A public health emergency of international concern has been declared by the World Health Organization. There has been a rise in cases from dozens of countries this year, including over 2,000 in the US.
The WHO convened an advisory committee to discuss the outbreak. There had been over 3000 cases reported from 47 countries, as well as evidence of sustained human-to-human transmission in some areas outside Africa, where it had previously been endemic among rodents. The experts agree that monkeypox has the potential to become a serious global health threat and that it would require intense effort and cooperation from countries to stop the virus from becoming established in new parts of the world. They decided that calling for aPHEIC would be premature.
The public health community wasn't happy with the WHO's decision. If the situation continues to get worse, the organization will revisit the issue. The second meeting of the advisory committee will be held on July 21.
The experts believed that monkeypox would meet the criteria for aPHEIC under a number of different conditions. Evidence of a growing rise in the rate of new cases over the next three weeks, both among the groups so far most at risk and in other populations, is one of the conditions included.
Since that time, there have been many more reports of monkeypox. Over 16,000 cases of monkeypox have been reported in over 75 countries, including more than 2,500 cases in the US. There have been reports of children contracting monkeypox and women contracting it.
The committee wasn't sure if monkeypox fit the criteria for aPHEIC. The WHO had the final say and felt that at least some of the criteria have been met.
The risk of monkeypox is moderate, except in the European region where the risk is high, according to the World Health Organization. There is a clear risk of further international spread according to the WHO Director-General. We have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we don't know enough and which meets the criteria in the International Health Regulations.
It is not the same as calling a disease outbreak a Pandemic. There isn't a formal authority for a Pandemic designation and aPHEIC isn't always a sign of a large global outbreak. The world has almost been wiped out by the disease, and it's still present in a few countries. Any sustained outbreak in countries that are still vulnerable to the disease would be a disaster. Since the beginning of the year, there has been aPHEIC alert over the spread of the disease.
It's important for the recognition of a significant public health threat. The WHO started to refer to it as a Pandemic after aPHEIC was declared in February 2020. Some public health researchers have begun to argue that the widespread nature of monkeypox transmission seen this year should be considered a Pandemic.
There are many differences between the two. There is evidence in the lab that monkeypox can be spread through respiratory droplets, but it is primarily being spread through close contact. Thanks to our earlier efforts to eradicate it, there is a vaccine that can be used against it. There have been few hospitalizations and life-threatening illnesses in the cases.
Men who have sex with men with multiple sexual partners have been most affected by the outbreak. It's possible that it's still possible to curb the virus before it's too late. He called for more resources to be put in place to stop the outbreak and for those most at risk for monkeypox to be given the resources.
The tools we have allow us to stop transmission.
Many scientists are skeptical that it is still possible to contain the virus before it gains a foothold in non-endemic areas of the world. Even if monkeypox isn't as damaging as covid-19, it could still become a painful routine germ. The virus may be able to cause large outbreaks in other populations, even if they are not currently affected by it.
It will not be easy to limit monkeypox's potential harm from here on out, as evidenced by the WHO's alert.
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