WHO says monkeypox is not an international public health emergency but should continue to be monitored

The WHO convened an emergency committee meeting on Thursday to discuss the severity of the monkeypox outbreak. The result of the meeting was announced on Saturday.

“Overall, in the report, they (the emergency committee) told me that the event does not constitute a Public Health Emergency of International Concern at this time, which is the highest level of alert the WHO can issue, but acknowledged that the convening of the committee itself reflects growing concern about the international spread of monkeypox,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement released on Saturday.

Tedros on Thursday called for increased surveillance of monkeypox, warning that “while men who have sex with men have been hardest hit by these new outbreaks, there is also a risk of severe illness for immunocompromised individuals, pregnant women and children if they infected.”

Health care workers are also at risk if they are not wearing appropriate personal protective equipment, Tedros said in his opening remarks at the meeting.

Tedros said last week that “the virus is behaving unusually compared to how it has behaved in the past” and as more countries become infected, a coordinated response is needed.

Saturday’s statement acknowledged a “growing health threat” that the WHO will monitor very closely.

What is a Public Health Emergency of International Concern?

The WHO defines a public health emergency of international concern, or PHEIC, as an “extraordinary event” that poses a “public health risk to other states as a result of the international spread of a disease” and “potentially requires a coordinated international response”.

This definition is taken from the International Health Regulations, which was created in 2005 and is a legal agreement involving 196 countries to help the international community prevent and respond to public health risks that could spread around the world.

The U.S. Centers for Disease Control and Prevention describes the regulations as “a legally binding agreement by 196 countries to build the capacity to detect and report potential public health emergencies around the world. The IHR require all countries to be able to detect, assess, report and respond to public health events.”

Two emergencies are ongoing: polio, which began in 2014, and Covid-19, which began in 2020.

Since the rules were put in place, four more PHEICs have been declared: H1N1 influenza from 2009 to 2010, Ebola from 2014 to 2016 and 2019 to 2020, and Zika virus in 2016.

Between January 1, 2022 and June 15, 2022, more than 3,200 confirmed cases of monkeypox and one death were reported to the WHO in 48 countries, Tedros said in his opening remarks.

According to the situation update, the death occurred in Nigeria.

Tedros stressed the importance of sharing information between countries and WHO.

“During other outbreaks, we sometimes saw the consequences of the lack of transparency of countries, the non-dissemination of information,” he said. “We need case finding, contact tracing, laboratory testing, genome sequencing, and implementation of infection prevention and control measures; we need information about the various monkeypox virus clades; we need clear case definitions to help detect infections and for all countries to remain vigilant and strengthen their capacity to prevent further transmission of monkeypox. It is likely that many countries will miss the opportunity to identify cases, including cases in the population without any recent travel.”

Monkeypox is a rare disease, a much less severe disease, related to the now eradicated smallpox virus.

It is endemic to parts of West and Central Africa and is usually transmitted from rodents or small mammals. It does not spread easily from one person to another.

However, monkeypox virus can be spread by contact with bodily fluids, monkeypox sores, or items such as clothing and bedding contaminated with the virus. It can also be transmitted from person to person through the air, usually in close surroundings, according to the CDC.

Keith Allen of CNN contributed to this report.

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