Monkeypox updates: Outbreak not yet public health emergency, WHO says
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Healio is tracking updates on the widening outbreak of monkeypox.
[Editor's note: This post was originally published on May 24. It is being updated regularly by Healio staff.]
Monkeypox not yet a public health emergency, WHO says
On Saturday, June 25, WHO declined to declare the ongoing monkeypox outbreak a public health emergency of international concern, or PHEIC.
The announcement came after an emergency committee convened Thursday to discuss the outbreak. They noted that more than 3,000 cases have been reported since mid-May outside of regions in West and Central Africa where the virus is endemic, and the first death associated with the outbreak has also been reported in an immunocompromised person.
WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, reiterated the seriousness of monkeypox as a health threat. In a statement, he said the outbreak “is clearly an evolving health threat” that “requires our collective attention and coordinated action now.”
“We will continue to monitor the situation closely, follow their advice for continuing vigilance and possible reconvening in the coming days and weeks based on the evolution of the outbreak,” he said. Tedros statement. WHO update.
Monkeypox virus ‘not known to linger in the air’
Unlike SARS-CoV-2, monkeypox virus “is not known to linger in the air and is not transmitted during short periods of shared airspace,” the CDC said in a statement, clarifying that airborne transmission of the virus has not been reported.
“Monkeypox spreads through direct contact with bodily fluids or sores on the body of someone who has monkeypox, or with direct contact with materials that have touched these bodily fluids and sores, such as clothing or linen,” CDC Director Rochelle P. Walensky, MD, MPH, said during a press briefing. “It may also spread through respiratory secretions when people have close, sustained face-to-face contact.”
Walensky added that monkeypox “is not thought to spread through interactions such as having a casual conversation, passing in the grocery store or touching the same item such as a doorknob.”
“We do not yet know whether the virus may be spread through contact with semen or vaginal fluids, or the potential for transmission from people who are infected with monkeypox but have no or mild symptoms,” she said.
The clarifications came days after the CDC posted, and then removed, a mask recommendation in its monkeypox travel advisory to avoid confusion, according to Reuters.
Walensky said people diagnosed during the ongoing outbreak occurring outside Africa have described “close, sustained physical contact with other people who were infected with the virus. This is consistent with what we’ve seen in prior outbreaks and what we know from decades of studying this virus and closely related viruses,” she said.
As of June 9, Walensky said there have been more than 1,300 reported cases of monkeypox in 31 countries outside of Africa, including 45 cases in 15 U.S. states and Washington, D.C. CDC statement. Reuters story.
CDC issues travel alert for monkeypox outbreak
The CDC has issued a travel alert for the monkeypox outbreak occurring outside Africa, advising travelers to “practice enhanced precautions” like avoiding close contact with sick people and any contaminated items they may have used, such as clothing or bedding.
The agency raised its travel notice for the outbreak from “watch” to “alert” — the second highest of three levels. The highest level, level three, instructs people to “avoid nonessential travel.”
The new warning came as the total number of confirmed cases of monkeypox outside of Africa surpassed 1,000 in 29 affected countries, according to the CDC, including 30 cases in the U.S. Travel notice. Outbreak map.
Genetic data suggest multiple monkeypox outbreaks, CDC says
New genetic sequencing data indicate there are at least two separate monkeypox outbreaks underway outside of Africa, the CDC said Friday, June 3. Read more.
CDC updates monkeypox case definitions
The CDC updated its case definitions for monkeypox, including adding a definition for a suspect case: someone with a new characteristic rash, or someone who meets one of the epidemiologic criteria for monkeypox and has a “high clinical suspicion” for the disease. CDC case definitions. Raj Panjabi, MD, tweet.
Monkeypox outbreak grows, may have been smoldering ‘for some time’
More than 550 monkeypox cases have been reported in 30 countries where the disease is not endemic, suggesting the outbreak may have been smoldering for a while before it was recognized, WHO said.
In a new assessment, WHO raised the risk that the outbreak poses to global public health from “low” to “moderate,” attributing the change to the unprecedented occurrence of cases in multiple geographical areas including the United States, where there were 18 confirmed cases in nine states as of May 31, according to the CDC. Read more.
How to prevent, diagnose and treat monkeypox
Clinicians should prepare now for the possibility of having to diagnose and treat cases of monkeypox, according to an opinion paper published in Annals of Internal Medicine.
Physicians in primary care, urgent care, emergency medicine, dermatology and STI clinics “may be most likely to identify new patients with monkeypox should they continue to appear,” Amesh Adalja, MD, and Tom Inglesby, MD, of the Johns Hopkins Center for Health Security, wrote. Read more.
Stigmatizing language discourages treatment, experts say
After the CDC announced that nine monkeypox cases have been confirmed in seven U.S. states, the Infectious Disease Society of America and HIV Medicine Association issued a statement expressing concern over the use of “racist and homophobic language” regarding the growing outbreak and noting that the disease is not exclusive to any specific population.
“Stigmatizing language that casts blame on specific communities undermines disease response and discourages those who need treatment from seeking it,” IDSA President Daniel P. McQuillen, MD, FIDSA and HIVMA Chair Marwan Haddad, MD, MPH, said in a joint statement.
“Monkeypox is spread through close physical contact, and no one community is biologically more at-risk than another,” they said.
The outbreak, which has spread to more than a dozen countries, has mostly involved — but is not limited to — men who have sex with men (MSM). IDSA statement.
List of countries with monkeypox cases grows
According to a CDC travel notice updated on Tuesday, 16 countries have reported at least one confirmed case of monkeypox in the ongoing outbreak occurring outside the African countries where the disease is endemic. The list includes the United States, Canada, Australia, Israel and 12 European countries. CDC travel notice.
The European CDC (ECDC) issued an update on Wednesday that listed several other affected countries with confirmed or suspected cases, including Argentina, Morocco and the United Arab Emirates. ECDC update.
UK raises case count to 71, says risk to population is ‘low’
Health officials in the United Kingdom reported 15 additional cases of monkeypox on Tuesday — 14 in England and one in Scotland, the first in that country. The U.K. has now confirmed 71 cases of the disease, but the U.K. Health Security Agency (UKHSA) said the risk to the population remains “low.” UKHSA release.
CDC expects more monkeypox cases in US
The CDC said Monday that it expects more people in the United States to test positive for monkeypox virus amid a widening outbreak of the disease in countries where it is not endemic. Cases have mostly involved — but are not limited to — men who have sex with men (MSM). The European Centre for Disease Prevention and Control said a predominance of cases occurring among MSM “and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse.” Read more.
Waning smallpox immunity ‘established the landscape’ for monkeypox resurgence
Waning population immunity against smallpox — a result of discontinued vaccination campaigns for the now-eradicated disease — “has established the landscape for the resurgence of monkeypox,” researchers said in a study published in February, months before the current outbreak. They came to the conclusion after systematically reviewing dozens of studies and other documents for data on the evolution of monkeypox epidemiology over the past 50 years, which revealed that cases have been increasing since routine smallpox vaccination ceased. Read more.
US, other countries report new cases of monkeypox
On May 18, the CDC confirmed that a Massachusetts resident who traveled from Canada via private transportation was infected with monkeypox virus, the first U.S. case of monkeypox this year. Cases of the disease popped up in other countries, too, sparking concern among experts. Read more.
Q&A: CDC disease detective answers questions about monkeypox
In December, we spoke with Faisal Minhaj, PharmD, a CDC Epidemic Intelligence Officer in the National Center for Emerging and Zoonotic Infectious Diseases, to answer some lingering questions about monkeypox after two travel-related cases were reported in the U.S. last year. Read more.
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