WHO warns of ‘real’ danger of monkeypox spreading outside Africa

The Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, warned Wednesday that the window to contain the global outbreak of monkeypox may be narrowing.

“The risk of monkeypox spreading in non-endemic countries is real,” he told a news briefing in Geneva.

Since the beginning of May, the World Health Organization has confirmed more than 1,000 cases of monkeypox in 29 countries outside West and Central Africa, where the virus is endemic.

If the outbreak is not contained, and the virus gains a foothold in new areas, it may mature indefinitely at low levels. Cases are also likely to rise to epidemic proportions in some places, which means that a large number of people will get sick in a short time frame.

“As you continue to move forward into the future and more and more individuals become infected, you begin to worry,” said Princess Albert Royce, professor of global health and epidemiology at George Mason University. “Is this going to become something that will continue to pass from person to person and then we will not be able to control it?”

Multiple epidemics around the world can constitute a pandemic. But experts aren’t betting on this outcome – WHO leaders and disease experts agree it’s not too late to reverse the trend.

“There is still a window of opportunity to prevent the spread of monkeypox in those who are currently at greater risk,” Dr Rosamund Lewis, WHO technical director on monkeypox, said at the news conference.

Two smallpox vaccines—both approved by the Food and Drug Administration—may be key to prevention efforts. The shot preferred by the United States government, called Jynneos, has been specifically approved for use against monkeypox.

“This is one of those rare diseases where you can vaccinate someone after they’ve been infected, before they have symptoms, and prevent the disease,” said Eric Toner, a senior researcher at the Johns Hopkins Center for Health Security.

“We’re going to have to really screw things up so we can’t contain it,” he added.

Can monkeypox become endemic in new countries?

Historically, monkeypox was not easily transmitted from person to person. Previously, the largest outbreak in the Western Hemisphere was a cluster of 47 cases of monkeypox virus in the United States in 2003. But there was no documented person-to-person transmission at that time. Every infected person has had contact with sick prairie dogs.

In the current outbreak, the primary driver of transmission appears to be skin-to-people contact, often involving exposure to rashes or lesions in infected persons.

“Right now, we’re more at risk of contracting the virus, and possibly becoming epidemic because of the constant human-to-human transmission and our inability to stop the cycle of transmission,” Ross said.

Several factors are involved in that cycle. First, some cases of monkeypox are difficult to identify. Patients develop a rash that can be confused with chickenpox, syphilis or herpes, but in some cases it may be limited to the genital area, making it more difficult to detect.

Second, disease experts worry that the United States is not processing tests fast enough to identify new cases in a timely manner.

“It still takes a few days from the time someone is identified to the time a diagnosis is confirmed,” Royce said.

Dr. Stuart Isaacs, associate professor of medicine at the University of Pennsylvania, said the virus could have “epidemic potential” in the United States — meaning there would be a significant increase in cases — if an infected person spread monkeypox to more than one. Another average person. This has not been the case in the past, and the United States has recorded fewer than 40 cases so far.

“It’s still too early to really say this conclusively [outbreak] It won’t explode, although the probability is still very low,” Isaac said.

He added that “the reason for the spread of this disease in Africa is the presence of reservoirs for animals.” “The virus circulates and spreads between animals, and then passes to humans or non-human primates every now and then.”

Discussions about the declaration of a monkeypox pandemic

In the past, countries outside Africa have quickly stopped an outbreak of monkeypox through testing and contact tracing, Royce said, but the current outbreak is unprecedentedly widespread and widespread.

Experts don’t yet know whether its scale is evidence that monkeypox has evolved to be better at transmitting human-to-human infection or whether countries are simply figuring out how widespread the disease has gone undetected for some time.

Already, an outbreak of monkeypox may meet the official definition of a pandemic: the virus is spreading from person to person in at least two countries, and there are community-wide outbreaks in many parts of the world.

“But in general, when we talk about epidemics, we’re talking about diseases in which everyone is at significantly greater risk in every country or almost every country,” Toner said. “So far, this hasn’t reached that threshold, and I don’t think it will ever.”

Ross said the fact that the Covid-19 pandemic likely isn’t over makes global health leaders wary of declaring an emergency.

“There is a lot of hesitation in declaring this a pandemic,” she said.

However, one reason for optimism is that this type of monkeypox is not usually life-threatening. Although the rash from monkeypox can be painful and scarring, experts said, doctors know how to treat it with smallpox antivirals and supportive care. No deaths have been reported in non-endemic countries so far.

“We should sound the alarm and study this and understand that,” Isaac said. “But we’re not in the panic phase yet.”

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