AP

WHO again considers declaring monkeypox a global emergency

Jul 20, 2022, 2:38 PM | Updated: Jul 21, 2022, 6:08 am

FILE - This 1997 image provided by the CDC during an investigation into an outbreak of monkeypox, w...

FILE - This 1997 image provided by the CDC during an investigation into an outbreak of monkeypox, which took place in the Democratic Republic of the Congo (DRC), formerly Zaire, and depicts the dorsal surfaces of the hands of a monkeypox case patient, who was displaying the appearance of the characteristic rash during its recuperative stage. The World Health Organization is convening its emergency committee on Thursday, July 21, 2022 to consider for the second time within weeks whether the expanding outbreak of monkeypox should be declared a global crisis. (CDC via AP, File)

(CDC via AP, File)

LONDON (AP) — As the World Health Organization’s emergency committee convened Thursday to consider for the second time within weeks whether to declare monkeypox a global crisis, some scientists said the striking differences between the outbreaks in Africa and in developed countries will complicate any coordinated response.

African officials say they are already treating the continent’s epidemic as an emergency. But experts elsewhere say the mild version of monkeypox in Europe, North America and beyond makes an emergency declaration unnecessary even if the virus can’t be stopped. British officials recently downgraded their assessment of the disease, given its lack of severity.

“I remain concerned about the number of cases, in an increasing number of countries, that have been reported,” WHO Director-General Tedros Adhanom Ghebreyesus told the emergency committee as its meeting got underway.

He said it was “pleasing” to note falling numbers of monkeypox cases in some countries but that the virus is still increasing elsewhere and that six countries reported their first infections last week.

Monkeypox has been entrenched for decades in parts of central and western Africa, where diseased wild animals occasionally infect people in rural areas in relatively contained epidemics. The disease in Europe, North America and beyond has circulated since at least May among gay and bisexual men. The epidemic in rich countries was likely triggered by sex at two raves in Spain and Belgium.

Some experts worry these and other differences could possibly deepen existing medical inequities between poor and wealthy nations.

There are now more than 15,000 monkeypox cases worldwide. While the United States, Britain, Canada and other countries have bought millions of vaccines, none have gone to Africa, where a more severe version of monkeypox has already killed more than 70 people. Rich countries haven’t yet reported any monkeypox deaths.

“What’s happening in Africa is almost entirely separate from the outbreak in Europe and North America,” said Dr. Paul Hunter, a professor of medicine at Britain’s University of East Anglia who previously advised WHO on infectious diseases.

The U.N. health agency said this week that outside of Africa, 99% of all reported monkeypox cases are in men and of those, 98% are in men who have sex with other men. Still, the disease can infect anyone in close, physical contact with a monkeypox patient, regardless of their sexual orientation.

“In these very active gay sexual networks, you have men who really, really don’t want people to know what they’re doing and may not themselves always know who they are having sex with,” Hunter said.

Some of those men may be married to women or have families unaware of their sexual activity, which “makes contact tracing extremely difficult and even things like asking people to come forward for testing,” Hunter said, explaining why vaccination may be the most effective way to shut down the outbreak.

That’s probably not the case in Africa, where limited data suggests monkeypox is mainly jumping into people from infected animals. Although African experts acknowledge they could be missing cases among gay and bisexual men, given limited surveillance and stigmatization against LGBTQ people, authorities have relied on standard measures like isolation and education to control the disease.

Dr. Placide Mbala, a virologist who directs the global health department at Congo’s Institute of National Biomedical Research, said there are also noticeable differences between patients in Africa and the West.

“We see here (in Congo) very quickly, after three to four days, visible lesions in people exposed to monkeypox,” Mbala said, adding that someone with so many visible lesions is unlikely to go out in public, thus preventing further transmission.

But in countries including Britain and the U.S., doctors have observed some infected people with only one or two lesions, often in their genitals.

“You wouldn’t notice that if you’re just with that person in a taxi or a bar,” Mbala said. “So in the West, people without these visible lesions may be silently spreading the disease.”

He said different approaches in different countries will likely be needed to stop the global outbreak, making it challenging to adopt a single response strategy worldwide, like those for Ebola and COVID-19.

Dr. Dimie Ogoina, a professor of medicine at Nigeria’s Niger Delta University, said he feared the world’s limited vaccine supplies would result in a repeat of the problems that arose in the coronavirus pandemic, when poorer countries were left empty-handed after rich countries hoarded most of the doses.

“It does not make sense to just control the outbreak in Europe and America, because you will then still have the (animal) source of the outbreak in Africa,” said Ogoina, who sits on WHO’s monkeypox emergency committee.

This week, U.S. officials said more than 100,000 monkeypox vaccine doses were being sent to states in the next few days, with several million more on order for the months ahead. The U.S. has reported more than 2,000 cases so far, with hundreds more added every day.

Some U.S. public health experts have begun to wonder if the outbreak is becoming widespread enough that monkeypox will become a new sexually transmitted disease.

Declaring monkeypox to be a global emergency could also inadvertently worsen the rush for vaccines, despite the mildness of the disease being seen in most countries.

Dr. Hugh Adler, who treats monkeypox patients in Britain, said there aren’t many serious cases or infections beyond gay and bisexual men. Still, he said it was frustrating that more vaccines weren’t available, since the outbreak was doubling about every two weeks in the U.K..

“If reclassifying monkeypox as a global emergency will make (vaccines available), then maybe that’s what needs to be done,” he said. “But in an ideal world, we should be able to make the necessary interventions without the emergency declaration.”

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

AP

moore redmond washington...

Associated Press

U.S. Supreme Court rules against Redmond couple challenging foreign income tax

The court ruled in the case of Charles and Kathleen Moore, of Redmond, Washington after they previously challenged a $15,000 tax bill.

2 days ago

Image:The New York Giants' Willie Mays poses for a photo during baseball spring training in 1972. M...

Associated Press

Willie Mays, Giants’ electrifying ‘Say Hey Kid,’ dies at 93

Willie Mays, whose singular combination of talent, drive and exuberance made him one of baseball’s greatest players, has died. He was 93.

4 days ago

Image: This photo provided by the Washington Department of Ecology shows a derailed BNSF train on t...

Associated Press

Judge orders BNSF to pay Washington tribe nearly $400M for trespassing with oil trains

BNSF Railway must pay the sum to a Native American tribe in Washington after it ran 100-car trains with crude oil on the tribe's reservation.

5 days ago

Photo: In this photo provided by Tieanna Joseph Cade, an amusement park ride is shown stuck with 30...

Associated Press

Crews rescue 28 people trapped upside down high on Oregon amusement park ride

Emergency crews in Oregon rescued 28 people after they were stuck dangling upside down high on a ride at a century-old amusement park.

5 days ago

juneteenth shooting texas...

Associated Press

2 killed and 6 wounded in shooting during a Juneteenth celebration in a Texas park

A shooting in a Texas park left two people dead and six wounded, including two children, on Saturday, authorities said.

6 days ago

Photo: Israeli soldiers drive a tank near the Israeli-Gaza border, in southern Israel, Wednesday, J...

Jack Jeffery, The Associated Press

8 Israeli soldiers killed in southern Gaza in deadliest attack on Israeli forces in months

An explosion in Gaza killed eight Israeli soldiers, the military said Saturday, making it the deadliest attack on Israeli forces in months.

7 days ago

WHO again considers declaring monkeypox a global emergency