Category: Monkey Pox

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Is monkeypox in the US? What to know about mpox in Tennessee - Tennessean

The Director-General of the World Health Organization (WHO), having concurred with the advice offered by the International Health Regulations (2005) (IHR or Regulations) Emergency Committee regarding the upsurge of mpox 2024 during its first meeting, held on 14 August 2024, has determined, on the same date, that the ongoing upsurge of mpox in the Democratic Republic of the Congo (DRC) and in a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the provisions of the Regulations. The communication of the Director-General regarding the determination of the above-mentioned PHEIC on 14 August 2024 is available here.

The Director-General is hereby transmitting the report of the first meeting of the IHR Emergency Committee regarding the upsurge of mpox 2024.

Noting that the Director-General will be communicating to States Parties a 12-month extension of the current standing recommendations for mpox, the temporary recommendations, issued by the Director-General in relation to the PHEIC associated with the ongoing upsurge of mpox are presented in the last section of this statement and reflect the advice offered by the Committee.

The Director-General is taking the opportunity to express his most sincere gratitude to the Chair, Vice-Chair, and Members of the IHR Emergency Committee, as well as to its Advisors.

Sixteen (16) Members of, and two Advisors to, the Emergency Committee were convened by teleconference, via Zoom, on Wednesday, 14 August 2024, from 12:00 to 17:00 CEST. Fifteen (15) of the 16 Committee Members and the two Advisors to the Committee participated in the meeting.

The Director-General of the World Health Organization (WHO) joined in person and welcomed the participants. The opening remarks by the Director-General are available here.

The Representative of the Office of Legal Counsel briefed the Members and Advisers on their roles and responsibilities and identified the mandate of the Emergency Committee under the relevant articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics provided the Members and Advisors with an overview of the WHO Declaration of Interests process. The Members and Advisors were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or actual conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each Member and Advisor was surveyed, with no conflicts of interest identified.

The Representative of the Office of Legal Counsel then facilitated the election of officers of the Committee, in accordance with the rules of procedures and working methods of the Emergency Committee. Professor Dimie Ogoina was elected as Chair of the Committee, Professor Inger Damon as Vice-Chair, and Professor Lucille Helen Blumberg as Rapporteur, all by acclamation.

The meeting was handed over to the Chair who introduced the objectives of the meeting, which were to provide views to the Director-General on whether the event constitutes a public health emergency of international concern (PHEIC), and if so, to provide views on the potential proposed temporary recommendations.

The WHO Secretariat presented an overview of the global epidemiological situation of mpox, highlighting that, during the first six months of 2024, the 1854 confirmed cases of mpox reported by States Parties in the WHO African Region account for 36% (1854/5199) of the cases observed worldwide. Of these confirmed cases in the WHO African region in 2024, 95% (1754/1854) were reported in the Democratic Republic of the Congo (DRC), that is experiencing an upsurge of cases of mpox, withmore than 15,000 clinically compatible cases and over 500 deaths reported, already exceeding the number of cases observed in the DRC in 2023.

The upsurge of mpox cases in the DRC is being driven by outbreaks associated with two sub-clades of clade I monkeypox virus (MPXV) clade Ia and clade Ib. Clade I mpox was classically described in studies conducted by WHO in the 1980s to have a mortality rate of approximately 10%, with most deaths occurring in children.

MPXV clade Ia is endemic in the DRC, the disease primarily affects children, data available for 2024 show an aggregated case fatality rate of 3.6%, and the spread is likely sustained through multiple modes of transmission including person-to-person transmission following zoonotic introduction in a community.

MPXV clade Ib is a new strain of MPXV that emerged in the DRC is transmitting between people, presumed via sexual contact, which has been spreading in the eastern part of the country. Although first characterized in 2024, estimates suggest it emerged around September 2023. The outbreak associated with clade Ib in the DRC primarily affects adults and is spreading rapidly, sustained largely, but not exclusively, through transmission linked to sexual contact and amplified in networks associated with commercial sex and sex workers.

Since July 2024, cases of mpox due to MPXV clade Ib, epidemiologically and phylogenetically linked to the outbreak in the eastern provinces of DRC, have been detected in four countries, neighbouring the DRC, which had not reported cases of mpox before: Burundi, Kenya, Rwanda and Uganda.

Additionally, in 2024, cases of mpox linked to MPXV clade Ia have been reported in the Central African Republic and the Republic of Congo, and cases linked to MPXV clade II have been reported in Cameroon, Cte dIvoire, Liberia, Nigeria and South Africa.

The clinical presentation of mpox associated with MPXV clade Ia has historically been characterized by more severe disease than that associated with MPXV clade II. Clade IIb viruses circulated during the multi-country outbreak that constituted a PHEIC from July 2022 to May 2023. There is, as yet, insufficient information available to fully characterize mpox severity due to clade Ib as data are emerging and, so far, few deaths were recorded, precluding age-stratified analyses.

The secretariat outlined challenges in understanding the true extent of infection, epidemiologic trends and morbidity and mortality, thus cautioning overinterpretation of available data to calculate crude CFRs by different clades/outbreaks.

The assessed risk presented by the WHO Secretariat grouping geographical areas as a result of the assessment of population groups affected, predominant modes of transmission, and MPXV clades involved , was: high for eastern DRC and neighbouring countries; high for areas of the DRC where mpox is known to be endemic; moderate for Nigeria and countries of West, Central and East Africa where mpox is endemic; and moderate for other countries in Africa and around the world.

The WHO Secretariat additionally provided an overview of the actions already taken to support readiness and response interventions in States Parties experiencing the upsurge of cases of mpox and facing such risk. These include, inter alia: the release of USD 1.45 million from the WHO Contingency Fund for Emergencies; initiating the process for including Emergency Use Listing two mpox vaccines; coordinating with partners and stakeholders, including to facilitate equitable access to vaccines, therapeutics, and diagnostics; the development of a regional response plan, costed at an initial USD 15 million, and more.

Representatives of Burundi, the Democratic Republic of the Congo, Kenya, Rwanda, South Africa and Uganda updated the Committee on the mpox epidemiological situation in their countries and the current response efforts, needs and challenges. Although most reported few cases of MPXV clade Ib related mpox, Burundi reported one hundred confirmed cases of mpox associated with clade Ib since July 2024, identified in multiple districts and 28% of cases were amongst children less than five years of age.

Members of, and Advisors to, the Committee then engaged in questions and answers with the presenters. The questions and discussions focused around the issues and challenges enumerated below:

Following the session open to invited States Parties, the Committee reconvened in a closed session to examine the questions in relation to whether the event constitutes a PHEIC or not, and if so, to consider the temporary recommendations drafted by the WHO Secretariat in accordance with IHR provisions.

The Chair reminded the Committee Members of their mandate and recalled that a PHEIC is defined in the IHR as an extraordinary event, which constitutes a public health risk to other States through the international spread of disease, and potentially requires a coordinated international response.

The Committee was unanimous in expressing the views that the ongoing upsurge of mpox meets the criteria of a PHEIC and that the Director-General be advised accordingly.

The considerations underpinning the unanimous views of the Committee further elaborated upon issues and challenges addressed during the question and answers session.

The Committee considered the event as extraordinary because of (a) the increase in mpox clade I disease occurrence in the DRC and the emergence of the new MPXV clade Ib, the human-to-human transmission context in which it is occurring, its rapid spread in some settings, and available evidence suggesting that MPXV clade I is associated with a more severe clinical presentation with respect to MPXV clade II; (b) the diverse, complex, dynamic, and rapidly evolving epidemiology observed across States Parties in the WHO African Region in terms of: overall rapid increase of the number of cases reported in some settings, differences in population age-groups affected, routes and modes sustaining transmissions in different contexts; and (c) the severity of the clinical presentation in children and immunocompromised individuals, including people living with uncontrolled HIV infection or advanced HIV disease, as well as the long-term consequences of MPXV infection.

Additionally, the Committee strongly underscored that its level of concern is further heightened by (a) uncertainties and gaps in knowledge and evidence related to (i) multiple epidemiological aspects, including drivers of transmission, morbidity and mortality associated with infections with different MPXV sub-clades; (ii) the incompleteness and uncertainties of available epidemiological data and considered by the Committee, due to the limitations of current surveillance (e.g., sub-optimal levels of case detection and case reporting), the availability and performance of laboratory diagnostics, and ongoing conflicts and humanitarian challenges in certain areas of the DRC experiencing the upsurge of mpox, that, ultimately, hamper the implementation of control measures; (iii) the impact of control measures, including the targeted use of vaccines and their overall effectiveness; and (b) the risk of occurrence of additional mutations of MPXV clade I and clade II, and their subsequent emergence and spread in the context of limited capacity to implement control measures.

The Committee considered that the event constitutes a public health risk to other States through the international spread of disease because of (a) the documented recent spread of MPXV clade Ib from eastern DRC to Burundi, Kenya, Rwanda and Uganda; (b) the limited capacity to control transmission in endemic situations and in areas of upsurge through enhanced surveillance enabling the implementation of targeted response interventions that are ultimately subordinated to (i) the unavailability of sustainable funding, and (ii) the limited ability to access vaccines, therapeutics, and diagnostics; and (c) the challenges in implementing concerted surveillance and response interventions in contiguous areas of bordering States Parties, in particular where borders are porous.

The Committee considered that the event requires a coordinated international response. The Committee noted that (a) mpox is endemic in parts of Africa, with surges increasingly reported, and also resulting in a multi-country outbreak determined to constitute a PHEIC in 2022-2023; and (b) the event is occurring in the context of standing recommendations issued by the Director-General in August 2023 under IHR provisions and following the termination of the afore mentioned PHEIC; the presence of the WHO Strategic framework for enhancing prevention and control of mpox- 2024-2027; and the activation for mpox of the i-MCM-Net. In that light and noting the declaration of the event as a Public Health Emergency of Continental Security by the Africa CDC on 13 August 2024, the Committee considered that international cooperation requires enhanced and coordination, in particular with respect to (a) the facilitation of equitable access to vaccines, therapeutics, and diagnostics; and (b) the mobilization of financial resources.

The Committee subsequently considered the draft of the temporary recommendations proposed by the WHO Secretariat, briefly presented during the meeting. The Committee indicated that it would be giving further consideration to the proposed temporary recommendations while finalizing the report of the meeting.

The Committee noted that, in his opening remarks, the Director-General communicated the 12-month extension of the current standing recommendations for mpox, which were set to expire on 20 August 2024. The Committee also noted that, should the Director-General determine that the upsurge of mpox constitutes a PHEIC, it would be the first time, since the entry into force of the Regulations, that temporary and standing recommendations to States Parties related to the same public health risk would coexist.

Therefore, the Committee underscored that any temporary recommendation that may be issued by the Director-General should be very specific and targeted, and hence, not duplicate the standing recommendations.

Notwithstanding that both, temporary and standing recommendations constitute non-binding advice to States Parties, the Committee advised that mechanisms to monitor the uptake, implementation and impact of such recommendations should be embedded in the set of temporary recommendations to States Parties that the Director-General may issue in relation to the event considered.

The Committee reiterated its concern regarding the evolution of the multi-faceted upsurge of mpox, including the many uncertainties surrounding it and the capacities in place to control the spread of mpox in States Parties experiencing the outbreaks, or in States Parties that may have to do so as a result of further international spread.

The Committee recognized the critical role of coordinated international cooperation in supporting States Parties efforts to control the spread of mpox in the WHO African Region including in facilitating access to and use of vaccines, therapeutics, and diagnostics; mobilizing financial resources for States Parties experiencing the upsurge of disease; and synergic initiatives by WHO and partners, including Africa CDC.

Nevertheless, the Committee indicated that the development of strategic approaches for States Parties to become more self-reliant in controlling the spread of mpox are warranted. To that effect, the Committee considers that the determination by the Director-General that the upsurge of mpox constitutes a PHEIC would stimulate States Parties facing the outbreaks to more effectively commit and employ domestic resources.

These temporary recommendations are issued to States Parties experiencing the upsurge of mpox, including, but not limited to, the Democratic Republic of the Congo and Burundi, Kenya, Rwanda, and Uganda.

They are intended to be implemented by those States Parties in addition to the current standing recommendations for mpox, which will be extended until 20 August 2025 and are presented at the end of this document for easy reference.

In the context of the global efforts to prevent and control the spread of mpox disease outlined in the WHO Strategic framework for enhancing prevention and control of mpox- 2024-2027, the aforementioned standing recommendations apply to all States Parties.

All current WHO interim technical guidance can be accessed on this page of the WHO website. WHO evidence-based guidance has been and will continue to be updated in line with the evolving situation, updated scientific evidence, and WHO risk assessment to support States Parties in the implementation of the WHO Strategic Framework for enhancing mpox prevention and control.

Pursuant to Article 3 Principle of the International Health Regulations (2005) (IHR), the implementation of these temporary recommendations, as well as of the standing recommendations for mpox, by States Parties shall be with full respect for the dignity, human rights and fundamental freedoms of persons, in line with the principles set out in Article 3 of the IHR.

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Emergency Coordination

Collaborative Surveillance and Laboratory Diagnostics

Safe and Scalable Clinical Care

International traffic

Vaccination

Risk communication and community engagement

Governance and financing

Addressing research gaps

Reporting on the implementation of temporary recommendations

A. States Parties are recommended to develop and implement national mpox plans that build on WHO strategic and technical guidance, outlining critical actions to sustain control of mpox and achieve elimination of human-to-human transmission in all contexts through coordinated and integrated policies, programmes and services. Actions are recommended to:

B. States Parties are recommended to, as a critical basis for actions outlined in A in support of the elimination goal, establish and sustain laboratory-based surveillance and diagnostic capacities to enhance outbreak detection and risk assessment. Actions are recommended to:

4. Include mpox as a notiable disease in the national epidemiological surveillance system.

5. Strengthen diagnostic capacity at all levels of the health care system for laboratory and point of care diagnostic conrmation of cases.

6. Ensure timely reporting of cases to WHO, as per WHO guidance and Case Reporting Form, in particular reporting of conrmed cases with a relevant recent history of international travel.

7. Collaborate with other countries so that genomic sequencing is available in, or accessible to, all countries. Share genetic sequence data and metadata through public databases.

8. Notify WHO about signicant mpox-related events through IHR channels.

C. States Parties are recommended to enhance community protection through building capacity for risk communication and community engagement, adapting public health and social measures to local contexts and continuing to strive for equity and build trust with communities through the following actions, particularly for those most at risk. Actions are recommended to:

9. Communicate risk, build awareness, engage with aected communities and at-risk groups through health authorities and civil society.

10. Implement interventions to prevent stigma and discrimination against any individuals or groups that may be aected by mpox.

D. States Parties are recommended to initiate, continue, support, and collaborate on research to generate evidence for mpox prevention and control, with a view to support elimination of human-to-human transmission of mpox. Actions are recommended to:

11. Contribute to addressing the global research agenda to generate and promptly disseminate evidence for key scientic, social, clinical, and public health aspects of mpox transmission, prevention and control.

12. Conduct clinical trials of medical countermeasures, including diagnostics, vaccines and therapeutics, in dierent populations, in addition to monitoring of their safety, eectiveness and duration of protection.

13. States Parties in West, Central and East Africa should make additional eorts to elucidate mpox-related risk, vulnerability and impact, including consideration of zoonotic, sexual, and other modes of transmission in dierent demographic groups.

E. States Parties are recommended to apply the following measures related to international travel. Actions are recommended to:

14. Encourage authorities, health care providers and community groups to provide travelers with relevant information to protect themselves and others before, during and after travel to events or gatherings where mpox may present a risk.

15. Advise individuals suspected or known to have mpox, or who may be a contact of a case, to adhere to measures to avoid exposing others, including in relation to international travel.

16. Refrain from implementing travel-related health measures specic for mpox, such as entry or exit screening, or requirements for testing or vaccination.

F. States Parties are encouraged to continue providing guidance and coordinating resources for delivery of optimally integrated clinical care for mpox, including access to specic treatment and supportive measures to protect health workers and caregivers as appropriate. States Parties are encouraged to take actions to:

17. Ensure provision of optimal clinical care with infection prevention and control measures in place for suspected and conrmed mpox in all clinical settings. Ensure training of health care providers accordingly and provide personal protective equipment.

18. Integrate mpox detection, prevention, care and research within HIV and sexually transmitted disease prevention and control programmes, and other health services as appropriate.

G. States Parties are encouraged to work towards ensuring equitable access to safe, eective and quality-assured countermeasures for mpox, including through resource mobilization mechanisms. States Parties are encouraged to take action to:

19. Strengthen provision of and access to diagnostics, genomic sequencing, vaccines, and therapeutics for the most aected communities, including in resource-constrained settings where mpox occurs regularly, and including for men who have sex with men and groups at risk of heterosexual transmission, with special attention to those most marginalized within those groups.

20. Make mpox vaccines available for primary prevention (pre-exposure) and post-exposure vaccination for persons and communities at risk of mpox, taking into account recommendations of the WHO Strategic Advisory Group of Experts on Immunization (SAGE).

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First meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024 - World Health Organization (WHO)

Since mid-June, one of our teams has been supporting Uvira health zone in South Kivu, and assisting the medical management of severe cases through an isolation center at the Uvira General Referral Hospital, as well as monitoring simple and moderate cases on an outpatient basis and isolating suspected cases. Our teams are training medical staff on medical management and are also involved in infection control and raising awareness in communities. Over the last seven weeks in Uvira, MSF has treated more than 600 patients, including 217 serious cases. We are also providing hospitals with kits for treatment and for taking samples of the disease. In Minova, our teams set up an isolation center at the general reference hospital.

In Goma, North Kivu, we have launched surveillance and awareness-raising activities in camps for displaced people where we are present. We are strengthening the capacity of health structures to manage triage, isolation, and the treatment of patients presenting symptoms of mpox.

In the northwest of DRC, two other interventions have been launched: one in the Bikoro health zone in Equateur and the other in the Budjala health zone in South-Ubangi. This time, operations will be long-term, lasting several months. We also aim to train medical staff in medical and psychological care and step up epidemiological surveillance and infection prevention and control, including community awareness-raisingparticularly for people who are sometimes harder to reach, such as people with disabilities. In Budjala, more than 500 patients were treated with our support between mid-June and mid-July. In Equateur, we will be conducting operational research with the health authorities to better understand the dynamics of the virus and combat the disease.

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Mpox outbreak in DR Congo: What to know - Doctors Without Borders (MSF-USA)

Just one day after the World Health Organization (WHO) declared the highest level of alert for mpox outbreaks in African countries for the second time in two years, the first case in Europe was also reported.

The infected individual is said to have contracted the virus while staying in an African region experiencing a significant outbreak of the disease, according to the Director-General of the Swedish Health Agency during a press conference on Thursday.

These recent developments have led to an increase in discussions on social media, with a noticeable rise in claims about the viral disease many of which are untrue.

Claim:"What they are selling us as MONKEYPOX is, in most cases, actually herpes zoster; one of the most common side effects of the COVID 'vaccine'",wrote this X-user on August 14, 2024, quoting the German doctor and politician Wolfgang Wodarg. The post has already been viewed 2 million times.

DW fact check: False

The claim originates from a video interview with Wolfgang Wodarg , a physician and former Social Democrat (SPD)member of the German Bundestag, who later became a leading candidate for the small party dieBasis (the base), which was founded in the context of protests against COVID-19 measures. The video was released in 2022 by the controversial Austrian broadcaster AUF1.

What the user claims in the accompanying text of the post has also been shared by others: Example 1 (Portuguese, 178K views),Example 2 (Spanish, 498.5K views), Example 3 (Spanish, 117K views).

Most of the posts we found on this topic were in Spanish and Portuguese. According to a study by Loyola University Andalusia , which analyzed the period from May 7 to September 10, 2022, the narrative that mpox is a side effect of COVID-19 vaccines was shared more frequently than any other false claim about mpox.

When asked if there is a connection between the COVID-19 vaccine and the mpox outbreak, microbiologist and immunologist Kari Moore Debbink from the Johns Hopkins Bloomberg School of Public Health in the US said in a DW interview: "The COVID mRNA vaccines were used globally, while mpox cases are typically found in specific countries in Africa, with some low case numbers outside of those regions. Therefore, there is no geographic link between COVID mRNA vaccine use and mpox cases."

William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center in Nashville, US, shares this opinion: "These are two completely different viruses, and of course, the vaccine against COVID has nothing to do with mpox."

We have already thoroughly debunked theclaim that the AstraZeneca COVID vaccine contains weakened viruses from chimpanzees as carriers for the DNA of the coronavirus spike protein in a previous fact-check.

The viral X-post also claims thatmpox isactually herpes zoster, also known as shingles, in most cases.

According to a 2022 study published in the Journal of the European Academy of Dermatology and Venereology , the varicella-zoster virus (VZV), which causes herpes zoster and chickenpox,can be reactivated through vaccinations. The study also shows that individuals vaccinated with various COVID-19 vaccines have an increased risk of herpes zoster outbreaks.

However, there is no connection between the mpox pathogen and VZV, says Kari Moore Debbink: "Mpox and herpes zoster are in different virus groups, so testing is easily able to discern between the two viruses. While both viruses can cause similar symptoms including rashes, fever, swollen lymph nodes, and malaise, there are also distinct characteristics of the rashes caused by each virus making it possible to tell them apart by sight and symptoms."

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Mpox is much less contagious than COVID-19. While the mpox pathogen is transmitted through close physical skin-to-skin contact or contact with contaminated materials (towels, beddingand clothing), the coronavirus is extremely contagious and can be spread through tiny droplets in the air from breathing, speaking, sneezingor coughing. COVID-19 canbe transmitted by others who have the virus, even if they have no symptoms. The California Department of Public Health has listed additional differences between coronaviruses and mpox viruses on its website.

The massive misinformation surrounding vaccinesin generalis a cause ofconcern for medical professionals.

"The misinformation that is being spread about all vaccines, about theCOVID-19 vaccine, and now mpox also just results in a great deal of confusion and mistrust in public health authorities.Thatmakes it much more difficult for countries and their ministries of public health to try to provide the best information and to help people. So, all of thisconfusion makes good intentions much more difficult," says Schaffner.

How to protect yourself from health-related misinformation and which questions can help areillustrated in this DW infographic:

This article was originally written in German.

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Fact check: No link between mpox and COVID vaccination - DW (English)

Image used for representational purpose. | Photo Credit: Reuters

The Union Health Ministry on Monday (August 19, 2024) said the strain of monkeypox virus currently in circulation in the Democratic Republic of Congo and more than a dozen African countries is virulent and has a death rate of 3% as opposed to 0.1% from the less virulent strain.

As per our assessment the chances of its spread into India from Africa are moderate. We are also not putting in any country-wise alert as there is no cause for alarm as of now. Hospitals and doctors, however, have been alerted that any patient coming in with symptoms must be reported immediately. India is also looking at large scale testing provisions should the need arise, said a senior Health Ministry official on Monday, adding that there are no reported cases of monkeypox in India as of date.

He added that although the possibility of a few imported cases being detected in the coming weeks cannot be ruled out, it has been assessed that the risk of a large outbreak with sustained transmission is presently low for India.

Also read | WHO declares mpox outbreaks in Africa a global health emergency

The World Health Organization (WHO) declared monkeypox a public health emergency of international concern (PHEIC) for the second time on August 14, warning that the viral disease could spread quickly to new countries. The announcement was made after an emergency committee of independent experts reviewed the rapidly rising number of infections in the Democratic Republic of the Congo (DRC) and the spread of the disease to new African nations where it had previously never been recorded.

The number of infections is 160% higher than in 2023, and the virus has spread to six new countries in 10 days, the Africa Centres for Disease Control and Prevention had noted, earlier this month.

There are two subtypes of the virus the more virulent Clade 1, endemic in the Congo Basin in central Africa and Clade 2, endemic in West Africa.

Monkeypox infections are usually self-limiting, lasting between 2-4 weeks and patients generally recover with supportive management. The transmission requires prolonged close contact with an infected person and is generally through the sexual route, direct contact with body/lesion fluid, or the contaminated clothing/linen of an infected person.

WHO had earlier declared monkeypox as a PHEIC in July 2022 and subsequently revoked the same in May 2023. Globally, since 2022, WHO has reported 99,176 cases and 208 deaths due to monkeypox from 116 countries. Since the 2022 declaration by WHO, a total of 30 cases were detected in India, with the last case in March 2024.

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Risk of large outbreak of mpox low in India for now, says Health Ministry official - The Hindu

Mpox has been declared a global emergency by the World Health Organization (WHO), with a new strain spreading across Africa at an alarming rate.

Officials announced last Wednesday that an outbreak of the strain in the Democratic Republic of the Congo (DRC) was now a "public health emergency of international concern".

It is the second time in three years that the WHO has designated an mpox epidemic as a global emergency.

It comes as the number of mpox cases reported so far this year has already exceeded last year's total, with more than 17,000 cases and 571 deaths according to the WHO.

But what is mpox, what are the symptoms, how is it treated, and what's being done about the outbreak?

The viral disease has occurred mostly in central and western Africa.

The most recent strain, first spotted in the DRC, has spread to neighbouring countries, including some that have never reported mpox cases before.

It was first identified in laboratory monkeys, according to the US Centers for Disease Control and Prevention (CDC).

It used to be known as monkeypox, but was renamed in 2022 by the WHO after receiving complaints that the original name was "racist and stigmatising".

Most cases are mild, but it can be deadly.

The disease spreads through close contact with infected people, including via sex and other skin-to-skin contact, with the latest outbreak in the continent beginning with the spread of an endemic strain known as Clade 1.

The new variant that has emerged, known as Clade 1b, appears to spread more easily through close contact, particularly among children.

Jean Claude Udahemuka, from the University of Rwanda, said last month that Clade 1b is "undoubtedly the most dangerous so far of all the known strains of mpox".

What are the symptoms?

Common symptoms of mpox are a skin rash or pus-filled lesions which can last two to four weeks.

The rashes can be located anywhere on the body and some people may only have one, while others can have hundreds or more.

These are other symptoms listed by the CDC:

The WHO says people may start to feel unwell before they get a rash or skin lesions, while for others the skin symptoms can be the first or only sign.

People with more severe mpox can suffer with the following symptoms, according to the WHO:

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New-born babies, children, people who are pregnant and people with underlying immune deficiencies may be at higher risk of more serious mpox disease and death, the WHO adds.

How is it treated?

Currently, there is no treatment approved specifically for mpox infections, according to the CDC.

It says that for most patients with mpox who have intact immune systems and don't have a skin disease, supportive care and pain control will help them recover without medical treatment.

People with severe mpox may require hospital treatment, supportive care and antiviral medicines to reduce the severity of lesions and shorten the time to recovery, the WHO says.

Many years of research on treatments for smallpox have led to the development of products that may also be useful for treating mpox, it adds.

It says an antiviral developed to treat smallpox called tecovirimat was approved by the European Medicines Agency for the treatment of mpox under exceptional circumstances in 2022. It also said its use for mpox has been limited so far.

However, a two-dose vaccine has been developed to protect against the virus, which is widely available in Western countries but not in Africa.

Scientists from the Africa Centres for Disease Control and Prevention (Africa CDC) say they need more than 10 million vaccine doses but only 200,000 are available.

How did things get worse in Africa?

Mpox has been endemic in parts of Africa for decades after it was first detected in humans in DR Congo in 1970.

But the Clade 1b strain first emerged in September among sex workers in the DRC mining town of Kamituga, about 170 miles (273km) from the border with Rwanda.

Africa CDC has said 96% of all cases and deaths were in the DRC, but it has also spread to neighbouring countries, with 18 nations reporting cases of mpox.

Keep up with all the latest news from the UK and around the world by following Sky News

'It's an emergency for the entire globe'

The WHO declared an emergency as it thinks the strain is "potentially the outbreak that can become a pandemic," according to Dr Jean Kaseya, the director general of Africa Centres for Diseases Control and Prevention.

When making the announcement, the WHO's director-general Dr Tedros Adhanom Ghebreyesus said: "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying.

"On top of outbreaks of other mpox clades in DRC and other countries in Africa, it's clear that a coordinated international response is needed to stop these outbreaks and save lives."

The WHO's committee chair, Professor Dimie Ogoina, added: "The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe.

"Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."

The WHO says it is focusing on making the vaccines more widely available, particularly for lower-income countries.

A day after the global emergency was declared, Swedish officials confirmed the country had recorded its first case of the new mpox variant.

Are there cases in the UK - and have there been before?

There are currently no cases of the virus in the UK, the UK Health Security Agency (UKHSA) has said, and its deputy director Dr Meera Chand claims the risk "is currently considered low".

"However, planning is under way to prepare for any cases that we might see in the UK," she added.

"This includes ensuring that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission."

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Government officials have now met to "ensure sufficient plans are in place to deal with any potential cases," Downing Street said.

Professor Paul Hunter, an infectious diseases expert, told Sky News it was "very likely" someone in the UK already has the new variant of the viral disease.

However, he said it probably wouldn't be confirmed for a few weeks until people with symptoms visit a doctor and their samples are tested.

There have been cases in the UK before, with most seen in 2022 when there was a global outbreak of a milder strain which spread to more than 100 countries, prompting the WHO to declare a public health emergency of international concern on 23 July 2022.

A total of 2,137 cases had been confirmed in the UK at that stage, but by 31 December 2022 that number had soared to 3,732 cases - 3,553 were in England, 34 in Northern Ireland, 97 in Scotland and 48 in Wales.

Before the spring of 2022, UK cases were usually associated with travel to or from countries where mpox is endemic, particularly in western or central Africa.

But in May that year, there was a large outbreak in the UK, mostly in men who are gay, bisexual, or have sex with other men.

A vaccination programme was launched in the UK in the summer of 2022 and closed the following July.

There have been no reported deaths due to mpox in the UK.

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How does mpox spread and what is the risk to the rest of the world? - Sky News

LONDON The World Health Organization has declared the ongoing outbreaks of mpox in Congo and elsewhere in Africa to be a global emergency, requiring urgent action to curb the virus transmission.

Sweden has since announced it had found the first case of a new form of mpox previously only seen in Africa in a traveler, while other European health authorities warned more imported cases were likely.

Heres a look at mpox and how likely it is to spread further:

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Get the latest public health updates.

That seems highly unlikely. Pandemics, including the most recent ones of swine flu and COVID-19, are typically sparked by airborne viruses that spread quickly, including by people who may not be showing symptoms.

Mpox, also known as monkeypox, is spread primarily through close skin-to-skin contact with infected people or their soiled clothes or bedsheets. It often causes visible skin lesions that could make people less likely to be in close contact with others.

To stay safe, experts advise avoiding close physical contact with someone who has lesions resembling mpox, not sharing their utensils, clothing or bedsheets and maintaining good hygiene like regular hand-washing.

On Friday, Europes Centre for Disease Prevention and Control said that more imported cases of mpox from Africa were highly likely, but the chances of local outbreaks in Europe were very low.

Scientists say the risk to the general population in countries without ongoing mpox outbreaks is low.

Mpox spreads very slowly unlike the coronavirus. Shortly after the coronavirus was identified in China, the number of cases jumped exponentially from several hundred to several thousand; in a single week in January, the case count increased more than tenfold.

By March 2020, when WHO described COVID-19 as a pandemic, there were more than 126,000 infections and 4,600 deaths about three months after the coronavirus was first identified.

In contrast, its taken since 2022 for mpox cases to hit nearly 100,000 infections globally, with about 200 deaths, according to WHO.

There are vaccines and treatments available for mpox unlike in the early days of the COVID-19 pandemic.

We have what we need to stop mpox, said Dr. Chris Beyrer, director of Duke Universitys Global Health Institute. This is not the same situation we faced during COVID when there was no vaccine and no antivirals.

Its unclear. The 2022 mpox outbreak in more than 70 countries was slowed within months, thanks largely to vaccination programs and drugs being made available to at-risk populations in rich countries.

At the moment, the majority of mpox cases are in Africa and 96% of those cases and deaths are in Congo, one of the worlds poorest countries whose health system has mostly collapsed from the strain of malnutrition, cholera and measles. Although Congolese officials requested 4 million vaccines from donors, it has yet to receive any.

Despite WHO declaring mpox a global emergency in 2022, Africa got barely any vaccines or treatments.

Beyrer of Duke University said it was in the worlds interest to invest now in squashing the outbreaks in Africa.

We are actually in a good place to get control of this pandemic, but we have to make the decision to prioritize Africa, he said.

Read more:

Will mpox trigger another pandemic like COVID-19? - The Dallas Morning News

Public health teams are learning more about the global mpox outbreak, which continues to gain momentum. As case counts rise locally and across the country its more important than ever that people understand how this virus is transmitted, what activities put people at risk and what to do if you think youre infected or have been exposed.

This situation continues to evolve, and the information below is based on the understanding of this outbreak at the time of this post's publication. Much like we did with COVID-19, well likely know much more in the weeks and months to come. But for now, heres what we think you should know about mpox and how you can stay safe.

Q: What is mpox?

A: Mpox began in animals and was transmitted to humans. Its transmitted through close contact with another mpox patient or from rodents carrying the disease. Its part of the same family as other poxviruses including smallpox (orthopoxviridae), and was first discovered in humans in 1970.

Q: What does mpox look like?

A: An mpox rash starts as red spots and progresses over time to pus-filled, blister-like lesions. They remain infectious until they eventually scab over and fall off, which can take up to a month. The lesions are generally all the same size and develop at the same rate. These painful pustules are usually but not always found on the face, hands, legs and feet. Sometimes this rash is found only in or on the genitals or anus, which means symptoms may be mistaken for a sexually transmitted infection or STI.

A person with mpox may feel like theyre coming down with a cold or flu days before their rash develops. They may also have swollen lymph nodes.

Q: How does mpox spread?

A: Mpox spreads through direct, prolonged skin-to-skin contact with lesions or the fluid inside them. Risk of exposure through skin increases with time and friction.

In addition, the virus can be spread by breathing in or directly contacting infected respiratory droplets or other body secretions, like saliva. Mpox has also been transmitted from surfaces that were contaminated with respiratory droplets or fluid from the lesions, but thats less likely to occur than infection from skin-to-skin contact.

Q: What activities are more likely to expose me to mpox?

A: Your risk escalates when your uncovered skin is in contact with an uncovered mpox lesion. That risk gets higher the more abrasion there is during the contact and the more time your skin touches the infected skin. Highest risk activities include sex, intimacy, and kissing. Other risky activities include living with someone who has mpox, sharing towels and sheets with an infected person, wrestling and attending raves, large concerts or circuit parties where lots of people are packed into close spaces.

Casual contact like public transportation, grocery shopping or touching door handles or gym equipment has a much lower, even negligible risk.

Q: How can I protect myself from mpox?

A: If you think youre going to be in a crowded space where your skin may be exposed to someone elses, wear more clothing and consider wearing a mask. If youre having sexual or intimate contact with multiple people or with anonymous partners, consider modifying your sexual behavior at least for now. Consider the risk of new or unknown partners and check your own skin and your partners skin for rashes or lesions. If youre eligible to get an mpox vaccine either because you are in a high-risk category or because youve been exposed you should strongly consider it. (Be aware that supplies and eligibility are limited for now.)

While youre unlikely to catch mpox from door handles or passing contact with someone whos infected, we recommend people continue to follow common-sense infection prevention measures, such as wearing masks, washing hands regularly and cleaning high-touch surfaces.

Q: How long does it take to become sick?

A: It can take anywhere from five to 21 days to become sick with mpox after an exposure. That long incubation period means we can give people treatments or vaccines early after an exposure to keep them from getting sick.

Once someone becomes infected, their illness lasts about two to four weeks.

Q: What should I do if Ive been exposed to mpox?

A: If you know youve had close contact with someone who has mpox, contact your healthcare provider or your local health department right away because you may be eligible to get a post-exposure vaccination. This is called post-exposure prophylaxis and may be help to keep you from getting infected.

These vaccines are limited so they are only reserved for people whove had high-risk exposure to someone with mpox.

Anyone who has had contact with mpox should plan to monitor symptoms for three weeks and get an mpox test if you begin to develop a rash or lesions.

Q: Can I get tested for mpox?

A: Mpox testing is widely available in the community and here at the University of Chicago Medicine. Unlike a COVID-19 test or a blood test, doctors can only test for mpox by scraping cells from a fluid-filled mpox lesion. Without a lesion or a rash, you wont be able to get a mpox test.

If you have a lesion, you should request an appointment with a primary care provider, community clinic, infectious diseases specialist, dermatologist or a sexual wellness clinic, since these providers will have the most familiarity with mpox cases.

At your appointment, your health care provider will examine your skin and ask questions about your exposure risk and your health history to determine if they think you may need an mpox test.

Q: How long will I need to isolate if I test positive for mpox?

A: One of the hardest things about mpox is that your isolation period is going to be especially long. It takes about four weeks for most peoples lesions to crust over and fall off. (You are considered infectious until this happens and fresh, healthy skin appears.) For some people, that may happen in two to three weeks, but for most people recovery takes about a month. This long isolation time means you may need to take short-term disability from work if youve been infected.

Q: Will I need medical care for mpox? How can I treat myself at home, and when do I need to see a doctor?

A: The good news is that most people will be able to stay at home and treat their symptoms with things like rest, fluids, calamine lotion and over-the-counter painkillers such as Tylenol or Advil.

But others may have more severe cases. In those situations, doctors can prescribe antiviral medications, such as cidofovir or tecovirimat, or may give someone immune globulin antibodies if they cant get other kinds of treatment. People who have lesions in their rectum or mouth, or who have swollen lymph nodes, may also need support for pain management. Youll also want to check with your doctor if you have lesions near your eye or if your lesions start to bruise or bleed. In those cases, you may need extra medical support.

Lastly, make sure you dont touch or scratch your lesions. That may spread them to other parts of your body, increases the time they take to heal and can make you prone to additional skin infections and leave you with more scarring.

Q: Are certain people more at risk for mpox?

A: Unlike previous outbreaks, most people currently being infected with confirmed cases of mpox are those who identify as gay or bisexual men. However, cases arent limited by sex or sexual orientation, and its inaccurate to assume mpox is only transmitted among those in the LBGTQ+ community. Theres a real risk of stigmatizing mpox infections if people take such a narrow view.

Q: Is mpox a sexually transmitted infection?

A: Mpox can be transmitted during sex, and about 95% of cases right now involve some sort of sexual or intimate contact. But its not categorized as a sexually transmitted infection since it can also be transmitted through other ways.

Q: Can I get vaccinated against mpox?

A:The two-dose series of mpox JYNNEOS vaccine is currently available to anyone who:

The vaccine is recommended for those who are or anticipate:

Q: What should I do if I live with someone who has mpox?

A: If someone in your house has mpox, have them isolate as much as possible and use their own bathroom (if thats an option). Wipe down high-touch surfaces regularly with a disinfectant labelled as killing viruses, wash your hands often with soap and water or use alcohol-based hand sanitizer and try not to touch their dishes, toothbrushes or drinking glasses. Both of you should wear masks if you need to be around each other, and they should cover their lesions as much as possible if they need to leave their isolation area. (This can be done by wearing long sleeves and pants, nitrile or latex gloves, and even using a Band-aid on a lesion thats on the face. They should follow these steps if they have to go to the doctor, too.)

When you live in close quarters with someone who has mpox, its also important to pay attention to how youre washing sheets, towels and clothing that may have come in contact with their skin lesions. This is because mpox viral particles can dry and stay on surfaces for up to 15 days. Dont shake out soiled linens or laundry instead, ball them up carefully and slowly while wearing a mask and gloves, then toss them directly in the washing machine. Use hot water and any soap or laundry detergent you have available. After the hot wash cycle, the laundry is no longer infectious.

Q: How dangerous is mpox?

A:This outbreak had initially involved whats known as the Western African clade (Clade II), which is less severe and has a fatality rate of about 1 percent. More recently, however, there has been an increased number of cases involving the Congo Basin clade (Clade I), which has a higher fatality rate. Many of those fatal cases have occurred in geographic areas where there arent many medical resources, which means people likely had worse outcomes than they would have in other regions of the world.

Read the original:

What you should know about the new mpox outbreak - UChicago Medicine

On 14 August 2024, the Director-General of the World Health Organization (WHO) determined that the resurgence of Mpox in the Democratic Republic of Congo (DRC) and a growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC). Temporary recommendations are being developed with input from the International Health Regulations Emergency Committee and will be available in the coming days.

The emergence and rapid spread of a new virus strain in the Democratic Republic of the Congo, clade Ib, which appears to spread mainly through sexual networks, and its detection in neighboring countries of the Democratic Republic of the Congo are one of the main reasons for the declaration of PHEIC.

This Epidemiological Update provides a summary of the situation in the Americas based on cases reported to the Pan American Health Organization / World Health Organization (PAHO / WHO) and published on the official websites of the Ministries and Health Agencies of the Americas.

Read this article:

Epidemiological Update Mpox in the Americas Region - 17 August 2024 - Pan American Health Organization

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How do you test for monkeypox? What you need to know about mpox virus. - NorthJersey.com