The World Health Organization warned on Friday that urgent action is needed to stem the spread of monkeypox in Europe, as cases have tripled in the past two weeks.
Europe is at the center of a global outbreak of the virus, with 90% of confirmed monkeypox cases reported there, according to the WHO. New infections have tripled since June 15, with 4,500 confirmed cases in 31 European countries.
Henri Kluge, the head of WHO Europe, called on governments to step up their efforts to prevent monkeypox from taking hold on the continent and warned that time is of the essence.
“Urgent and coordinated action is essential if we are to turn the tide in the race to reverse the ongoing spread of this disease,” Kluge said.
The World Health Organization on Saturday declined to declare monkeypox a public health emergency of international concern, the highest alert level. However, WHO chief Tedros Adhanom Ghebreyesus said monkeypox was an emerging health threat. Tedros called on governments to step up surveillance and contact tracing and ensure high-risk people have access to vaccines and antivirals.
Kluge said the WHO will likely soon reconsider whether monkeypox is a global health emergency, given the “rapid evolution 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 spreads primarily through close physical contact, with much of the transmission in the current outbreak occurring through sex. However, isolated cases have now been reported in which the patients had not contracted the virus during sexual contact, said Kluge. Family members of infected people, heterosexual contacts, and children have also contracted the virus, he said.
Of the patients for whom information on their status was available, 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 fast-moving outbreak expanding into previously unaffected areas by the hour, day and week,” Kluge said.
The stigma against men having sex with men in some countries has made it difficult to get a full picture of the outbreak, Kluge said. Some people with monkeypox symptoms may avoid going to a healthcare provider for a diagnosis because they fear the repercussions if someone finds out they’re gay or bisexual, Kluge said. However, it is also crucial to clearly communicate the reality of the current outbreak, he added.
“We know from our lessons in dealing with HIV how stigma fuels outbreaks and epidemics, but allowing our fear of stigma to prevent us from taking action can be just as damaging,” Kluge said.
Kluge said health authorities in Europe need to quickly ramp up monkeypox surveillance and their capacity to diagnose the disease and sequence samples. Contacts of people with monkeypox also need to be identified quickly to stop the spread, he said.
Health officials must also educate high-risk communities and the general public on precautions to take when attending mass gatherings this summer, Kluge said. And vaccines must be distributed fairly, with a focus on those most at risk, he added.
Monkeypox spreads primarily through close physical contact with an infected person or through contaminated materials such as shared clothing or bed sheets. The virus can spread through respiratory droplets when an infected person has lesions in the throat or mouth. However, this requires permanent personal contact. Monkeypox is not thought to spread through aerosol particles like Covid-19.
Respiratory droplets fall to the ground quickly while aerosol particles linger in the air longer, which is one of the reasons Covid is so contagious.
Monkeypox belongs to the same virus family as smallpox but has milder symptoms. Most people recover within two to four weeks without specific medical treatment.
Monkeypox often begins with flu-like symptoms such as fever, headache, sore throat, body aches, chills, fatigue, diarrhea, and swollen lymph nodes. A rash that looks like pimples or blisters then appears on the body. People are most 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 have developed a rash on just 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.