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WHO sounds highest alarm level for monkeypox

The World Health Organization on Saturday sounded the highest level of alarm for monkeypox, declaring it a ‘public health emergency of international concern’. The same announcement was used for Covid-19 in January 2020.

The threat level, however, is moderate for all regions of the world – except for Europe, where it is assessed as high.

More than 16,000 cases of monkeypox have been reported from 75 countries. India has reported three cases of the viral illness from Kerala, with the Union Health Ministry issuing guidelines for its surveillance. Earlier this week, the ministry directed port authorities to conduct strict screening of international travelers and coordinate with agencies such as immigration departments at international ports and airports to streamline health screening processes as well as ensure connectivity with designated hospital facilities at each port of entry.

WHO Director-General Dr Tedros Adhanom Ghebreyesus told a press conference on Saturday: “WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except for the European region where we assess the risk as high. There is a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment. So in short, we have an outbreak that is spreading rapidly around the world, through new modes of transmission, about which we understand very little and which meet the criteria of international health regulations.”

He added: “For all these reasons, I have decided that the global outbreak of monkeypox represents a public health emergency of international concern.”

Last month, 3,040 cases were reported from 47 countries.

The Emergency Committee under the International Health Regulations, which met on Thursday to review the new numbers, could not agree on declaring a public health emergency.

Nevertheless, the WHO based the declaration on cases reported from different countries, meeting three criteria for such a declaration (a situation that is serious, sudden, unusual or unexpected; has public health implications beyond the borders of the affected state; and may require immediate international action ), and the potential for human health risks, international spread and interference with international traffic.

Five people have died of the infection so far.

This is the seventh time the highest alarm level has been used since 2009 These are previous examples: the H1N1 pandemic (2009), the increase in polio cases (2014), the Ebola outbreak in West Africa (2014), the Zika virus pandemic (2015–16), the Kivu Ebola epidemic in the Democratic Republic of Congo (2018–20), and Covid-19.

Monkeypox is a viral infection that is transmitted mainly from animals to humans, previously there was limited transmission to humans because the smallpox vaccine used to eradicate the disease also protected against monkeypox. The first human cases were reported in the Democratic Republic of Congo in 1970 and subsequently became endemic in several West and Central African countries.

Monkeypox is spread from person to person through close contact with someone who has a monkeypox rash, but now scientists are also looking at whether the disease is sexually transmitted, being diagnosed in men who have sex with men.

The most common symptoms of monkeypox include fever, headache, muscle aches, back pain, low energy, and a pox rash with swollen lymph nodes that lasts two to three weeks. It is a self-limiting disease, but can be fatal especially in children and those with weakened immune systems. Complications of infection include pneumonia, secondary skin infections, confusion and eye problems.

Dr. Rosamund Lewis, WHO’s chief expert on monkeypox, told the press conference that the transmission pattern of infection is changing over the years and long chains of transmission are emerging. He said, “The hypothesis is – and this remains to be confirmed – that as the virus has moved into a post-Covid world where people have been able to travel again, it has established itself in groups with frequent social gatherings and frequent events involving close proximity. Physical and sexual contact, and sometimes sexual contact with multiple partners over a period of days or weeks.” Additionally, this is a population with traditionally active health-seeking behaviors.

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