THE RISK OF monkeypox becoming established in non-endemic nations is real, the WHO has warned, with more than a thousand cases now confirmed in such countries.

World Health Organization chief Tedros Adhanom Ghebreyesus said the UN health agency was not recommending mass vaccination against the virus, and added that no deaths had been reported so far from the outbreaks.

“The risk of monkeypox becoming established in non-endemic countries is real,” Tedros told a press conference.

The zoonotic disease is endemic in humans in nine African countries but outbreaks have been reported in the past month in several other states – mostly in Europe, and notably in Britain, Spain and Portugal.

“More than 1,000 confirmed cases of monkeypox have now been reported to WHO from 29 countries that are not endemic for the disease,” Tedros said.

“So far, no deaths have been reported in these countries. Cases have been reported mainly, but not only, among men who have sex with men.

“Some countries are now beginning to report cases of apparent community transmission, including some cases in women.”

The initial symptoms include a high fever, swollen lymph nodes and a blistery chickenpox-like rash.

Tedros said he was particularly concerned about the risk the virus poses to vulnerable groups, including pregnant women and children.

He said the sudden and unexpected appearance of monkeypox outside endemic countries suggested that there might have been undetected transmission for some time, but it was not known for how long.

One case of monkeypox in a non-endemic country is considered an outbreak.

Tedros said that while this was “clearly concerning”, the virus had been circulating and killing in Africa for decades, with more than 1,400 suspected cases and 66 deaths so far this year.

“The communities that live with the threat of this virus every day deserve the same concern, the same care and the same access to tools to protect themselves,” he said.

UK

More than 300 cases of monkeypox have now been identified in England.

The UK Health Security Agency (UKHSA) announced that it has detected 18 additional cases of monkeypox in England, bringing England’s total to 305.

Officials have also found another case in Scotland, bringing the total number of cases there to 11.

Across the UK, 321 cases have been identified up to 7 June, including two in Northern Ireland and three in Wales, UKHSA said.

It comes after the virus became a so-called “notifiable disease” in England, meaning all medics must alert local health authorities to suspected cases.

In a statement, the Health Protection Surveillance Centre (HSPC) said it has been notified of seven confirmed cases of monkeypox in Ireland.

All cases are male and aged between 30 and 50 years, with 37 years being the median age.

The HSPC said that these cases are not unexpected following the presence of monkeypox cases in the UK and many European countries.

“For each case, Public Health is following up those who had close contact with the case while they were infectious,” the statement added.

“Public health risk assessments have been undertaken, and those who were in contact with the cases are being advised on what to do in the event that they become ill.”

Vaccines

In the few places where vaccines are available, they are being used to protect those who may be exposed, such as healthcare workers.

Tedros added that post-exposure vaccination, ideally within four days, could be considered for higher-risk close contacts, such as sexual partners or household members.

Tedros said the WHO would issue guidance in the coming days on clinical care, infection prevention and control, vaccination and community protection.

He said people with symptoms should isolate at home and consult a health worker, while people in the same household should avoid close contact.

Few hospitalisations have been reported, apart from patients being isolated, the WHO said at the weekend.

Sylvie Briand, the WHO’s epidemic and pandemic preparedness and prevention director, said the smallpox vaccine could be used against monkeypox, a fellow orthopoxvirus, with a high degree of efficacy.

The WHO is trying to determine how many doses are currently available and to find out from manufacturers what their production and distribution capacities are.

© AFP 2022, with reporting by Jane Moore and the Press Association.