Disease experts call on WHO and governments for greater action on monkeypox

Tubes labeled “Monkeypox virus positive and negative” can be seen in this illustration taken May 23, 2022. (Reuters / Dado Ruvic / Illustration / File Photo)

Some prominent infectious disease experts are pushing for faster action by global health authorities to contain a growing monkeypox outbreak that has spread to at least 20 countries.

They argue that governments and the World Health Organization should not repeat the first missteps of the COVID-19 pandemic that delayed case detection, helping the spread of the virus.

Although monkeypox is not as transmissible or dangerous as COVID, these scientists say, clearer guidance is needed on how to isolate a person infected with monkeypox, more explicit advice on how to protect people at risk, and testing and improved contact tracking.

“If this becomes endemic (in more countries), we will have another bad disease and many difficult decisions to make,” said Isabelle Eckerle, a professor at the Geneva Center for Emerging Viral Diseases in Switzerland.

WHO is considering whether the outbreak should be assessed as a potential public health emergency of international concern (PHEIC), an official told Reuters. A WHO determination that an outbreak constitutes a global health emergency – as it did with COVID or Ebola – would help accelerate research and funding to contain a disease.

“It’s still under scrutiny, but still no emergency committee (on monkeypox),” said Mike Ryan, WHO’s program director for health emergencies, on the sidelines of the agency’s annual meeting in Geneva.

However, experts say WHO is unlikely to reach such a conclusion anytime soon, because monkeypox is a known threat that the world has the tools to fight. Discussing whether to set up an emergency committee, the body that recommends declaring a PHEIC, is only part of the agency’s routine response, WHO officials said.

Eckerle asked WHO to encourage countries to put in place more coordinated and stringent isolation measures even without a declaration of emergency. He worries that talking about mild viruses, as well as the availability of vaccines and treatments in some countries, “potentially leads to lazy behavior on the part of public health authorities.”

It’s not the same as COVID

More than 300 suspected and confirmed cases of monkeypox, a generally mild disease that spreads through close contact, causing flu-like symptoms and a distinctive rash, have been reported this month.

Most have been in Europe rather than Central and West African countries where the virus is endemic. No deaths have been reported in the current outbreak.

LIGHT: Facts box: Monkeypox cases around the world

However, global health officials have expressed alarm over the growing epidemic in non-endemic countries. WHO said it expects the numbers to rise as surveillance increases.

Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, tweeted that monkeypox was different from SARS-CoV-2, the new coronavirus, but “we’re making some of the same mistakes as far as the firm response is concerned. hand tools. “

On Friday, the WHO reiterated that the monkeypox virus is containable with measures that include rapid detection and isolation of cases and contact tracing.

Infected people – and in some cases their close contacts – are advised to isolate themselves for 21 days, but it is unclear to what extent people would respect such a long period away from work or other commitments. The laboratory’s ability to test for monkeypox is also not yet widely established, Eckerle said, meaning rapid diagnosis can be difficult.

Mass vaccination is not considered necessary but some countries, including Britain and France, are offering vaccines to healthcare professionals and close contacts.

Other experts say the current response is proportionate and that to deem monkeypox a global health emergency and to declare a PHEIC would be inappropriate at this stage.

“This is reserved for threats with the highest level of risk based on infectivity, severity and international risk of escalation,” said Dale Fisher, president of the Global Outbreak Alert and Response Network (GOARN) and professor of medicine in Singapore.

Beyond the labels, experts said the most important lesson of the past couple of years is that preventing pandemics once they have started to spread is too late.

“It’s always disappointing when the world wakes up with a new disease only when it hits high-income countries,” said Piero Olliaro, professor of poverty-related infectious diseases at Oxford University and an expert on monkeypox.

To prepare for pandemics, “you have to do it where there are diseases now,” he said.

—Jennifer Rigby’s Report; Additional reporting by Emma Farge; Editing by Josephine Mason, Michele Gershberg and Daniel Wallis

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