World health experts have warned we should prepare for deaths in Europe from monkeypox.
As the numbers infected rose to more than 1500 - 470 of them in the UK - Dr Catherine Smallwood, Monkeypox Incident Manager the World Health Organization (corr) in Europe warned: “Thankfully in the European Region we have had no deaths registered in the current outbreak but we should be prepared for those to happen because we do know that monkeypox can be a severe disease and we have some patients who have been hospitalised and it can lead to some severe outcomes in several population groups.”
She said those most at risk were young children, pregnant women and individuals who are immuno-suppressed.
Smallwood warned: “As the virus continues to spread and affect different population groups we will likely see some severe cases.”
The strain of monkeypox which is now in 25 “non-endemic countries” is the one normally found in the Western Africa which is the less serious of the two known types but it still kills around 3.3 per cent of patients.
There are currently 13 cases of monkeypox in Scotland and 524 cases in the UK.
Skin to skin or skin to mouth contact is still considered the most likely route of transmission but worrying new evidence in Italy has found monkeypox in the semen of men who have been infected.
Smallwood said anyone who has become infected with monkeypox should refrain from sex until all the scabs have fallen off and even then, as a precaution, should use a condom for 12 weeks afterwards while investigations continue to see if the virus can be spread by sexual intercourse.
Earlier WHO Regional Director for Europe, Dr Hans Kluge, told journalists that Europe remains “the epicentre of this escalating outbreak” with 85 per cent of the global total of cases.
Next week an Emergency Committee of WHO will be convened under International Health Regulations to advise on whether the current spread constitutes a public health emergency of international concern.
Kluge said: “The magnitude of this outbreak poses a real risk; the longer the virus circulates, the more it will extend its reach, and the stronger the disease’s foothold will get in non-endemic countries.
“Governments, health partners and civil society need to act with urgency, and together, to control this outbreak.”
Kluge said it was essential enhanced surveillance, contact tracing and infection prevention and control were carried out
He said: “Once identified, patients with suspected or confirmed monkeypox should be isolated until their symptoms are fully resolved, with the necessary infection control measures and the support they need to see them through to recovery.
“We need to identify close contacts of cases and support them as well, to self-monitor for 21 days for any early signs of monkeypox, such as fever.”
He pointed out: “So far in Europe, the majority – though not all – of reported patients, have been among men who have sex with men. Many – but not all patients – report multiple and sometimes anonymous sexual partners.
“Identifying, tracing and notifying sexual partners quickly is, therefore, often difficult, but remains critical in order to stop onwards spread.”
But he stressed: “We must remember that the monkeypox virus is not in itself attached to any specific group.
“Stigmatising certain populations undermines the public health response as we have seen time and again in contexts as diverse as HIV/AIDS, tuberculosis and COVID-19. Monkeypox will be opportunistic in its fight for survival, and its spread will depend on the conditions provided to it.”
And while there has been discussion in some quarters about banning music festivals, including Pride events, Kluge stated: “These events are powerful opportunities to engage with young, sexually active and highly mobile people.
“Monkeypox is not a reason to cancel events but an opportunity to leverage them to drive our engagement.
“WHO and health partners are reaching out quickly to communities, event organisers and dating apps to provide clear information to raise awareness about monkeypox infection and strengthen individual and community protection.”
But he criticised: “For decades, monkeypox has been endemic in parts of western and central Africa – and for decades it has been neglected by the rest of the world.
“Now that it is in Europe and elsewhere, we have seen yet again how a challenge in one part of the world can so easily and quickly be a challenge for all of us – and how we must all work together to ensure a coordinated response that is fair to one and all, especially the most vulnerable. But have we truly learned these lessons?
“There currently are limited amounts of vaccines and antivirals for monkeypox, and limited data on their use. Mass vaccination is not recommended or needed at this time.
“Targeted vaccination, either before or after exposure to the virus can benefit contacts of patients, including health-care workers. Yet, we are already seeing a rush in some quarters to acquire and stockpile these.
“But what about those countries in Africa where monkeypox has long been endemic – should they not be part of any global strategy to address the disease?
“Once again, a “me first” approach could lead to damaging consequences down the road, if we do not employ a genuinely collaborative and far-thinking approach.”
And he added:”I beseech governments to tackle monkeypox without repeating the mistakes of the pandemic – and keeping equity at the heart of all we do.”
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