Monkeypox Declared Global Health Emergency By WHO

Monkeypox Declared Global Health Emergency By WHO

In just over two months a global outbreak of monkeypox in non-endemic countries has led to more than 15 000 cases, with over two thirds reported in the WHO European Region. On 23 July 2022 the WHO Director-General determined that this multicountry outbreak constitutes a Public Health Emergency of International Concern (PHEIC). This represents the highest level of alert under the International Health Regulations.

Majority of the cases are being reported in WHO European Region. In India, 4 cases have been reported till date. Currently, most cases are being resolved without hospitalization or any medication. Death rate is also less.

• The WHO had constituted a committee in June 2022, to study if monkeypox is PHEIC.
• It reconvened the committee on July 21 and declared the monkey pox a PHEIC.
• Last time WHO declared an PHEIC was in 2020 for covid-19.
• Monkeypox disease is caused by monkeypox virus.
• It involves fever for few days and lymph node swelling and a rash, that can leave scars.
• It is much less severe than Covid-19 and spreads less easily. This is why, WHO declared an emergency.

Monkeypox was declared PHEIC because, it is fulfilling the first two criteria of an emergency:

• Spread of the Virus outside West and Central Africa are unusual pattern
• It has already spread internationally, with cases in 75 countries.

PHEIC vs Pandemic:

PHEIC is different than the pandemic. Pandemic is an epidemic that occur over a wide area and affects large number of people. On the other hand, PHEIC is a carefully defined term. It is defined as a situation that is under control, but has potential to grow out of control. Till date, only 6 PHEICs have been declared including Zika, Ebola and Covid-19.

What is Monkeypox?

Monkeypox got its name in 1958, when it was detected in several laboratory apes. It is a zoonotic viral disease, which means it can be transmitted from animals to humans. It can also pass from human to human.

Human monkeypox was first identified in 1970 in the Democratic Republic of the Congo (DRC) in a 9-month-old boy, in a region where smallpox (a close relative) had been eliminated in 1968.

Symptoms are similar to those seen, in the past, in smallpox patients, but it is clinically less severe (smallpox was eradicated worldwide in 1980). In 2003, the first Monkeypox outbreak outside Africa was reported in the United States and was linked to contact with infected pet prairie dogs.

Despite the name, most of the animals susceptible to contracting the disease, and then infecting people, are rodents, such as Gambian giant rats, dormice, or tree squirrels.

What are symptoms of monkeypox?

Symptoms usually include one or more of the following:  

• rash, spots, ulcers, or blister-like lesions anywhere on the body, but often in the genital area 
• swollen and painful lymph glands 
• fever, headache and muscle aches, chills or exhaustion.

How is monkeypox transmitted from animals to humans?

The virus can be spread to people when they come into physical contact with infected animals, which include rodents and primates.

The risk of contracting it from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including contact with their flesh and blood).

It is crucial to stress that any food containing meat or animal parts should be cooked, especially in countries where Monkeypox is endemic.

How is it spread from person to person?

The virus is spread through physical contact with someone who has symptoms. Rashes, body fluids (such as fluids, pus, or blood from skin lesions), and scabs are particularly infectious.

Ulcers, lesions or sores can also be infectious since the virus can be spread through saliva. Contact with objects that have been in contact with the infected person – such as clothing, bedding, towels – or objects such as eating utensils can also represent a source of infection.

People who have the disease are contagious while they have symptoms (usually within the first two to four weeks). It is not clear whether or not people who are asymptomatic can transmit the disease.

How can I protect myself and others?

1. You can reduce the risk of contagion by limiting contact with people who suspect they have the disease, or are confirmed cases.
2. Those who live with infected people should encourage them to self-isolate and, if possible, cover any breaks in the skin (for example, by wearing clothing over the rash).
3. It is important to wear a face mask when in close proximity to the infected person, especially if they are coughing or have mouth sores, and when touching the clothing or bedding of an infected person. Avoid skin-to-skin contact by wearing disposable gloves.
4. Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, especially after coming into contact with the infected person, with their clothing (including sheets and towels), or touching other items or surfaces (such as utensils or dishes) that may have come into contact with rashes or respiratory secretions.
5. Clean and disinfect any contaminated surfaces and dispose of contaminated waste (such as dressings) properly, and wash the infected person’s clothing, towels, sheets, and eating utensils with warm water and detergent.

Is there any treatment?

• Symptoms often go away on their own without the need for treatment. It is important to care for the rash by letting it dry if possible or cover it with a moist bandage if necessary to protect the area.
• Avoid touching any eye or mouth sores. Mouthwashes and eye drops can be used as long as products containing cortisone are avoided.
• For severe cases, an antiviral agent known as tecovirimat, that was developed for smallpox, was licensed by the European Medicines Agency (EMA) for Monkeypox in 2022, based on data in animal and human studies. It is not yet widely available.

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