WHO eyes monkeypox global emergency; cases surge in Britain, elsewhere in Europe

Monkeypox cases rose almost 40 percent in Britain in under five days, according to data shared by the U.K. Health Security Agency. As of June 16, 574 cases had been recorded, and by June 20, the number had risen to 793.

After 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 across 48 nations in the past six weeks, according to the WHO, which publishes data on monkeypox in weekly intervals. As of June 15, one death had been reported .

The WHO’s International Health Regulations Emergency Committee met 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 a PHEIC following a similar meeting in January 2020.

U.S. monkeypox response mirrors early coronavirus missteps, experts say

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

“The emergency committee and then the [WHO] director general’s announcement 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 an adviser, told The Washington Post.

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Monkeypox is spread through close contact and has so far primarily affected men who have sex with men. It begins with flu-like symptoms before fluid-filled lumps or lesions appear on the skin, which can leave behind permanent scarring. Health officials say that the latest outbreak has frequently brought genital rashes, and while most cases are mild and patients recover in three weeks, the virus can be fatal and is more of a risk to pregnant people or those with weakened immune systems.

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 some patients may not want to divulge information about who they have been intimate with — which can complicate the public health response.

“One of the difficulties people are having with implementing control is actually getting a full list of people’s sexual contacts,” said Paul Hunter, a professor of medicine at the University of East Anglia. “It’s exactly the issue that we faced when we were dealing with HIV/AIDS in the early [1990s].”

And, as in the early days of the coronavirus outbreak, it’s unclear whether cases in some countries are going undetected. Some experts speculate that Britain may have higher numbers because its extensive public health surveillance network allows it to identify more infections.

WHO director general Tedros Adhanom Ghebreyesus acknowledged at the start of Thursday’s meeting that monkeypox is likely more widespread than official numbers indicate. “Person-to-person transmission is ongoing and is likely underestimated,” he told members of the emergency committee.

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

But as infections have surged and authorities have struggled to “track down the contacts of cases early enough to make an impact,” Hunter said he has grown “less confident.”

“Unless we turn a corner very soon on this, I think we will probably need to start thinking about what’s next,” he added.

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