Monkey pox cases have risen nearly 40 percent in less than five days in Britain, according to data shared by the UK Health Security Agency. By 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 recorded 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 the WHO, which publishes data on monkey pox on a weekly basis. On June 15, one death had been reported.
The WHO’s International Health Regulations Emergency Committee 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 into action. The novel coronavirus, which causes Covid-19, was labeled PHEIC after a similar meeting in January 2020.
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So far, response in most European countries has focused on community outreach, contact tracing and isolation for known cases of monkeypox. That could change if the WHO, which first sounded 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 announcement by the Director General will raise the political level of this,” David Heymann, a 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.
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Monkeypox is spread through close contact and so far has mainly affected men who have sex with men. It starts with flu-like symptoms before fluid-filled lumps or lesions appear on the skin, which can leave permanent scars. Health officials say the latest outbreak has often caused genital rashes, and while most cases are mild and patients recover within three weeks, the virus can be deadly and poses a greater risk to pregnant people or those with weakened immune systems.
To contain the outbreak, a broader understanding of its origin, along with vaccination of high-risk groups and contact tracing, is necessary, experts say, although they note that some patients may not want to disclose information about who they’ve been intimate with – which may complicate the public health response.
“One of the problems people have in implementing monitoring is getting a complete list of people’s sexual contacts,” said Paul Hunter, a professor of medicine at the University of East Anglia. “It’s exactly the problem we faced when we were dealing with HIV/AIDS in the beginning [1990s]†
And, as in the early days of the coronavirus outbreak, it’s unclear whether cases go undetected in some countries. Some experts speculate that Britain may have higher numbers as it can identify more infections thanks to its extensive public health surveillance network.
WHO Director-General Tedros Adhanom Ghebreyesus acknowledged early in Thursday’s meeting that monkeypox is likely more widespread than official figures indicate. “The person-to-person transmission is ongoing and is likely to be underestimated,” he told emergency committee members.
The UK has been proactively monitoring people with known cases of monkeypox and in some cases has distributed smallpox vaccines known to protect against monkeypox infection to their closest contacts and at-risk groups. In theory, this approach — which Hunter described as “ring vaccination” — “should have worked,” he said.
But as the number of infections has risen and authorities have struggled to “spot the contacts of cases early enough to have an impact,” Hunter said he has become “less confident”.
“Unless we turn a corner very quickly here, I think we should probably start thinking about what’s next,” he added.
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UK health officials said Tuesday that some gay and bisexual men, believed to be at higher risk for exposure, will be given vaccines to contain the monkeypox outbreak. The UK Health Security Agency stressed that while the virus poses a greater threat “in the sexual networks of gay, bisexual and other men who have sex with men”, anyone can contract the disease through close contact with an infected person.
Scientists are studying this outbreak and will know more once the virus is sequenced. “We are beginning to understand how widespread” [monkeypox] is real,” said Heymann. “We know it’s widespread in certain populations and we need to know if it’s spreading in other populations as well.”
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Two years after treating the first coronavirus patient in Germany, Clemens Wendtner treated the first monkeypox patient in Germany in May. The man, who has not been identified, was a sex worker from Brazil, said Wendtner, chief infectious diseases doctor at Schwabing clinic in Munich.
A handful more monkeypox patients have been treated at his ward in recent weeks, Wendtner said. Some have reported “very painful” rectal lesions, for which intravenous pain medications are given to help with the discomfort. Wendtner and his colleagues have been closely monitoring their discoveries during this outbreak and recently documented their discovery of monkeypox virus DNA in both semen and blood.
Most patients were discharged after a day or so and were advised to isolate at home for 21 days – in accordance with the German Infectious Disease Act. Most cases have been reported in Berlin, one of Europe’s party hotspots, which will host Pride events next month.
“The summer season is the festive season,” he warned, adding that there are likely to be more cases in the coming week and that the current outbreak may not have peaked yet.
While men are significantly more at risk, Wendtner warned that female sex workers could also be at risk. “The risk factor is a pattern of sex without protection,” he explained.
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Outside of Europe, other countries are also struggling with new cases.
The first case of monkey pox in the United States was discovered 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 levels of infection.
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Singapore on Tuesday confirmed a case of monkey pox in a British man, the first in Southeast Asia. South Korea also confirmed its first case of monkey pox on Wednesday. The patient is a South Korean national who entered the country from Germany, health officials said. On Thursday, South Africa also announced its first case of monkey pox, 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’s important to remember, experts say, that this is not a new disease. Monkeypox has been circulating in Africa for decades — leading some to point to a double standard in response to the outbreak in Europe.
“This is a disease that has been neglected,” Heymann said. After smallpox was eradicated in 1980, the world stopped administering smallpox vaccines routinely. Monkeypox, which is less contagious than smallpox, continued to spread in western and central Africa, but outbreaks there were not thoroughly investigated due to a lack of resources, he added.
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WHO’s Tedros said on Thursday that nearly 1,500 suspected monkey pox cases and about 70 deaths have been reported in central Africa this year. “While the epidemiology and viral clade may be different in these cases, it is a situation that cannot be ignored,” he warned.