The WHO’s director-general, DrTedros, hopes that global efforts to curb the spread of the virus will now intensify. The designation gives the organisation more power to co-ordinate action to stop transmission
a “public health emergency of international concern”, the highest level of alert in its hierarchy of warnings. The committee advising Tedros Adhanom Ghebreyesus, the’s director-general, did not reach a consensus on whether to elevate monkeypox to that level, with six of its members in favour of doing so and the remaining nine opposed. Nonetheless, Dr Tedros decided to declare an emergency. He hopes that global efforts to curb the spread of the virus will now intensify.
The virus causes flu-like symptoms and skin blisters from which the virus sheds. People can pick it up from infected bedding, clothes or utensils, but scientists think that skin-to-skin contact is the primary route of transmission. Large respiratory droplets can also spread the disease. In the current outbreak about 70% of cases are in Europe and 15% are in America, though far more limited testing in other regions means that transmission chains there may be going undetected.
The current outbreak in America and Europe is almost entirely concentrated among men who have sex with men . Disease investigators have found that, at least for now, many cases occur through male sexual networks, such as “sex-on-site” parties in saunas and clubs. About 99% of cases outside of Africa are men, most of whom are young or middle-aged. Among monkeypox cases who disclosed their sexual orientation to disease investigators in England, 97% were men who have sex with men.
Scientists are still trying to work out the ways in which the disease is caught. It is already clear that the virus does not spread easily through respiratory droplets. In the current cohort of monkeypox patients it has transmitted almost entirely through skin-to-skin contact, including sex. Occasional cases among household members of patients have been diagnosed, but they have been rare.
The WHO’s emergency alert will draw attention to how monkeypox vaccines are being distributed around the world. The jab used for the disease now, made by Bavarian Nordic, a Danish company, was originally developed for smallpox, a related virus that was eradicated through mass vaccination in the 1970s. It has been used against monkeypox in America and Europe based on limited data of efficacy from monkeypox outbreaks in Africa.
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