A portion of skin tissue collected from a lesion on a monkey’s skin that has been infected with the monkeypox virus is seen at 50X magnification on the fourth day of the rash’s development in 1968. CDC / Distribution via REUTERS
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GENEVA, May 28 (Reuters) – Some prominent infectious disease experts have called for faster action by global health authorities to curb the growing monkeypox epidemic, which has spread to at least 20 countries.
They argue that governments and the World Health Organization should not repeat the early missteps of the COVID-19 pandemic, which delayed the detection of cases by helping the virus spread.
Although smallpox is not as portable or dangerous as COVID, these scientists say there should be clearer guidelines on how a person infected with smallpox should be isolated, clearer advice on how to protect people who are at risk, and improved contact testing and tracking.
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“If this becomes endemic (in more countries), we will have another nasty disease and very difficult decisions to make,” said Isabel Eckerle, a professor at the Geneva Center for Emerging Viral Diseases in Switzerland.
The WHO is considering whether the outbreak should be assessed as a potential public health emergency of international importance (PHEIC), an official told Reuters. The WHO’s determination that the outbreak is a global health emergency – as happened with COVID or Ebola – would help speed up research and funding to control the disease.
“It’s always being considered, but there’s still no emergency committee (for monkeypox),” said Mike Ryan, director of the WHO’s emergency health program, on the sidelines of the agency’s annual meeting in Geneva.
However, experts say the WHO is unlikely to reach such a conclusion any time soon, as monkeypox is a known threat that the world has tools to fight. Discussing whether to set up an emergency commission, the body that recommends declaring PHEIC, is only part of the agency’s routine response, WHO officials said.
Eckerle called on the WHO to encourage countries to introduce more coordinated and stringent isolation measures, even without a declaration of emergency. She worries that rumors that the virus is a cure, as well as the availability of vaccines and treatments in some countries, “potentially lead to lazy behavior on the part of public health authorities.”
NOT THE SAME AS COVID
More than 300 suspected and confirmed cases of monkeypox have been reported this month, usually a mild disease that spreads through close contact, causing flu-like symptoms and a distinctive rash.
Most were in Europe, not in Central and West Africa, where the virus is endemic. No deaths have been reported in the current epidemic.
However, global health officials have expressed concern about the growing outbreak in non-endemic countries. The WHO said it expects their numbers to increase as surveillance increases.
Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, wrote on Twitter that monkeypox is different from SARS-CoV-2, the new coronavirus, but “we make some of the same mistakes when it comes to responding decisively with hand tools.”
On Friday, the WHO reiterated that the monkeypox virus could be controlled with measures, including rapid detection and isolation of cases and tracing of contacts. Read more
People who are infected – and in some cases their close contacts – are advised to isolate themselves for 21 days, but it is unclear to what extent people would stick to such a long time away from work or other commitments. Laboratory capacity for testing for monkeypox is also not yet widely established, Eckerle said, which means a quick diagnosis can be difficult.
Mass vaccination is not considered necessary, but some countries, including Britain and France, offer vaccines to health professionals and close contacts. Read more
Other experts argue that the current response is proportionate and that considering monkeypox a global health emergency and declaring PHEIC would be inappropriate at this stage.
“This is reserved for threats with the highest level of risk based on infectivity, severity and international risk of escalation,” said Dale Fisher, chairman of the Global Epidemic Prevention and Response Network (GOARN) and a professor of medicine in Singapore.
In addition to labels, experts said the most important lesson of the past two years is that preventing pandemics once they start spreading is too late.
“It’s always frustrating when the world wakes up to a new disease only when it hits high-income countries,” said Piero Oliaro, a professor of infectious disease-related poverty at Oxford University and an expert on monkeypox.
To prepare for pandemics, “you have to do it where the diseases are now,” he said.
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Report by Jennifer Rigby; Additional report by Emma Farge; Edited by Josephine Mason, Michelle Gerschberg and Daniel Wallis
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