The World Health Organization’s head for Europe warned on Friday that cases of monkeypox in the region had tripled in the past two weeks and urged countries to do more to ensure the once-rare disease does not gain a foothold on the continent. And African health authorities said they were treating the expanding monkeypox outbreak as an emergency, calling on rich countries to share limited vaccine supplies to avoid equity problems seen during the COVID-19 pandemic. The head of the WHO for Europe, Dr. Hans Kluge said in a statement that increased efforts were needed despite the UN health agency’s decision last week that the escalating epidemic did not yet warrant declaring a global health emergency. “Urgent and coordinated action is imperative if we are to turn a corner in the fight to reverse the continued spread of this disease,” Kluge said. To date, more than 5,000 cases of monkeypox have been reported from 51 countries around the world that do not normally report the disease, according to the US Centers for Disease Control and Prevention. Kluge said the number of infections in Europe represents about 90% of the global total, with 31 countries in the WHO European region having identified cases. Kluge said figures reported to the WHO show that 99% of cases were in men – the majority in men who have sex with men. But he said there were now “small numbers” of cases among household contacts, including children. Most people reported symptoms such as rash, fever, fatigue, muscle pain, vomiting and chills. Scientists warn that anyone who comes into close physical contact with someone who has monkeypox or their clothing or bedding is at risk of becoming infected. Vulnerable populations such as children and pregnant women are thought to be more likely to suffer from severe disease. About 10% of patients were hospitalized for treatment or isolation, and one person was admitted to an intensive care unit. No deaths have been reported. Kluge said the problem of stigma in some countries can make some people wary of seeking health care, and said the WHO is working with partners, including organizers of gay pride events. In the UK, which has the largest outbreak of monkeypox outside of Africa, officials have noted that the disease is spreading in “defined sexual networks of homosexuals, bisexuals or men who have sex with men”. British health authorities said there was no evidence to suggest continued transmission beyond these populations. A top WHO adviser said in May that the rise in cases in Europe was likely linked to male sexual activity at two rave parties in Spain and Belgium. Ahead of UK gay pride events this weekend, London’s top public health doctor has asked people with symptoms of monkeypox, such as swollen glands or blisters, to stay home. But in Africa, the WHO says that according to detailed data from Ghana, cases of monkeypox were almost evenly split between men and women, and no spread among men who have sex with men has been detected. WHO director for Europe Kluge also said that vaccine procurement “must apply the principles of equity”. The main vaccine used against monkeypox was originally developed for smallpox, and the European Medicines Agency said this week that it had begun evaluating whether it should be approved for monkeypox. The WHO said supplies of the vaccine, made by Bavarian Nordic, are extremely limited. Countries including the UK and Germany have already started vaccinating people at high risk of monkeypox. the UK recently expanded its vaccination program to mainly gay and bisexual men who have multiple sexual partners and are thought to be more vulnerable. Until May, monkeypox had never been known to cause large outbreaks beyond parts of central and western Africa, where it has sickened people for decades, is endemic in many countries, and mostly causes limited outbreaks when it jumps to humans from infected wild animals. To date, there have been approximately 1,800 suspected cases of monkeypox in Africa, including more than 70 deaths, but only 109 have been laboratory confirmed. Lack of laboratory diagnosis and weak surveillance means that many cases go undetected. “This particular outbreak for us means an emergency,” said Ahmed Ogwell, deputy director of Africa’s Centers for Disease Control. The WHO says monkeypox has spread to African countries where it has not been seen before, including South Africa, Ghana and Morocco. But more than 90% of the continent’s infections are in Congo and Nigeria, according to WHO Africa director Dr Moeti Matshidiso. Vaccines have never been used to stop outbreaks of monkeypox in Africa. Officials relied mostly on contact tracing and isolation. The WHO noted that similar to last year’s fight over COVID-19 vaccines, countries with stocks of monkeypox vaccines are yet to share them with Africa. “We don’t have any donations that have been offered to (poorer) countries,” said Fiona Bracca, head of the WHO’s emergency response team in Africa. “We know that those countries that have some reserves, they keep them mostly for their own populations.” Matshidiso said the WHO was in talks with manufacturers and countries with stockpiles to see if they could share. “We would like to see the global spotlight on monkeypox act as a catalyst to defeat this disease once and for all in Africa,” he said on Thursday. Our Morning and Afternoon Newsletters are compiled by Globe editors, giving you a brief overview of the day’s most important headlines. Register today.
