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WHO declares monkeypox a global emergency as spread continues

 Monkeypox virus particles obtained from a clinical sample associated with the 2003 prairie dog outbreak.
Cynthia S. Goldsmith, Russell Regnery
Monkeypox virus particles obtained from a clinical sample associated with the 2003 prairie dog outbreak.

The World Health Organization has declared monkeypox a public health emergency of international concern.

“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,” said WHO Director-General Tedros Adhanom Ghebreyesus on Saturday.

The risk of monkeypox, globally, is moderate, Tedros said, “except in the European region where we assess the risk as high.”

There is also a clear risk of further international spread. More than 16,000 cases of monkeypox have been confirmed in 74 countries so far. Nearly 3,000 cases have been confirmed in the U.S., touching all but a handful of states, according to the U.S. Centers for Disease Control and Prevention.

As of July 22, CDC data shows a wide range of confirmed cases across the Midwest and surrounding area. States with just a handful of cases include: Iowa, Ohio, Missouri, Nebraska, Kansas and Wisconsin. Indiana, Michigan and Minnesota have 31, 27 and 19 cases, respectively, and Illinois has more than 200 confirmed cases.

Tedros said he decided to declare monkeypox a public health emergency of international concern even though the WHO expert committee tasked with assessing the situation could not reach a consensus.

There are no deaths reported in the U.S. so far. But deaths have been reported in Nigeria and Congo, where a more dangerous version of the virus is circulating.

The CDC recommends that anyone with a rash that looks like monkeypox should speak with their health care provider, even if they don’t think they came in contact with an infected person. Anyone with active monkeypox symptoms should isolate at home in a separate room from others.

There are two vaccines licensed by the U.S. Food and Drug Administration to prevent monkeypox: JYNNEOS, also known as Imvamune or Imvanex, and ACAM2000. But supplies are limited. The U.S. Department of Health and Human Services says nearly 200,000 doses have been distributed in recent weeks.

These vaccines can protect people against monkeypox illness when received before or after a recent exposure, according to the CDC, although data is not yet available on the effectiveness of the vaccines in the current outbreak.

In a presentation in May by Dr. Rosamund Lewis, the WHO’s technical lead on monkeypox, said the disease is self-limiting and symptoms typically last two to four weeks. The incubation period is usually six to 13 days but can range from five to 21 days. Symptoms include fever, headache, swollen lymph nodes and a skin rash or lesions. The skin lesions usually appear one to three days after fever onset.

The current outbreak in Europe, the Americas and elsewhere is not typical of previous ones, according to the WHO. In prior years, monkeypox was reported in several African countries, with occasional cases in other countries linked to travel from Nigeria.

Tedros said the current outbreak is concentrated among men who have sex with men, “especially those with multiple sexual partners. That means that this is an outbreak that can be stopped with the right strategies.”

But the risk of monkeypox is not limited to people who are sexually active or men who have sex with men. The WHO says anyone who has close contact with someone who has symptoms is at risk.

Monkeypox cases are being identified at sexual health clinics, so “one reason we are currently hearing more reports of cases of monkeypox in communities of men who have sex with men may be because of positive health seeking behaviour in this population group,” the WHO website states.

In addition, “given that the virus is currently moving from person to person in these social networks, men who have sex with men may currently be at higher risk of being exposed if they have close contact with someone who is infectious.”

Tedros called on all countries to “work closely with communities of men who have sex with men, to design and deliver effective information and services, and to adopt measures that protect the health, human rights and dignity of affected communities,” noting that “stigma and discrimination can be as dangerous as any virus.”

HHS Secretary Xavier Becerra issued a statement following the WHO decision to declare monkeypox a global health emergency, describing the move a "call to action" for the global health community.

"Monkeypox has spread around the world and we will continue to take decisive action to tackle it both here in the U.S. and, working in concert with our partners abroad, globally," Becerra said.

Regarding the Biden-Harris administration's efforts to make vaccines, testing and treatments available to people in need, Becerra said: "We are determined to accelerate our response in the days ahead."

This story comes from a reporting collaboration that includes the Indianapolis Recorder and Side Effects Public Media, a public health news initiative based at WFYI. Contact Farah at Follow on Twitter: @Farah_Yousrym.

Copyright 2022 Side Effects Public Media. To see more, visit Side Effects Public Media.

Farah Yousry covers health equity for Side Effects Public Media, in partnership with the Indianapolis Recorder. She focuses on healthcare disparities in minority communities across the Midwest. Before moving to the U.S., she worked as a journalist for local news organizations in Egypt during the Arab Spring and the contentious political period following the Egyptian revolution. She has worked with the BBC World Service for over five years, producing radio, television and digital features for an audience in the tens of millions across Europe and the Middle East. Farah speaks Arabic, English and Mandarin Chinese.