WHO assesses global public health risk of Monkeypox as “moderate”

The World Health Organization (WHO) on Monday assessed the public health risk of Monkeypox at global level as “moderate” considering this is the first time that monkeypox cases and clusters are reported concurrently in widely disparate WHO geographical areas.

As of 26 May, a cumulative total of 257 laboratory confirmed cases and around 120 suspected cases have been reported to WHO from over 23 countries. WHO also said that additionally, the sudden appearance and wide geographic scope of many sporadic cases indicates that widespread human-to-human transmission is already underway, and the virus may have been circulating unrecognised for several weeks or longer.

“The public health risk could become high if this virus exploits the opportunity to establish itself as a human pathogen and spreads to groups at higher risk of severe disease such as young children and immunosuppressed persons; a large part of the population is vulnerable to monkeypox virus, as smallpox vaccination, which confers some cross-protection, has been discontinued since 1980 or earlier in some countries,” said the WHO a bulletin.

“The situation is evolving rapidly and WHO expects that there will be more cases identified as surveillance expands in non-endemic countries, as well as in countries known to be endemic who have not recently been reporting cases,” the WHO said.

No deaths have been reported and the cases are being reported without known epidemiological links to non-endemic countries to the disease in West or Central Africa. The vast majority of reported cases to the WHO so far, have no established travel links to an endemic area and have presented through primary care or sexual health services. The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area is atypical, the global health body warned.

“Early epidemiology of initial cases notified to WHO by countries shows that cases have been mainly reported amongst men who have sex with men (MSM). One case of monkeypox in a non-endemic country is considered an outbreak. The sudden appearance of monkeypox simultaneously in several non-endemic countries suggests that there may have been undetected transmission for some time as well as recent amplifying events,” said the WHO bulletin. The WHO last week also issued public health advice for gay, bisexual and others who fall under the MSM category.

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe. The name monkeypox originates from the initial discovery of the virus in monkeys in Statens Serum Institute, Copenhagen, Denmark, in 1958. The first human case was identified in a young child in the Democratic Republic of the Congo in 1970. Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding, according to WHO.