Monkeypox outbreak is declared a global health emergency

The World Health Organization has declared the international monkeypox outbreak a global emergency.

The decision underscores concerns about rapidly spreading infections sparked by the virus. More than 16,500 cases of monkeypox have been reported in 75 countries.

The move to label the outbreak a Public Health Emergency of International Concern, the highest level of alert the WHO can issue, is expected to marshal new funding to fight the outbreak and to pressure governments into action.

“In short, we have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little,” said WHO Director-General Tedros Adhanom Ghebreyesus.

The decision means the world is now confronting two viral diseases that have crossed the extraordinary threshold of being declared health emergencies: covid-19 and monkeypox.

The the coronavirus pandemic was labeled a global crisis by global health agency early in 2020.

WHO officials said the global risk of monkeypox is moderate, but that it is high in Europe, where most of the infections have been recorded in an outbreak that ignited in the spring.

The announcement was accompanied by recommendations to boost a coordinated global response designed to intensify surveillance, accelerate research into vaccines and therapeutics, and strengthen infection control in hospitals.

Tedros said that one of the reasons he moved to declare monkeypox a global health emergency is the potential for stanching the outbreak, which appears to be concentrated among men who have sex with men.

“That means that this is an outbreak that can be stopped with the right strategies in the right groups,” Tedros said.

The WHO director-general stressed that all containment measures should respect the “human rights and dignity” of gay and bisexual men.

“Stigma and discrimination can be as dangerous as any virus,” Tedros said.

WHO officials also said higher rates of safe behavior and a culture of public health in the community shaped by the AIDS crisis can help end the outbreak.

The majority of reported cases of monkeypox currently are in males, and most of these cases occur among males who identified themselves as gay, bisexual and other men who have sex with men (MSM), in urban areas, and are clustered in social and sexual networks.

Early reports of children affected include a few with no known epidemiological link to other cases.

Transmission is occurring in many countries that had not previously reported cases of monkeypox, and the highest numbers of cases are currently reported from countries in Europe and the Americas.

The clinical presentation of monkeypox occurring in outbreaks outside Africa is generally that of a self-limited disease, often atypical to cases described in previous outbreaks, with rash lesions localized to the genital, perineal/perianal or peri-oral area, that often do not spread further, and appears prior to the development of lymphadenopathy, fever, malaise, and pain associated with lesions.

The mean incubation period among cases reported is estimated at 7.6 to 9.2 days (based on surveillance data from the Netherlands, the United Kingdom of Great Britain and Northern Ireland (United Kingdom), and the United States of America (United States).

The mean serial interval is estimated at 9.8 days (95% CI 5.9-21.4 day, based on 17 case-contact pairs in the United Kingdom).

A small number of cases have been reported among health workers. Investigations so far have not identified cases of occupational transmission, although investigations are ongoing.

Serial interval is defined as the time from illness onset in the primary case to illness onset in the secondary case, while incubation period is the time from infection occurred to the onset of signs and symptoms.

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