Disease experts call on WHO and governments to take more action on monkeypox

A portion of skin tissue, harvested from a lesion on the skin of a monkey infected with monkeypox virus, seen at 50-fold magnification on the fourth day of rash development in 1968. CDC/Handout via REUTERS

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GENEVA (Reuters) – Some prominent infectious disease experts are pushing for faster action by global health authorities to contain the growing outbreak of monkeypox, which has spread to at least 20 countries.

They argue that governments and the World Health Organization should not repeat the early stumbles of the COVID-19 pandemic that delayed the discovery of cases, which helped the virus spread.

While monkeypox is not as transmissible or dangerous as COVID, these scientists say, clearer guidelines on how to isolate a person with monkeypox, clearer advice on how to protect those at risk, and improved testing and contact tracing are needed.

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

An official told Reuters that the World Health Organization is studying whether the outbreak should be assessed as a potential public health emergency of international concern. The World Health Organization’s decision that the outbreak constitutes a global health emergency – as happened with COVID or Ebola – should help accelerate research and funding to contain the disease.

“It’s always under consideration, but there is no emergency committee yet (on monkeypox),” Mike Ryan, director of the WHO’s Health Emergencies Programme, said on the sidelines of the agency’s annual meeting in Geneva.

However, experts say it is unlikely the World Health Organization will come to such a conclusion soon, because monkeypox is a known threat that the world has tools to combat. WHO officials said that discussion of whether to establish an emergency committee, the body that recommends declaring a primary health emergency, is just part of the agency’s routine response.

Eckerl called on the World Health Organization to encourage countries to put in place more coordinated and stricter isolation measures even without declaring an emergency. She is concerned that talk of the virus being mild, as well as the availability of vaccines and treatments in some countries, “potentially leads to lazy behavior from public health authorities.”

Not the same as covid

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

Most of them were in Europe and not in the countries of Central and West Africa where the virus is endemic. No deaths have been reported in the current outbreak.

However, global health officials have expressed concern about the growing outbreak in non-endemic countries. The World Health Organization said it expects the numbers to rise as monitoring increases.

Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, wrote on Twitter that monkeypox was different from the new SARS-CoV-2 coronavirus, but that “we’re making some of the same mistakes in terms of responding decisively with tools in our hands.”

The World Health Organization confirmed, on Friday, that the monkeypox virus is contained by measures that include rapid detection and isolation of cases and tracing of contacts. Read more

Infected people – and in some cases close contacts – are advised to isolate for 21 days, but it is not clear how long people will stick to this long period away from work or other commitments. Eckerl said the lab’s ability to test for monkeypox has not yet been widely established, which means a quick diagnosis can be difficult.

Mass vaccination is not necessary, but some countries, including Britain and France, provide vaccines for health care workers and close contacts. Read more

Other experts say the current response is proportional and that declaring monkeypox a global health emergency and declaring a public health emergency (PHEIC) would not be appropriate at this point.

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

Beyond the labels, experts said the most important lesson of the past two years is that it is too late to prevent epidemics once they start spreading.

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

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

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(Reporting by Jennifer Rigby) Additional reporting by Emma Farge. Editing by Josephine Mason, Michelle Gershberg and Daniel Wallis

Our Standards: Thomson Reuters Trust Principles.

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