Triple homes in Europe, urgent action needed to contain spread

The World Health Organization warned on Friday that urgent action was needed to contain the spread of monkeypox in Europe, as cases have tripled in the past two weeks.

Europe is the center of a global virus outbreak with 90% of confirmed cases of monkeypox reported there, according to the WHO. New infections have tripled since June 15 with 4,500 confirmed cases in 31 European countries.

Henri Kluge, head of WHO Europe, called on governments to step up their efforts to prevent monkeypox from establishing themselves on the continent, warning that time is running out.

“Urgent and coordinated action is imperative if we are to turn a corner in the race to reverse the continued spread of this disease,” Kluge said.

The World Health Organization on Saturday refused to declare monkeypox a public health emergency of international concern, its highest alert level. However, WHO chief Tedros Adhanom Ghebreyesus said monkeypox is an evolving health threat. Tedros called on governments to step up surveillance, contact tracing and ensure people at high risk have access to vaccines and antivirals.

Kluge said the WHO would likely reconsider whether monkeypox is a global health emergency soon, given the “rapidly evolving and emergency nature of the event.” He said 99% of monkeypox patients in Europe are men between the ages of 21 and 40. The majority of patients who provided demographic information identified themselves as men who have sex with men, he said.

Monkeypox is primarily spread through close physical contact, with much of the transmission in the current outbreak occurring sexually. However, a small number of cases have now been reported in which patients did not catch the virus through sexual contact, Kluge said. Family members of infected people, heterosexual contacts as well as children have also caught the virus, he said.

Of the patients for whom information was available on their status, nearly 10% were hospitalized for treatment or isolation and one patient ended up in an intensive care unit, Kluge said. No one in Europe has died from the virus so far, he said.

“There is simply no room for complacency – especially here in the European Region with its rapidly evolving epidemic which every hour, day and week is extending its reach into previously unaffected areas,” said said Kluge.

The stigmatization of men who have sex with men in some countries has made it difficult to get a full picture of the epidemic, Kluge said. Some people with monkeypox symptoms might avoid seeing health care providers for a diagnosis because they fear the consequences if someone finds out they’re gay or bisexual, Kluge said. However, clearly communicating the reality of the current outbreak is also crucial, he added.

“We know from our lessons in the fight against HIV how stigma further fuels outbreaks and epidemics, but allowing our fear to create stigma to prevent us from taking action can be just as damaging,” said said Kluge.

Kluge said public health authorities in Europe must quickly step up surveillance for monkeypox and their ability to diagnose the disease and sequence samples. Contacts of people with monkeypox also need to be quickly identified to stop the spread, he said.

Public health authorities also need to educate high-risk communities and the general public about precautions to take during mass gatherings this summer, Kluge said. And vaccines must be distributed equitably with a focus on those most at risk, he added.

Monkeypox is mainly spread through close physical contact with an infected person or contaminated material such as shared clothing or bedding. The virus can spread through respiratory droplets if an infected person has sores in their throat or mouth. This, however, requires sustained face-to-face contact. Monkeypox is not thought to be spread through aerosol particles like Covid-19.

Respiratory droplets quickly fall to the ground, while aerosol particles linger in the air longer, which is one of the reasons Covid is so contagious.

Monkeypox belongs to the same family of viruses as smallpox, but it has milder symptoms. Most people recover in two to four weeks without specific medical treatment.

Monkeypox often begins with flu-like symptoms, such as fever, headache, sore throat, body aches, chills, exhaustion, diarrhea, and swollen lymph nodes. A rash that looks like pimples or blisters then appears on the body. People are more contagious when they have the rash.

Kluge said the vast majority of patients in Europe had a rash and about three-quarters reported flu-like symptoms.

Some patients in the current outbreak developed a rash only on the genitals or anus before showing flu-like symptoms, according to the US Centers for Disease Control and Prevention. In other cases, patients developed the rash without any flu-like symptoms.