CDC via AP, File
FILE - This 1997 image provided by the CDC during an investigation into an outbreak of monkeypox, which took place in the Democratic Republic of the Congo (DRC), formerly Zaire, and depicts the dorsal surfaces of the hands of a monkeypox case patient, who was displaying the appearance of the characteristic rash during its recuperative stage.
LONDON (AP) — The World Health Organization said the expanding monkeypox outbreak in more than 70 countries is an “extraordinary” situation that now qualifies as a global emergency, a declaration Saturday that could spur further investment in treating the once-rare disease and worsen the scramble for scarce vaccines.
Although monkeypox has been established in parts of central and west Africa for decades, it was not known to spark large outbreaks beyond the continent or to spread widely among people until May, when authorities detected dozens of epidemics in Europe, North America and elsewhere.
Declaring a global emergency means the monkeypox outbreak is an “extraordinary event” that could spill over into more countries and requires a coordinated global response. WHO previously declared emergencies for public health crises such as the COVID-19 pandemic, the 2014 West African Ebola outbreak, the Zika virus in Latin America in 2016 and the ongoing effort to eradicate polio.
The emergency declaration mostly serves as a plea to draw more global resources and attention to an outbreak. Past announcements had mixed impact, given that the U.N. health agency is largely powerless in getting countries to act.
Last month, WHO’s expert committee said the worldwide monkeypox outbreak did not yet amount to an international emergency, but the panel convened this week to reevaluate the situation.
According to the U.S. Centers for Disease Control and Prevention, more than 16,000 cases of monkeypox have been reported in 74 countries since about May. To date, monkeypox deaths have only been reported in Africa, where a more dangerous version of the virus is spreading, mainly in Nigeria and Congo.
In Africa, monkeypox mainly spreads to people from infected wild animals like rodents, in limited outbreaks that typically have not crossed borders. In Europe, North America and elsewhere, however, monkeypox is spreading among people with no links to animals or recent travel to Africa.
WHO’s top monkeypox expert, Dr. Rosamund Lewis, said this week that 99% of all the monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men. Experts suspect the monkeypox outbreaks in Europe and North America were spread via sex at two raves in Belgium and Spain.
THE MONKEYPOX EMERGENCY
Michael Head, a senior research fellow in global health at Southampton University, said it was surprising WHO hadn’t already declared monkeypox a global emergency, explaining that the conditions were arguably met weeks ago.
Some experts have questioned whether such a declaration would help, arguing the disease isn’t severe enough to warrant the attention and that rich countries battling monkeypox already have the funds to do so; most people recover without needing medical attention, although the lesions may be painful.
“I think it would be better to be proactive and overreact to the problem instead of waiting to react when it’s too late,” Head said. He added that WHO’s emergency declaration could help donors like the World Bank make funds available to stop the outbreaks both in the West and in Africa, where animals are the likely natural reservoir of monkeypox.
In the U.S., some experts have speculated whether monkeypox might be on the verge of becoming an entrenched sexually transmitted disease in the country, like gonorrhea, herpes and HIV.
“The bottom line is we’ve seen a shift in the epidemiology of monkeypox where there’s now widespread, unexpected transmission,” said Dr. Albert Ko, a professor of public health and epidemiology at Yale University. “There are some genetic mutations in the virus that suggest why that may be happening, but we do need a globally-coordinated response to get it under control,” he said.
Ko called for testing to be immediately scaled up rapidly, saying that similar to the early days of COVID-19, that there were significant gaps in surveillance.
“The cases we are seeing are just the tip of the iceberg,” he said. “The window has probably closed for us to quickly stop the outbreaks in Europe and the U.S., but it’s not too late to stop monkeypox from causing huge damage to poorer countries without the resources to handle it.”
In the U.S., some experts have speculated that monkeypox might become entrenched there as the newest sexually transmitted disease, with officials estimating that 1.5 million men are at high risk of being infected.
Dr. Placide Mbala, a virologist who directs the global health department at Congo’s Institute of National Biomedical Research, said he hoped any global efforts to stop monkeypox would be equitable. Although countries including Britain, Canada, Germany and the U.S. have ordered millions of vaccine doses, none have gone to Africa.
“The solution needs to be global,” Mbala said, adding that any vaccines sent to Africa would be used to target those at highest risk, like hunters in rural areas.
“Vaccination in the West might help stop the outbreak there, but there will still be cases in Africa,” he said. “Unless the problem is solved here, the risk to the rest of the world will remain.”
-
Expert: Monkeypox likely spread by sex at 2 raves in Europe
Cynthia S. Goldsmith, Russell Regner/CDC via AP
Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic.
The illness was first identified by scientists in 1958 when there were two outbreaks of a “pox-like” disease in research monkeys — thus the name monkeypox. The first known human infection was in 1970, in a 9-year-old boy in a remote part of Congo.
Cynthia S. Goldsmith, Russell Regner/CDC via AP
Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic.
The illness was first identified by scientists in 1958 when there were two outbreaks of a “pox-like” disease in research monkeys — thus the name monkeypox. The first known human infection was in 1970, in a 9-year-old boy in a remote part of Congo.
-
Expert: Monkeypox likely spread by sex at 2 raves in Europe
AP photo/Janet Hostetter
Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.
Most patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.
The incubation period is from about five days to three weeks. Most people recover within about two to four weeks without needing to be hospitalized.
Monkeypox can be fatal for up to one in 10 people and is thought to be more severe in children.
People exposed to the virus are often given one of several smallpox vaccines, which have been shown to be effective against monkeypox. Anti-viral drugs are also being developed.
On Thursday, the European Centre for Disease Prevention and Control recommended all suspected cases be isolated and that high-risk contacts be offered the smallpox vaccine.
AP photo/Janet Hostetter
Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.
Most patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.
The incubation period is from about five days to three weeks. Most people recover within about two to four weeks without needing to be hospitalized.
Monkeypox can be fatal for up to one in 10 people and is thought to be more severe in children.
People exposed to the virus are often given one of several smallpox vaccines, which have been shown to be effective against monkeypox. Anti-viral drugs are also being developed.
On Thursday, the European Centre for Disease Prevention and Control recommended all suspected cases be isolated and that high-risk contacts be offered the smallpox vaccine.
-
-
Expert: Monkeypox likely spread by sex at 2 raves in Europe
AP Photo/Anja Niedringhaus, File
The World Health Organization estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6,000 cases annually, and Nigeria, with about 3,000 cases a year.
Patchy health monitoring systems mean many infected people are likely missed, experts say.
Isolated cases of monkeypox are occasionally spotted outside Africa, including in the U.S. and Britain. The cases are typically associated with travel to Africa or contact with animals from areas where the disease is more common.
In 2003, 47 people in six U.S. states had confirmed or probable cases. They caught the virus from pet prairie dogs that been housed near imported small mammals from Ghana.
AP Photo/Anja Niedringhaus, File
The World Health Organization estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6,000 cases annually, and Nigeria, with about 3,000 cases a year.
Patchy health monitoring systems mean many infected people are likely missed, experts say.
Isolated cases of monkeypox are occasionally spotted outside Africa, including in the U.S. and Britain. The cases are typically associated with travel to Africa or contact with animals from areas where the disease is more common.
In 2003, 47 people in six U.S. states had confirmed or probable cases. They caught the virus from pet prairie dogs that been housed near imported small mammals from Ghana.
-
Expert: Monkeypox likely spread by sex at 2 raves in Europe
AP Photo/Allen Sullivan
It's the first time monkeypox appears to be spreading among people who didn't travel to Africa.
In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden. Most of the cases involve men who have had sex with men.
Britain's Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening.
The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.
On Wednesday, U.S. officials reported one case of monkeypox in a man who had recently traveled to Canada, where authorities are investigating potential infections.
AP Photo/Allen Sullivan
It's the first time monkeypox appears to be spreading among people who didn't travel to Africa.
In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden. Most of the cases involve men who have had sex with men.
Britain's Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening.
The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.
On Wednesday, U.S. officials reported one case of monkeypox in a man who had recently traveled to Canada, where authorities are investigating potential infections.
-
-
Expert: Monkeypox likely spread by sex at 2 raves in Europe
Cynthia S. Goldsmith, Russell Regner/CDC via AP
It's possible, but it's unclear at the moment.
Monkeypox has not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people, their body fluids and their clothing or bedsheets.
Michael Skinner, a virologist at Imperial College London, said it's still too early to determine how the men in the U.K. were infected.
“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person’s sexual orientation and irrespective of the mode of transmission," Skinner said.
Francois Balloux of University College London said monkeypox said sex qualifies as the kind of close contact needed to transmit the disease.
The U.K. cases "do not necessarily imply any recent change in the virus’ route of transmission,” Balloux said.
___
Barry Hatton in Lisbon, Portugal, contributed to this report.
Cynthia S. Goldsmith, Russell Regner/CDC via AP
It's possible, but it's unclear at the moment.
Monkeypox has not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people, their body fluids and their clothing or bedsheets.
Michael Skinner, a virologist at Imperial College London, said it's still too early to determine how the men in the U.K. were infected.
“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person’s sexual orientation and irrespective of the mode of transmission," Skinner said.
Francois Balloux of University College London said monkeypox said sex qualifies as the kind of close contact needed to transmit the disease.
The U.K. cases "do not necessarily imply any recent change in the virus’ route of transmission,” Balloux said.
___
Barry Hatton in Lisbon, Portugal, contributed to this report.
