GENEVA: Some prominent infectious diseaseexperts are pushing for faster action from global healthauthorities to contain a growing monkeypox outbreak that hasspread to at least 20 countries.
They are arguing that governments and the World HealthOrganization should not repeat the early missteps of theCOVID-19 pandemic that delayed the detection of cases, helpingthe virus spread.
While monkeypox is not as transmissible or dangerous asCOVID, these scientists say, there needs to be clearer guidanceon how a person infected with monkeypox should isolate, moreexplicit advice on how to protect people who are at risk, andimproved testing and contact tracing.
“If this becomes endemic (in more countries), we will haveanother nasty disease and many difficult decisions to take,”said Isabelle Eckerle, a professor at the Geneva Centre forEmerging Viral Diseases in Switzerland.
The WHO is considering whether the outbreak should beassessed as a potential public health emergency of internationalconcern (PHEIC), an official told Reuters. A WHO determinationthat an outbreak constitutes a global health emergency - as itdid with COVID or Ebola - would help accelerate research andfunding to contain a disease.
“It is always under consideration, but no emergencycommittee as yet (on monkeypox),” Mike Ryan, director of theWHO’s health emergencies programme, said on the sidelines of theagency’s annual meeting in Geneva.
However, experts say it is unlikely the WHO would reach sucha conclusion soon, because monkeypox is a known threat the worldhas tools to fight. Discussing whether to set up an emergencycommittee, the body that recommends declaring a PHEIC, is justpart of the agency’s routine response, WHO officials said.
Eckerle called for the WHO to encourage countries to putmore coordinated and stringent isolation measures in place evenwithout an emergency declaration. She worries that talk of thevirus being mild, as well as the availability of vaccines andtreatments in some countries, “potentially leads to lazybehaviour from public health authorities.”
Not the same as Covid
More than 300 suspected and confirmed cases of monkeypox, ausually mild illness that spreads through close contact, causingflu-like symptoms and a distinctive rash, have been reportedthis month.
Most have been in Europe rather than in the Central and WestAfrican countries where the virus is endemic. No deaths havebeen reported in the current outbreak.
However, global health officials have expressed alarm overthe growing outbreak in non-endemic countries. The WHO has saidit expects numbers to rise as surveillance increases.
Angela Rasmussen, a virologist at the University ofSaskatchewan in Canada, wrote on Twitter that monkeypox wasdifferent to SARS-CoV-2, the novel coronavirus, but “we aremaking some of the same mistakes with regard to respondingdecisively with the tools at hand.”
On Friday, the WHO reiterated that the monkeypox virus iscontainable with measures including the quick detection andisolation of cases and contact tracing.
People who are infected - and in some cases their closecontacts - are advised to isolate for 21 days, but it is notclear to what extent people would adhere to such a long timeaway from work or other commitments. The lab capacity to testfor monkeypox is also not yet widely established, said Eckerle,meaning rapid diagnosis can be difficult.
Mass vaccination is not considered necessary but somecountries, including Britain and France, are offering vaccinesto healthcare workers and close contacts.
Other experts say the current response is proportionate andthat deeming monkeypox a global health emergency and declaring aPHEIC would be inappropriate at this stage.
“This is reserved for threats with the highest level of riskbased on infectivity, severity and international risk ofescalation,” said Dale Fisher, chair of the Global OutbreakAlert and Response Network (GOARN) and a professor of medicinein Singapore.
Beyond labels, experts said the most important lesson of thelast two years is that preventing pandemics once they havestarted spreading is too late.
“It is always disappointing when the world wakes up to a newdisease only when it hits high-income countries,” said PieroOlliaro, a professor of poverty-related infectious diseases atOxford University and monkeypox expert.
To prepare for pandemics, “you have to do that where thediseases are now,” he said.
