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Europe in 'urgent' fight against monkeypox

Monkeypox cases tripled in Europe over the past two weeks in what WHO calls a race to prevent the virus from becoming entrenched in the region.

An electron microscope image shows mature, oval-shaped monkeypox virions
An electron microscope image shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 U.S. prairie dog outbreak (AN/Cynthia S. Goldsmith, Russell Regnery)

GENEVA (AN) — Monkeypox cases tripled in Europe over the past two weeks in what the World Health Organization calls a race to prevent the virus from becoming entrenched in the region. African public health authorities say it's already considered an emergency in some nations.

WHO’s Europe director, Dr. Hans Kluge, said the continent remains at the center of an expanding outbreak of the virus, with almost 90 percent of lab-confirmed and globally reported monkeypox cases reported there since mid-May. New infections tripled to more than 4,500 lab-confirmed cases across 31 European nations since mid-June, he said, spreading to six new countries and areas.

"Urgent and coordinated action is imperative if we are to turn a corner in the race to reverse the ongoing spread of this disease," Kluge told a news media briefing on Friday.

"So let me be clear. There is simply no room for complacency," he said. "Especially right here in the European region, with its fast-moving outbreak that with every hour, day and week is extending its reach into previously unaffected areas."

The public health threat has risen to such a serious level that WHO's Europe office and the European Center for Disease Prevention and Control are issuing joint bulletins with the findings from their joint surveillance of the continent's monkeypox outbreak. The findings come from 26 nations and areas that submitted detailed information through the European Surveillance System, dubbed TESSy.

Kluge said most of the cases reported in Europe are among people aged 21 to 40, and 99 percent are males "with the majority of those for whom we have information being men who have sex with men." But he said small numbers of cases involve "household members, heterosexual contacts, and non-sexual contacts, as well as among children."

Almost 10 percent of patients were hospitalized for treatment or isolation; one patient was admitted to a hospital's intensive care unit. Experts say people face a risk of infection if they have close physical contact with someone who has monkeypox, or with their clothing or bedsheets. Children and pregnant women are considered the most likely to have severe reactions to the disease.

"Fortunately, no people are reported to have died so far," said Kluge. "The vast majority of cases have presented with a rash and about three-quarters have reported systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhea, chills, sore throat or headache."

An "emergency" in Africa, "high" threat in Europe

Globally there have been 5,783 monkeypox cases reported from 52 countries, territories and areas where the disease is not usually seen, according to the latest data from the U.S. Centers for Disease Control and Prevention.

The top 10 highest numbers are in the U.K., with 1,235 cases; Germany, 1,054; Spain, 800; France, 498; the U.S., 459; Portugal, 402; the Netherlands, 288; Canada, 287; Italy, 192; and Belgium, 117.

Earlier this week, the Africa Centers for Disease Control and Prevention said there have been 79 lab-confirmed cases and 73 deaths among the 1,715 reported cases of monkeypox from eight endemic and two non-endemic Africa Union member nations since the start of the year.

But it noted that going back to the start of the COVID-19 pandemic in early 2020, there have been 12,141 documented cases and 363 deaths from monkeypox in Africa, and the number of cases has "continued to rise" on the continent.

Until recent months, monkeypox was not known to have caused large outbreaks beyond central and west Africa, where it is endemic in some countries. The vast majority of cases are in Congo and Nigeria, but the disease is now found in nations such as Ghana and South Africa where it wasn't previously detected.

"The technical and financial resources required to effectively respond to monkeypox in Africa are not yet optimally mobilized," said Africa CDC, which called on wealthier countries to share vaccine supplies. "Monkeypox remains a public health emergency in affected African countries and is a high-risk pathogen for other neighboring countries."

A vaccine originally developed for smallpox can be used against monkeypox, but supplies are limited. Smallpox vaccines are thought to be 85% effective against monkeypox, WHO said, while just one vaccine against monkeypox exists but is approved for use only in Canada and the United States.

After summoning an emergency committee, WHO declined to call monkeypox a public health emergency of international concern, its highest alert level, less than a week ago. Kluge, however, said "the rapid evolution and emergency nature of the event means that the committee will revisit its position shortly."

The U.N. health agency believes monkeypox poses a "high" threat to public health in Europe, he said, due to "the rapid expansion of the disease, with continued challenges hampering our response, and with additional cases being reported among women and children."

After the committee met on June 25, WHO Director-General Tedros Adhanom Ghebreyesus described monkeypox as "an evolving health threat." He urged governments to do more surveillance, contact tracing and patient care, and to provide people who are most at risk of contracting the disease with adequate vaccines and antiviral treatments.