Europe is the center of a global outbreak of the virus with 90% of confirmed monkeypox cases reported there, according to the WHO. New infections have tripled since June 15 with 4,500 confirmed cases in 31 European countries. Henri Kluge, the head of WHO Europe, called on governments to step up efforts to prevent monkeypox from establishing itself on the continent, warning that time is of the essence. “Urgent and coordinated action is imperative if we are to turn a corner in the fight to reverse the continuing spread of this disease,” Kluge said. The World Health Organization on Saturday declined to declare monkeypox a public health emergency of international concern, the highest level of alert. But WHO chief Tedros Adhanom Ghebreyesus said monkeypox was an evolving health threat. Tedros called on governments to step up surveillance, contact tracing and ensure high-risk people have access to vaccines and antiviral drugs. Kluge said the WHO will likely soon review whether monkeypox is a global health emergency, given the “rapid evolution and emergency nature of the event”. He said 99% of monkeypox patients in Europe are men between the ages of 21 and 40. The majority of patients who provided demographic information identified as men who have sex with men, he said. Monkeypox is spread primarily through close physical contact with much of the transmission in the current outbreak occurring through sex. However, small numbers of cases have now been reported in which patients did not contract the virus during intercourse, Kluge said. Family members of infected people, heterosexual contacts as well as children have also contracted the virus, he said. Among patients for whom condition information was available, nearly 10 percent were hospitalized for treatment or isolation, and one patient ended up in an intensive care unit, Kluge said. No one in Europe has died from the virus so far, he said. “There is simply no room for complacency – especially here in the European Region with the rapidly evolving epidemic that is expanding its reach into previously unaffected areas by the hour, day and week,” Kluge said. The stigmatization of men who have sex with men in some countries has made it difficult to get a full picture of the epidemic, Kluge said. Some people with monkeypox symptoms may avoid going to health care providers for a diagnosis because they fear the consequences if someone finds out they are gay or bisexual, Kluge said. However, clearly communicating the reality of the current epidemic is also critical, he added. “We know from our lessons in dealing with HIV how stigma fuels epidemics and epidemics, but allowing our fear to create stigma to prevent us from acting can be just as damaging,” Kluge said. Kluge said public health authorities in Europe need to quickly step up monkeypox surveillance and their ability to diagnose the disease and follow samples. Contacts of people who have monkeypox also need to be traced quickly to stop the spread, he said. Public health authorities also need to inform high-risk communities and the general public about precautions to take when attending mass gatherings this summer, Kluge said. And vaccines must be distributed fairly, with an emphasis on those most at risk, he added. Monkey pox is spread primarily through close physical contact with an infected person or contaminated material, such as shared clothing or bed linen. The virus can spread through respiratory droplets if an infected person has lesions in their throat or mouth. However, this requires constant face-to-face contact. Monkeypox is not thought to be transmitted via aerosol particles like Covid-19. Respiratory droplets fall quickly to the ground, while aerosol particles stay in the air longer, which is one of the reasons Covid is so contagious. Monkeypox belongs to the same family of viruses as smallpox, but has milder symptoms. Most people recover in two to four weeks without specific medical treatment. Monkey pox often begins with flu-like symptoms, including fever, headache, sore throat, body aches, chills, exhaustion, diarrhea, and swollen lymph nodes. Then a rash that looks like pimples or blisters appears on the body. People are most contagious when they have the rash. Kluge said the vast majority of patients in Europe had a rash, and about three-quarters reported flu-like symptoms. Some patients in the current outbreak have developed a rash only on the genitals or anus before developing flu symptoms, according to the US Centers for Disease Control and Prevention. In other cases, patients developed the rash without any flu symptoms.
