WHO Declares Monkeypox Outbreak A Public Health Emergency, Only These Vaccines Are Approved For The Treatment

Add as a preferred source on Google

WHO Director-General Dr Tedros Adhanom Gheyesus has declared rise of mpox in the Democratic Republic of the Congo (DRC) and other African nations a public health emergency of international concern (PHEIC). This decision follows advice from an IHR Emergency Committee, which reviewed data from WHO and affected countries.

The committee highlighted that the mpox surge could spread further within Africa and potentially beyond. Dr Tedros stated, "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it's clear that a coordinated international response is needed to stop these outbreaks and save lives."

What Is Monkey Virus?

Monkeypox is a viral zoonotic disease caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Though it is relatively rare, monkeypox has gained attention due to its potential to cause outbreaks and its similarity to smallpox, a disease eradicated in the 20th century.

Understanding the causes, symptoms, risk factors, prevention strategies, and treatment options for monkeypox is crucial for managing and controlling its spread.

Monkeypox Causes

Monkeypox is caused by the monkeypox virus, which is part of the Orthopoxvirus genus within the Poxviridae family. The virus is known to infect both animals and humans. It was first identified in monkeys in 1958, hence the name "monkeypox," although rodents are now recognized as the primary reservoirs of the virus.

The transmission of monkeypox to humans occurs primarily through contact with infected animals, such as rodents or primates, that harbor the virus. Human-to-human transmission can also occur through respiratory droplets, direct contact with bodily fluids, or contaminated materials like bedding or clothing.

Monkeypox Symptoms

The symptoms of monkeypox can range from mild to severe and typically appear within 5 to 21 days after exposure to the virus. The progression of the disease is similar to smallpox but usually less severe. Key symptoms of monkeypox include:

1. Fever: A high fever is one of the initial symptoms and is often accompanied by chills and sweats.
2. Headache: Intense headaches and muscle aches are common.
3. Fatigue: General malaise and weakness may be experienced.
4.Lymphadenopathy: Swelling of lymph nodes, particularly in the neck, armpits, and groin.
5. Rash: A characteristic rash begins with flat lesions that progress to raised bumps and eventually develop into fluid-filled blisters. The rash usually appears on the face, arms, and legs, and can spread to other parts of the body.
6. Lesions: The skin lesions go through several stages, including macules, papules, vesicles, pustules, and finally scabs, before healing.

The disease typically lasts between 2 to 4 weeks, with the rash being one of the most distinguishing features of monkeypox.

Risk Factors for Monkeypox

Several factors can increase the risk of contracting monkeypox, including:

1. Direct Contact with Infected Animals: Handling or coming into contact with the bodily fluids, tissues, or secretions of infected animals can pose a risk. This is particularly relevant for individuals who work with wildlife or have close contact with pets that may have been exposed.

2. Close Contact with Infected Individuals: Human-to-human transmission can occur through prolonged face-to-face contact or through contact with infected bodily fluids or contaminated items.

3. Travel to Endemic Areas: Monkeypox is more common in Central and West African countries where the virus is endemic. Traveling to these regions increases the risk of exposure.

4. Immune System Status: Individuals with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive treatments, are at a higher risk of severe illness.

5. Lack of Vaccination: Individuals who have not been vaccinated against smallpox may be at higher risk, as the smallpox vaccine provides some cross-protection against monkeypox.

Monkeypox Prevention

Preventing monkeypox involves several strategies to minimize the risk of exposure and transmission:

1. Avoid Contact with Infected Animals: If you are in an area where monkeypox is known to occur, avoid handling or coming into contact with wild animals, particularly rodents and primates. Proper handling and cooking of meat can also reduce the risk.

2. Practice Good Hygiene: Regular handwashing with soap and water or using hand sanitizer can help prevent the spread of the virus. Avoid touching your face, especially your eyes, nose, and mouth, with unwashed hands.

3. Use Personal Protective Equipment (PPE): In settings where exposure to monkeypox is possible, such as in healthcare or research environments, wearing appropriate PPE like gloves, masks, and gowns can reduce the risk of transmission.

4. Avoid Close Contact with Infected Individuals: If someone is infected with monkeypox, avoid close contact and ensure that they practice good hygiene. Isolate the infected person if possible to prevent the spread of the virus.

5. Vaccination: Although there is no specific vaccine for monkeypox, the smallpox vaccine has been shown to provide some level of protection against the monkeypox virus. In outbreak situations or for individuals at high risk, vaccination may be recommended.

Monkeypox Treatment

There is no specific antiviral treatment for monkeypox, and management primarily focuses on supportive care and alleviating symptoms.
WHO's Strategic Advisory Group of Experts on Immunization recommends two vaccines currently used for mpox. These vaccines are approved by national regulatory authorities including those in Nigeria and DRC.

The vaccines are Jynneos, also called Imvanex in Europe, which is made by Danish company Bavarian Nordic, and LC16, which is manufactured by Japanese company KM Biologics that are effective against mpox.

The US Food and Drug Administration approved the Jynneos vaccine for use against smallpox and mpox in 2019. LC16 was developed for smallpox but is also effective against mpox.

Last week, Dr Tedros initiated the Emergency Use Listing process for these vaccines to expedite access for lower-income countries.

Apart from this, treatment strategies include:

1. Symptomatic Treatment: Medications to reduce fever, pain, and itching can help manage symptoms. Antipyretics (fever reducers) and analgesics (pain relievers) may be used to provide relief.

2. Wound Care: Proper care of the skin lesions is essential to prevent secondary bacterial infections. Keeping the affected areas clean and covered can help promote healing.

3. Hydration and Nutrition: Maintaining adequate hydration and nutrition is important, especially if the patient has difficulty eating or drinking due to illness.

4. Isolation: Infected individuals should be isolated to prevent the spread of the virus to others. This is particularly important in healthcare settings or during outbreaks.

5. Antiviral Medications: In severe cases or for high-risk patients, antiviral medications such as tecovirimat (TPOXX) or brincidofovir (Tembexa) may be used under medical supervision. These medications are not specifically approved for monkeypox but have been used based on their efficacy against related viruses.

In addition to these treatments, healthcare providers may monitor patients closely for complications and provide supportive care as needed.
WHO anticipates needing an initial US$15 million for surveillance, preparedness, and response activities. A needs assessment is underway across WHO's three levels. To facilitate immediate action, WHO has released US$1.45 million from its Contingency Fund for Emergencies.

The organisation may need additional funds soon and urges donors to fully support the mpox response needs. WHO is also working with vaccine manufacturers on potential donations and coordinating with partners like Gavi and UNICEF through the interim Medical Countermeasures Network.

This PHEIC determination marks the second such declaration related to mpox within two years. In July 2022, a multi-country outbreak was declared a PHEIC due to rapid spread via sexual contact across various nations where mpox had not been previously seen. That PHEIC ended in May 2023 after a sustained decline in global cases.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.