World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus has decided to declare monkeypox a “public health emergency of international concern,” according to a news conference early Saturday afternoon. The announcement comes after the meeting of the organization’s experts, held last Thursday, at which they failed to “reach consensus”.
Despite this, Adhanom Ghebreyesus has used his power as the organization’s supreme leader to make the decision based on the wide spread the virus has caused in recent weeks. When the expert committee agreed to postpone the decision a month ago, about 4,000 cases had been diagnosed worldwide, a number that has quadrupled in that time and exceeds 16,500. The number of countries affected is now 75, almost twice as many as then.
The public health emergency declared this Saturday is the highest level of alert envisaged by the International Health Regulations, a consideration that only the coronavirus and polio have previously had. The measure confers authority on WHO at the international level through recommendations that will be binding on member countries.
The director of the WHO has stated that “the new modes of transmission that have facilitated the spread of the virus are still poorly understood”, making it necessary to exercise extreme vigilance at international level and develop public health measures to identify new cases. “The risk of monkeypox is moderate worldwide except in the European region where it is high,” he added.
Spain is the hardest-hit country in the world with 3,500 cases and a growth of around a hundred new positives a day – this number is an average as not all municipalities report new diagnoses with the same frequency – although this is foreseeable in the next few years In A few days later it will be surpassed by the United States, which has already accumulated almost 3,000 positives and is now the country in the world where the outbreak is growing the most.
The UK and Germany are the other two hardest-hit countries, each with around 2,200 cases. In Latin America, with nearly 700 diagnoses, it is Brazil where the virus is most prevalent and where diagnoses are growing fastest.
The current outbreak has surprised authorities and experts due to the rapid spread the virus has had around the world in the last two months since the UK issued its first international warning in mid-May. Although far from the explosive behavior of the coronavirus, that of monkeypox has maintained an uninterrupted sustained upward trend in recent weeks, a phenomenon that had never occurred before.
But this is not the only novelty in the behavior of the virus. When the outbreak broke out, the main concern was that records from the endemic countries of Central and West Africa reflected a mortality rate of between 1% and 10% of infected people, although these percentages were expected to be lower in developed countries – due to better general health of the population and available healthcare systems – the doctors who have treated the sick have been surprised by the ease of the vast majority of cases.
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A first explanation for this is that of the two known variants of the virus, the one leading the outbreak is the less virulent one, found in West African countries like Nigeria. The second reason was that the rashes that the patients suffer – along with symptoms such as fever, malaise, fatigue… – are in most cases concentrated in the perianal and genital areas and spread much less to the rest of the body which is in described in the scientific literature.
Experts attribute this fact to the way the virus is transmitted in the current outbreak, which in more than 90% of cases is linked to risky practices such as group sex or multiple partners between men having sex with other men. But this greater ease has also been observed in infections that have occurred outside of these environments, as the virus can also be transmitted through close contact, large drops of saliva, and sharing items of clothing such as towels or sheets. Even when those infected were children—there were about twenty domestic infections—they had a mild illness.
Nevertheless, the WHO considers it foreseeable at the current rate that the monkeypox virus will continue to spread worldwide and will therefore increasingly affect risk groups, which include pregnant women and immunocompromised people in addition to children, so that the declaration of an international emergency is justified.