GENEVA – The World Health Organization (WHO) said on Tuesday there have been 131 confirmed monkeypox cases and 106 further suspected cases since the first was reported on May 7 outside the countries where it usually spreads.
While the outbreak is unusual, it remains “containable” and limited, the WHO said, and it is convening further meetings to support member states with more advice on how to tackle the situation.
Monkeypox is a usually mild viral infection that is endemic in parts of west and central Africa. It spreads chiefly through close contact, and until the recent outbreak has only rarely been seen in other parts of the world. The majority of the recent cases have been reported in Europe.
“We encourage you all to increase the surveillance of monkeypox to see where transmission levels are and understand where it is going,” said Sylvie Briand, WHO director for Global Infectious Hazard Preparedness.
She said it was unclear if the cases were the “tip of the iceberg” or if the peak in transmission has already passed.
Speaking at the World Health Assembly in Geneva, Briand reiterated WHO’s view that it is unlikely that the virus has mutated but said that transmission may be being driven by a change in human behaviour, particularly as people return to socializing as COVID-19 restrictions are lifted worldwide.
Many, but not all, of the cases have been reported in men who have sex with men, and Briand said it was particularly important to try to prevent sexual transmission.
Symptoms include a fever and a distinctive bumpy rash. The West African strain of monkeypox, which is the one identified in the current outbreak, has a mortality rate of around 1%.
While she said the outbreak was “not normal,” she stressed that it was “containable”. There are also vaccines and treatments available for monkeypox, she added, calling for appropriate containment measures, more research, and global collaboration.
“Let’s not make a mountain out of a molehill,” she said.
The WHO does not believe the monkeypox outbreak outside of Africa requires mass vaccinations as measures like good hygiene and safe sexual behavior will help control its spread, a senior official said on Monday.
Richard Pebody, who leads the high-threat pathogen team at WHO Europe, also told Reuters in an interview that immediate supplies of vaccines and antivirals are relatively limited.
His comments came as the US Centers for Disease Control and Prevention said it was in the process of releasing some Jynneos vaccine doses for use in monkeypox cases.
Moderna Inc is testing potential vaccines against monkeypox in pre-clinical trials.
Germany said on Monday it was assessing options for vaccinations, while Britain has offered them to some healthcare workers.
Public health authorities in Europe and North America are investigating more than 100 suspected and confirmed cases of the viral infection in the worst outbreak of the virus outside of Africa, where it is endemic.
The primary measures to control the outbreak are contact tracing and isolation, Pebody said, noting that it is not a virus that spreads very easily, nor has it so far caused serious disease. The vaccines used to combat monkeypox can have some significant side effects, he added.
It is unclear what is driving the outbreak, with scientists trying to understand the origin of the cases and whether anything about the virus has changed.
MUTATION
There is no evidence the virus has mutated, a senior executive at the UN agency said separately on Monday.
Many – but not all – of the people who have been diagnosed in the current monkeypox outbreak have been men who have sex with men. But that may be because this demographic is likely to seek medical advice or access sexual health screening more readily, the WHO said earlier in the day.
Rosamund Lewis, head of the smallpox secretariat that is part of the WHO Emergencies Program, told a briefing that mutations tended to be typically lower with this virus, although genome sequencing of cases will help inform understanding of the current outbreak.
Health experts watch for concerning mutations that could make a virus more easily transmissible or severe.
Over 100 suspected and confirmed cases in a recent outbreak in Europe and North America have not been severe, said Maria van Kerkhove, the WHO’s emerging diseases and zoonoses lead and technical lead on COVID-19.
“This is a containable situation,” particularly in Europe, she said. “But we can’t take our eye off the ball with what’s happening in Africa, in countries where it’s endemic.”
The outbreaks are atypical, according to the WHO, occurring in countries where the virus does not regularly circulate. Scientists are seeking to understand the origin of the cases and whether anything about the virus has changed.
The WHO is asking dermatology and primary healthcare clinics, as well as sexual health clinics, to be alert to potential cases.
