Health authorities have been urged to be vigilant, expand surveillance and facilitate contact tracing as cases of monkeypox continue to emerge in countries not used to seeing the virus.
On Monday May 23, some 90 cases of monkeypox were reported in nine EU member states: Austria, Belgium, France, Germany, Italy, Portugal, Spain, Sweden and the Netherlands. JThe virus has also been reported in Israel, the United States and Australia, with just under 200 confirmed cases so far.
Monkeypox has been known for about 40 years and is endemic in some countries in Africa, but “this is the first time we’ve seen cases in many countries at the same time, in people who haven’t traveled to the areas endemic to Africa,” said Rosamund Lewis, head of the smallpox secretariat at WHO, Monday.
Over the past five years, cases of monkeypox outside endemic areas have only been seen in travellers.
Given the spread of the virus, the European Commission is working on a coordinated response, said the head of health Stella Kyriakides said on Monday: “We must all remain vigilant, ensure that adequate contact tracing and diagnostic capacity is in place, and ensure that we have the necessary vaccines, antivirals and personal protective equipment for the health professionals”.
The same day, The European Center for Disease Prevention and Control (ECDC) has published the first risk assessment concerning the multi-country outbreak of monkeypox. He recommends that EU/EEA countries focus on rapid identification, case management, contact tracing and reporting of new cases of monkeypox.
Countries are encouraged to update their contact tracing mechanisms, orthopoxvirus diagnostic capacity and review the availability of smallpox vaccines, antivirals and personal protective equipment for healthcare workers.
WHO emerging diseases and zoonoses lead, Maria Van Kerkhove, said we need to be alert to cases in countries that don’t usually experience monkeypox.
“We need to equip ministries, governments and country health clinics to recognize what monkeypox is and ensure that those suspected of having monkeypox receive the appropriate clinical care. . We want to stop human-to-human transmission,” she said, adding that this can be done in non-endemic countries.
Kerkhove added that isolating cases is a way to prevent further transmission. ECDC recommends that infected people stay in isolation until the scabs fall off and avoid close contact with immunocompromised people and pets. It is also advisable to avoid sexual activity and close physical contact until the rash has healed. Most cases can stay at home with supportive care.
She also stressed the need to protect those caring for people and front-line workers collecting samples.
As the the incubation period of the virus is usually 6 to 13 days but can also reach 21 days, The ECDC advises close contacts of monkeypox cases to self-monitor for the development of symptoms for 21 days after the last exposure.
The risk for the general population “is very low”
Human-to-human transmission of monkeypox goes through close contact with infectious material from skin lesions of an infected person, respiratory droplets during prolonged face-to-face contact, and fomites.
Andrea Ammon, director of the ECDC, said that “for the general population, the probability of spread is very low”.
But currently diagnosed cases of human monkeypox are mostly in men who have sex with men, suggesting transmission can occur through intimate relationships.
“The likelihood of further spread of the virus through close contact, such as during sexual activity between people with multiple sexual partners, is considered high,” Ammon said.
Monkeypox is not a sexually transmitted disease but, like many other diseases, it can also be transmitted through sexual contact.
WHO Strategic Advisor to the Department of HIV, Hepatitis and STI Programmes, Andy Seale, explained that “you can catch a cough or a cold through sexual contact. But that doesn’t mean it’s a sexually transmitted disease.
He continued: “The difference is that sexually transmitted infections are caused by sexual intercourse, anal, vaginal, oral. And you don’t have to have sexual contact to transmit monkeypox.”
On Sunday 22 May, the Joint United Nations Program on HIV/AIDS (UNAIDS) urged the media, governments and communities to respond with a rights-based and evidence-based approach that avoids stigma, as a significant portion of recently reported cases of monkeypox have been identified among gay, bisexual and other men who have sex with men.
Seale pointed out that the spread could happen in any group. “We see cases among men who have sex with men, but it’s not a “gay disease” as some people on social media have tried to label it. This is simply not the case,” he stressed.
Lewis added that “it’s not about discrimination. It’s not about stigma. It’s about saying, where are you seeing the first cases? »
Most observed cases are mild
So far, most cases had mild symptoms of illness, but the monkeypox virus can cause severe illness in young children, pregnant women and immunocompromised people, the ECDC warned.
Kyriakides assured that “we are closely monitoring the situation, and although currently the probability of spread in the general population is low, the situation is changing”.
The ECDC has warned that if human-to-human transmission occurs and the virus spreads through an animal population, there is a risk that the disease could become endemic in Europe.
On Tuesday, the EU Health Security Committee will discuss monkeypox.
[Edited by Alice Taylor]