Monkeypox – A International Public Health Emergency

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During Saturday July 23, the WHO Director-General declared the escalating global monkeypox outbreak a Public Health Emergency of International Concern. Tedros said the outbreak is spreading rapidly and there is a “clear risk of further international spread.” Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox.

GENÈVE JULY 24: On July 23, the WHO Director-General declared the escalating global monkeypox outbreak a Public Health Emergency of International Concern (PHEIC). Currently, the vast majority of reported cases are in the WHO European Region. WHO/Europe remains committed to partnering with countries and communities to address the outbreak with the required urgency.

Tedros said the outbreak is spreading rapidly and there is a “clear risk of further international spread.” There are vaccines available for monkeypox, but those supplies are strained. More than 16,500 cases of monkeypox have been reported in 74 countries.

Since early May 2022, cases of monkeypox have been reported from countries where the disease is not endemic, and continue to be reported in several endemic countries. Most confirmed cases with travel history reported travel to countries in Europe and North America, rather than West or Central Africa where the monkeypox virus is endemic.

This is the first time that many monkeypox cases and clusters have been reported concurrently in non-endemic and endemic countries in widely disparate geographical areas.

Most reported cases so far have been identified through sexual health or other health services in primary or secondary health-care facilities and have involved mainly, but not exclusively, men who have sex with men.

Monkeypox Virus

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in countries of central and west Africa.

Monkeypox is a zoonosis: a disease that is transmitted from animals to humans. Cases are often found close to tropical rainforests where there are animals that carry the virus. Evidence of monkeypox virus infection has been found in animals including squirrels, Gambian poached rats, dormice, different species of monkeys and others.

Monkeypox presents with fever, an extensive characteristic rash and usually swollen lymph nodes. The incubation period of monkeypox can range from 5 to 21 days. The febrile stage of illness usually lasts 1 to 3 days with symptoms including fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle ache), and an intense asthenia (lack of energy).

The febrile stage is followed by the skin eruption stage, lasting for 2 to 4 weeks. Lesions evolve from macules (lesions with a flat base) to papules (raised firm painful lesions) to vesicles (filled with clear fluid) to pustules (filled with pus), followed by scabs or crusts.

The proportion of patients who die has varied between 0 and 11% in documented cases and has been higher among young children.

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