Monkeypox has become a global health emergency, says WHO

The World Health Organization has declared the spread of monkeypox to be a “public health emergency of international concern”, its highest alert level

By Jason Arunn Murugesu

WHO director-general Tedros Adhanom Ghebreyesus at a press conference on 23 July

WHO/Lindsay Mackenzie

The World Health Organization (WHO) has declared monkeypox a global health emergency. It announced on 23 July that the spread of the viral infection constitutes a “public health emergency of international concern”, its highest alert level, putting it on par with the ongoing coronavirus pandemic and global efforts to eradicate polio.

The decision follows more than 16,000 reported cases of monkeypox across 75 countries this year. There have been more than 2000 in the UK so far, according to the UK Health Security Agency (UKHSA).

But the WHO panel was split on whether to declare monkeypox a global emergency, with director-general Tedros Adhanom Ghebreyesus acting as a tiebreaker. Some members of the panel argued that the disease isn’t so severe and that case numbers don’t seem to be rising exponentially, while others countered that confirmed case numbers are probably an underestimate and that the disease requires a coordinated international response.

Monkeypox can affect anybody, but so far the vast majority of cases have been in men who have sex with men, according to the WHO. It reported that 99 per cent of cases have been in this group in the UK, the US, Canada and Spain, the countries that have provided the most data to the WHO. It is more likely to occur in people who have had multiple sexual partners recently.

One way Monkeypox is thought to spread is via skin-to-skin contact, including sex, but until this year there was no indication that this form of transmission was particularly prominent. A study published last week, which analysed monkeypox cases in 16 countries, found that just 0.8 per cent of cases were probably caused by non-sexual close contact. The study also found that 13 per cent of people required hospitalisation.

In the current outbreak, there have been five confirmed deaths from the disease in Africa so far, according to the WHO, although dozens more are suspected. There have been no deaths reported elsewhere.

Symptoms of monkeypox include fever, headaches, fatigue and a rash. The rashes typically develop on the face first and then on other parts of the body. The WHO reports that the UK is also planning to list the inflammation of the lining of the rectum as a symptom.

Designating monkeypox as a global emergency means that the outbreak is unprecedented, affects multiple countries and requires a coordinated international response, said Hugh Adler at the Liverpool School of Tropical Medicine in the UK, in a statement to the UK’s Science Media Centre.

“Naming this a public health emergency of international concern adds political weight and urgency to this situation,” he said. “It ensures that this outbreak can be prioritised.”

Countries already experiencing monkeypox cases have been told by the WHO to raise awareness among those most at risk and to increase their efforts to identify and isolate people with the disease. These places should also step up vaccination programmes, they have been told.

Imvanex, also known as Jynneos in the US, is a smallpox vaccine that has been shown to also be effective against monkeypox. It was approved for monkeypox use in the European Union earlier this week. People most at risk of contracting the disease in the UK have been offered the vaccine. The NHS has recently ordered another 100,000 doses of the jab.

The fact the disease is currently concentrated among a specific group of people and that a vaccine already exists, suggests the outbreak can be stopped, said Ghebreyesus. “With the tools we have right now, we can stop transmission and bring this outbreak under control,” he said.

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