The World Health Organization issued its highest level of alert on Saturday in an attempt to contain the outbreak of monkeypox, which has affected nearly 17,000 people in 74 countries, its director general announced, and mainly affects men having sex with other men.
“I have decided to declare a public health emergency of international concern”, said Tedros Adhanom Ghebreyesus during a press briefing, adding that the risk in the world was relatively moderate except in Europe, where it is high. He explained that the committee of experts had failed to reach a consensus, remaining divided on the need to trigger the highest level of alert. In the end, it is up to the general manager to decide.
“It’s a call to action, but it’s not the first,” said Mike Ryan, the WHO’s emergency manager, who says he hopes this will lead to collective action against the disease.
Since early May, when it was detected outside of African countries where it is endemic, the disease has struck more than 16,836 people in 74 countries, according to the US Centers for Disease Control and Prevention’s dashboard. dated July 22. Monkeypox is not a sexually transmitted disease but, outside endemic areas, it affects men who have sex with men, with rare exceptions. If the health authorities have reported a drop in the rate of contagion, the number of cases is increasing rapidly.
The qualification “public health emergency of international concern” (USPPI) is used in situations “serious, sudden, unusual or unexpected”. It is defined by the WHO as a “extraordinary event” the propagation of which constitutes a “risk to public health in other states” and may require “coordinated international action”.
This is only the 7th time that the WHO has used this level of alert. During a first meeting on June 23, the majority of the experts of the Emergency Committee had recommended to Dr. Tedros not to pronounce the emergency of USPPI.
Risk of stigma
Detected in early May, the unusual upsurge in monkeypox cases outside West and Central African countries has since spread across the globe, with Europe as its epicenter.
First detected in humans in 1970, monkeypox is less dangerous and contagious than its cousin human smallpox, eradicated in 1980. In most cases, sufferers are men who have sex with men , relatively young, and living mainly in cities, according to the WHO.
A study published Thursday in the scientific journal New England Journal of Medicine, the largest carried out on the subject and based on data from 16 different countries, confirms that in the vast majority (95%) of recent cases, the disease was transmitted during sexual contact and 98% of those affected were gay or bisexual men.
“This mode of transmission represents both an opportunity to implement targeted public health interventions, and a challenge, because in some countries, affected communities face discrimination that threatens their lives,” had raised Thursday Dr. Tedros in front of the committee of experts. “There is a real concern that men who have sex with men could be stigmatized or blamed for the spike in cases, making it much harder to trace and stop,” he warned.
Vaccinate those most at risk
On Friday, the European Medicines Agency said it approved the use of a human smallpox vaccine to expand its use against the spread of monkeypox. This vaccine is in fact already used for this purpose in several countries, including France. The Imvanex vaccine, from Danish company Bavarian Nordic, has been approved in the EU since 2013 for the prevention of smallpox.
The WHO recommends vaccinating those most at risk as well as health workers likely to be confronted with the disease. In New York, thousands of people have already been vaccinated with the Jynneos vaccine. In France, after weeks without communicating, the Ministry of Health finally indicated that 30,000 doses of vaccine against monkeypox had been destocked from strategic stocks, including more than 20,000 already sent to the field. That is ten times less than the number of doses – 300,000 – needed according to the Aides association to vaccinate all those at risk. About 3,000 vaccines had been administered since July 8, according to information from the Têtu.com site.