ICYMI: WHO releases situation update on monkeypox

NEWS DIGEST – According to WHO, as of 2nd June, 2022 since the outbreak of the Monkeypox virus on 13th May 2022, the organization received 780 laboratory-confirmed cases of monkeypox from 27 States members across four WHO regions that are not endemic to the monkeypox virus.

So far, most reported cases from non-endemic countries have been presented through sexual health or other health services in primary or secondary health care facilities involving men who have sex with men (MSM).

The West African cases of the virus have been confirmed from patients with a travel history reported to have travelled to countries In Europe and North America, rather than West or Central Africa where the monkeypox virus is endemic.

The sudden and unexpected appearance of monkeypox simultaneously in several non-endemic countries suggests that there might have been undetected transmission for some unknown duration of time followed by recent amplifier events.

WHO assesses the risk at the global level as moderate considering this is the first time that many monkeypox cases and clusters are reported concurrently in non-endemic and endemic countries.

WHO risk assessment

Currently, the public health risk of monkeypox at the global level is assessed as moderate considering this is the first time that many monkeypox cases and clusters are reported concurrently in non-endemic and endemic countries.

Cases were initially and mainly identified amongst men who self-identified as part of extended sexual networks.

The sudden appearance and wide geographic scope of many cases that initially appeared to be that extended human-to-human transmission was facilitated by frequent encounters between persons nearby and/or with physical contact.

Also, human-to-human transmission occurs through direct physical contact with skin or mucous membranes that may have recognized or unrecognized infectious lesions such as mucocutaneous ulcers and respiratory droplets.

Although the current risk to human health and the general public remains low, the public health risks could become high if this virus exploits the opportunity to establish itself in nonendemic countries as a widespread human pathogen.

There is also a risk to health workers if they are not using adequate infection prevention and control (IPC) measures or wearing appropriate personal protective equipment (PPE) when necessary, to prevent transmission of the virus.

Public health response

Clinical and public health incident response has been activated at WHO and in the many Member States to coordinate comprehensive case findings, contact tracing, laboratory investigation, clinical management, isolation, and implementation of infection, prevention and control measures

Several European countries have published full-length genome sequences of the monkeypox virus found in the current outbreak, while investigations are ongoing, preliminary data from PCR assays indicate that the monkeypox virus genes detected belong to the West African clade.

WHO advice

All countries should be on the alert for signals related to people presenting with a rash that progresses in sequential stages – macules, papules, vesicles, pustules, scabs, at the same stage of development over all affected areas of the body – that may be associated with fever, enlarged lymph nodes, back pain, and muscle aches.

Any individual meeting the definition for a suspected case should be offered testing and the decision to test should be based on both clinical and epidemiological factors, linked to an assessment of the likelihood of infection.

Infection prevention and control (IPC) measures including supportive isolation of confirmed cases should remain in place until lesions have crusted, scabs have fallen, off, and a fresh layer of skin has formed underneath.