are considering the best approach in the midst of the long-standing coronavirus pandemic.

Cases of monkeypox have increased by nearly 40% in Britain in less than five days, according to data shared by the UK’s Health Safety Agency. As of June 16, 574 cases had been registered and by June 20 the number had risen to 793.

After Great Britain, Spain, Germany and Portugal have the most registered cases. And it’s a growing threat outside of Europe: More than 3,200 cases have been confirmed in 48 countries in the past six weeks, according to WHO, which publishes data on monkeypox at weekly intervals. As of June 15, one death had been reported.

The WHO Emergency Committee on International Health Regulations met on Thursday to discuss whether the monkeypox outbreak should be labeled a “Public Health Emergency of International Concern,” which would mobilize new funding and spur governments to act. The new coronavirus, which causes covid-19, was tagged as a PHEIC following a similar encounter in January 2020.

The monkeypox response in the United States mirrors the first missteps of the coronavirus, experts say

So far, the response in most European countries has been to focus on raising awareness of at-risk communities, contact tracing and isolation for known cases of monkeypox. That could change if WHO, which first raised the alarm about monkeypox infections in countries where the virus is not endemic in May, raises the threat level of the outbreak.

“The emergency committee and then the [WHO] The CEO’s announcement will raise the political level of this, “David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine who attended the meeting as a consultant, told the Washington Post.

The United States will expand monkeypox testing in commercial laboratories as the outbreak escalates

Monkeypox is spread through close contact and has so far mainly affected men who have sex with men. It starts with flu-like symptoms before lumps or fluid-filled lesions appear on the skin, which can leave permanent scars. Health officials say the latest outbreak often resulted in genital rashes, and although most cases are mild and patients recover within three weeks, the virus can be fatal and is more of a risk for people who are pregnant or with a weakened immune system.

To contain the outbreak, a broader understanding of its origins along with vaccination of at-risk groups and contact tracing is imperative, experts say, although they note that some patients may not want to divulge information about who they have been intimate with, the which can complicate the public health response.

“One of the difficulties people face in implementing control is actually getting a complete list of people’s sexual contacts,” said Paul Hunter, a professor of medicine at the University of East Anglia. “It is exactly the problem we faced when we first dealt with HIV / AIDS [1990s]. “

And, as in the early days of the coronavirus outbreak, it’s unclear whether cases in some countries are not being detected. Some experts speculate that Britain may have higher numbers because its vast public health surveillance network allows it to identify more infections.

WHO Director-General Tedros Adhanom Ghebreyesus acknowledged early in Thursday’s meeting that monkeypox is likely more prevalent than official numbers indicate. “Person-to-person transmission is ongoing and is probably underestimated,” he told members of the emergency committee.

The UK proactively monitored people with known cases of monkeypox and, in some cases, distributed smallpox vaccines, known to protect against monkeypox infection, to their close contacts and groups at risk. In theory, this approach – which Hunter described as “ring vaccination” – “should have worked,” he said.

But as infections escalated and authorities struggled to “track case contacts early enough to have an impact,” Hunter said he had become “less confident.”

“Unless we turn the corner on this very soon, I think we will probably have to start thinking about what’s going to happen,” he added.

Biden: US explores monkeypox vaccines; ‘everyone’ should be worried

British health officials said Tuesday that some gay and bisexual men, considered to be at higher risk of exposure, will be offered vaccines to help curb the monkeypox outbreak. The UK Health Security Agency stressed that although the virus is more of a threat “in the sexual networks of gays, bisexuals and other men who have sex with men”, anyone can contract the disease through close contact with an infected individual.

Scientists are studying this outbreak and will know more once the virus is sequenced. “We are beginning to understand how widespread it is [monkeypox] it really is, “Heymann said.” We know it is widespread in some populations and we need to know if it is spreading to other populations as well.

What is monkeypox, the rare virus now confirmed in the US and Europe?

Two years after treating the first German coronavirus patient, Clemens Wendtner treated the first German monkeypox patient in May. The man, who has not been identified, was a Brazilian prostitute, said Wendtner, chief of infectious diseases at Munich’s Schwabing clinic.

A handful of other monkeypox patients have been treated in his ward in recent weeks, Wendtner said. Some have reported “very painful” rectal lesions, for which painkillers are given intravenously to relieve discomfort. Wendtner and his colleagues closely recorded their findings during this outbreak, recently documenting their discovery of monkeypox virus DNA in both sperm and blood.

Most of the patients were discharged after about a day and were advised to isolate themselves for 21 days at home, in line with the German infectious disease law. Most of the cases have been reported in Berlin, one of the party hotspots in Europe, which will host Pride events next month.

“Summer season is holiday season,” he warned, adding that more cases are likely in the coming week and that the current epidemic may not have peaked yet.

While men are significantly more at risk, Wendtner warned that sex workers could also be in danger. “The risk factor is a pattern of unprotected sex,” she explained.

WHO to rename monkeypox after scientists call it “discriminatory”

Outside of Europe, other countries are also grappling with new cases.

The first case of monkeypox in the United States was detected on May 17. More than 100 cases have been added in the past five weeks, according to data from the Centers for Disease Control and Prevention. California, New York, and Illinois are listed as the states with the highest level of infection.

Some experts in the United States are calling on the White House to implement thorough testing to avoid the failures of the coronavirus pandemic.

Singapore confirmed on Tuesday a case of monkeypox in a British man, the first in Southeast Asia. South Korea also confirmed its first case of monkeypox on Wednesday. The patient is a South Korean citizen who entered the country from Germany, health officials said. On Thursday, South Africa also announced its first case of monkeypox, Reuters reported. The 30-year-old has no travel history, health experts said, meaning his illness would not have been contracted outside of South Africa.

It is important to remember, experts say, that this is not a new disease. Monkeypox has been around in Africa for decades, leading some to stress a double standard in the response to the epidemic in Europe.

“This is a disease that has been neglected,” Heymann said. After smallpox was eradicated in 1980, the world stopped giving smallpox vaccines as a matter of routine. Monkeypox, which is less contagious than smallpox, has continued to spread in West and Central Africa, but the outbreaks have not been thoroughly researched due to a lack of resources, she added.

As the monkeypox panic spreads, doctors in Africa see a double standard

WHO’s Tedros said Thursday that nearly 1,500 suspected cases of monkeypox and about 70 deaths have been reported in Central Africa this year. “Although the epidemiology and the viral clade in these cases may be different, it is a situation that cannot be ignored,” she warned.

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