The World Health Organization is convening a meeting of experts on June 23 to decide whether monkeypox should be declared a global health emergency, as was the case with Covid-19 two years ago. However, unlike the new coronavirus, monkeypox is not a new disease. But although it has been around for decades, the emergence of cases in which monkeypox is not usually observed and the way it spreads has raised concerns. Where have cases been reported? As of May 13, more than 1,600 confirmed and about 1,500 suspected cases of monkeypox have been reported to the WHO by at least 39 countries. Seven of them are African countries where the disease is endemic, while the rest are those where the disease was either not known or was previously detected in only minimal quantities. In 2022, a total of 72 monkeypox deaths were reported, all of which were limited to Africa and none to the newly affected countries. The WHO said the outbreak of smallpox in places without direct or recent links to travel to areas where the disease is endemic “suggests there may have been undetected transmission for weeks or more.” The latter cases are related to a less deadly variant of monkeypox, known as a fire in West Africa, which has a total mortality rate of less than one percent. WHO chief Tedros Adanom Gebreyesus said the “global outbreak of monkeypox was clearly unusual and alarming”, with another senior official noting that the risk of spread was “high” in Europe and “moderate” in the rest of the world, despite that there are gaps in knowledge about how the virus is transmitted. The WHO said the outbreak of monkeypox this time was marked by various symptoms among those infected, and many cases “do not present with the classic clinical picture of monkeypox” such as fever, swollen lymph nodes and rashes on the face and limbs. Does sexual intercourse play a role? Monkeypox is transmitted through close physical contact with a symptomatic patient. However, it is unclear whether people who have no symptoms can spread the disease. The WHO said that “human-to-human transmission can also occur through” respiratory droplets (and possibly short-range aerosols). The WHO said a significant number of initially reported cases of the epidemic involved men having sex with men (MSM), but noted that the modes of transmission during sexual intercourse remained unknown and “it is unclear what the role of sexual intercourse is. body role fluids, including semen and vaginal fluids, play a role in the transmission of monkeypox ”. A WHO adviser reportedly attributed the spread to two recent raves in Spain and Belgium to MSM or gay and bisexual communities in Europe. But experts and health officials are trying to clarify that sexual preferences have nothing to do with the spread of monkeypox, and the high proportion of cases among MSM communities only underscores the fact that transmission is common in close contact with an infected person. Fear of the stigma associated with infectious diseases – something that has been observed in HIV-AIDS and more recently in Covid-19 – although there is concern about monkeypox. So much so that it is reported that the WHO is working on a new name for monkeypox amid calls from scientists for a “non-discriminatory and non-stigmatizing” name for the virus. How about vaccines? Smallpox vaccination is known to provide cross-protection against monkeypox, but the WHO notes that any immunity from such vaccines will only be available to people over the age of 42-50, as smallpox vaccination programs have ended worldwide. in 1980 eradication of the disease. Although some countries have strategic supplies of older smallpox vaccines, the WHO has said that these first-generation vaccines are not recommended for use because they do not meet current safety standards. Instead, he recommends second- and third-generation smallpox vaccines, along with a single vaccine (MVABN) that is specifically approved against monkeypox. However, given that the supply of new vaccines is limited, the WHO has stated that it does not currently recommend mass vaccination and that “decisions on the use of smallpox or monkey vaccines should be based on a full assessment of the risks and benefits of every single case” . Text: Kenneth Mohanti and Anjishnu Das; Source: WHO, US CDC, press releases
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