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  • Pathfinder
    replied
    WHO Director-General's opening remarks at the media briefing – 25 August 2023

    25 August 2023

    ...
    Just over a year ago, I declared a public health emergency of international concern over the global outbreak of what was then called monkeypox, and is now known as mpox.

    So far, more than 90 thousand cases and 156 deaths have been reported to WHO, from 114 countries. However, we know the true number of cases and deaths is higher, due to under-reporting in several countries.

    Outside Africa, most cases are among men, and in cases where sexual orientation is reported, most cases are among men who have sex with men.

    In May of this year, I declared an end to mpox as a public health emergency of international concern.

    The number of reported cases, hospitalizations and deaths globally has declined steadily since August last year.

    However, we have seen a significant increase in cases in the last two months in Asia, and cases continue to be reported regularly in Africa.

    As I did with COVID, I established a review committee to advise me on standing recommendations to support countries to manage mpox in the long-term.

    On Tuesday this week, on the advice of the committee, I issued those recommendations, in seven major areas.

    First, all countries should develop and implement national mpox plans, with the aim of eliminating human-to-human transmission.

    Second, to maintain control and achieve elimination, countries should ensure mpox is closely monitored and sustain outbreak surveillance.

    Third, all countries should enhance community protection, through risk communication, working closely with community representatives and organizations, and by combating stigma and discrimination.

    Fourth, all countries should initiate, support, and collaborate on research on mpox prevention and control.

    Fifth, all countries should provide information to travellers who may be at risk on how to protect themselves and others.

    Sixth, all countries should deliver optimal clinical care for mpox, integrated into programmes for HIV and other sexually transmitted infections and other health services as needed.

    And seventh, all countries should work towards ensuring equitable access to safe, effective and quality-assured vaccines, tests and treatments for mpox, to reach those most at risk or in need of care.

    ...​

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  • Pathfinder
    replied
    ...
    Statement by Dr Hans Henri P. Kluge, WHO Regional Director for Europe to the press on COVID-19, extreme heat and mpox

    27 June 2023 Statement
    ...
    Alongside an increased recent risk of extreme heat, I would also like to draw your attention to a recent resurgence of mpox infections, first in the United States and then in the UK, Spain, Belgium and the Netherlands.

    The European Region recorded 22 new mpox cases during the month of May.

    While this might seem low, it tells us the virus continues to circulate in the European Region, particularly affecting men who have sex with men, and we could see a resurgence. For those of you who know you are at higher risk, there are things you can do.

    Get vaccinated against mpox if vaccines are available and you are eligible.

    Limit contact with others if you have symptoms, and avoid close physical contact, including sexual contact, with someone who has mpox.

    At WHO we continue urging countries to reach everyone at risk, to eliminate discrimination and mpox from the community.

    I welcome the UK’s recent decision to continue its vaccination programme and urge other countries to continue to reduce barriers to testing, vaccination and care for persons belonging to groups at continued risk.
    ...

    Good morning. This summer will be the first in more than 3 years that many of us will enjoy without the looming threat of COVID-19.Whilst it may not be a global public health emergency, COVID-19 has not gone away. Close to 1000 new COVID-19 deaths continue to occur across the Region every week, and this is an underestimate due to a drop in countries regularly reporting COVID-19 deaths to WHO. And it continues to disproportionately affect the weakest and the most vulnerable. COVID-19 exploited an epidemic of diseases, including cancers, cardiovascular disease, diabetes, and chronic lung illnesses, which account for 75% of mortality in our region today. Those with such underlying conditions were, and still are, far more vulnerable to severe forms of COVID-19.Yet simple solutions can help reduce the burden of these so-called noncommunicable diseases, and fight the next pandemic when it arrives. Those of us with the means and opportunity can, for example, undertake 25 minutes of moderate exercise a day, quit smoking, moderate alcohol consumption and limit salt intake. Long COVID remains a complex condition we still know very little about. According to estimates from our collaborating centre, the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, nearly 36 million people across the WHO European Region may have experienced long COVID in the first 3 years of the pandemic. That’s approximately 1 in 30 Europeans over the past 3 years. That’s 1 in 30 who may still be finding it hard to return to normal life. 1 in 30 who could be suffering in silence, left behind as others move on from COVID-19.We are listening to the calls from long COVID patients and support groups, and raising awareness of their plight, but clearly much more needs to be done to understand it. Long COVID remains a glaring blind spot in our knowledge, that urgently needs to be filled. Unless we develop comprehensive diagnostics and treatment for long COVID, we will never truly recover from the pandemic. We are encouraging more research to be undertaken and urging those eligible for COVID-19 vaccination to be vaccinated. This under-recognized condition should be taken seriously, across the health and social sectors, and we should ensure ample care is available for patients. Ultimately, the best way to avoid long COVID is to avoid COVID-19 in the first place. The priority must be to vaccinate vulnerable populations, the elderly, people with underlying medical conditions, and the immunocompromised. We should ensure at least 70% vaccine coverage for these groups, including both primary and additional booster doses. A few words about the unusually warm summer we are experiencing. A new report from the European Union and the World Meteorological Organization recently warned that Europe has been warming twice as fast as the global average since the 1980s, and extreme heat in the summer months is becoming the norm, not the exception. Last year in our region, extreme heat claimed 20 000 lives between June and August. Last week, Spain and Portugal recorded temperatures in excess of 40 degrees, greatly increasing the risk of wildfires. Earlier this month, Kazakhstan saw deadly wildfires claim the lives of at least 15 people, 14 of whom were firefighters. At the same time, other parts of our region saw flash flooding and landslides, which also claimed lives. So, look out for each other during the summer months by checking in on your elderly relatives and neighbours, limiting outdoor activity when it’s very warm, staying hydrated, keeping your homes cool, and allowing yourself time to rest. Alongside an increased recent risk of extreme heat, I would also like to draw your attention to a recent resurgence of mpox infections, first in the United States and then in the UK, Spain, Belgium and the Netherlands.The European Region recorded 22 new mpox cases during the month of May. While this might seem low, it tells us the virus continues to circulate in the European Region, particularly affecting men who have sex with men, and we could see a resurgence. For those of you who know you are at higher risk, there are things you can do.Get vaccinated against mpox if vaccines are available and you are eligible. Limit contact with others if you have symptoms, and avoid close physical contact, including sexual contact, with someone who has mpox. At WHO we continue urging countries to reach everyone at risk, to eliminate discrimination and mpox from the community. I welcome the UK’s recent decision to continue its vaccination programme and urge other countries to continue to reduce barriers to testing, vaccination and care for persons belonging to groups at continued risk.In summary, all 3 of these health emergencies: COVID-19, mpox and extreme heat, call for a change in our collective approaches, in our allocation of resources and also in our individual behaviours.Thank you.   

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at the media briefing – 11 May 2023
    11 May 2023
    ...

    Finally to mpox.

    In July last year, I declared a public health emergency of international concern over the multi-country outbreak of mpox as the virus spread rapidly across the world.

    In total, more than 87 thousand cases and 140 deaths have been reported to WHO, from 111 countries.

    WHO has been very encouraged by the rapid response of countries. We now see steady progress in controlling the outbreak based on the lessons of HIV and working closely with the most affected communities.

    Almost 90% fewer cases were reported in the past three months, compared with the previous three months.

    In particular, the work of community organizations, together with public health authorities, has been critical for informing people of the risks of mpox, encouraging and supporting behaviour change, and advocating for access to tests, vaccines and treatments to be accessible to those most in need.

    Pharmaceutical companies and regulatory agencies have also played an important role in helping to expand access to these countermeasures.

    While stigma has been a driving concern in managing this epidemic and continues to hamper access to care for mpox, the feared backlash against the most affected communities has largely not materialized.

    For that, we are thankful.

    Yesterday, the emergency committee for mpox met and recommended to me that the multi-country outbreak of mpox no longer represents a public health emergency of international concern.

    I have accepted that advice, and am pleased to declare that mpox is no longer a global health emergency.

    However, as with COVID-19, that does not mean that the work is over. Mpox continues to pose significant public health challenges that need a robust, proactive and sustainable response.

    While we welcome the downward trend of mpox cases globally, the virus continues to affect communities in all regions, including in Africa, where transmission is still not well understood.


    Travel-related cases in all regions highlight the continued threat.

    There is a particular risk for people living with untreated HIV infection.

    It remains important for countries to maintain their testing capacities and to continue their efforts, assess their risk, quantify their needs to respond, and act promptly when needed.

    Integration of mpox prevention and care into existing health programmes is recommended, to allow continued access to care, and rapid response to address future outbreaks.

    WHO will continue to work towards supporting access to countermeasures as more information on effectiveness of interventions becomes available.
    ...


    --------------------

    See also:

    Fifth Meeting of the International Health Regulations (2005) (IHR) Emergency Committee on the Multi-Country Outbreak of monkeypox (mpox) (WHO. May 11, 2023)

    Fifth Meeting of the International Health Regulations (2005) (IHR) Emergency Committee on the Multi-Country Outbreak of monkeypox (mpox) 11 May 2023 Statement Reading time: 8 min (2202 words) The WHO Director-General transmits the report of the fifth meeting of the International Health Regulations (2005) (IHR) Emergency

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at the media briefing – 15 February 2023

    15 February 2023

    ===

    On Friday, the Emergency Committee for the global outbreak of mpox met to assess whether in its view, the outbreak remains a public health emergency of international concern.

    The committee has advised me that in its view, mpox remains a global health emergency, and I have accepted that advice.

    The committee acknowledged the progress made in reducing mpox transmission globally, and the continued decline in reported cases since its last meeting.

    However, more than 30 countries continue to report cases, and the possible under-detection and under-reporting of confirmed cases in some regions is concerning, particularly in countries where animal to human transmission of mpox has been reported before.

    WHO continues to call on all countries to maintain surveillance for mpox, and to integrate services for prevention, preparedness and response into national control programmes, including for HIV and other sexually transmitted infections.

    ===

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at 4th meeting of the IHR Emergency Committee: multi-country outbreak of mpox -

    9 February 2023
    ...
    It is very pleasing to see how, thanks to the hard work of affected countries, cases of mpox have declined since I declared a public health emergency of international concern last July.

    The number of reported cases of mpox has continued to drop to low levels in all regions since the last time you met, and this looks like a sustained decline.

    More than 85,000 cases of mpox have now been reported to WHO, with 92 deaths.

    Since November, 90 percent of cases have been reported from the Region of the Americas.

    But WHO continues to receive case reports from around the world, with more than 30 countries reporting in the last month.

    It is important to note that it is difficult to chart the true trajectory of the epidemic in the African Region due to the limited data available to WHO. Data sharing remains critical for all countries.

    That said, the slowdown in reported cases indicates the effectiveness of response measures globally.

    Whether or not you advise me that the outbreak continues to constitute a public health emergency of international concern, bringing the outbreak to an end still requires intense effort. If we do not stop human-to-human transmission, we could face a resurgence of cases.

    And of course, we must remember that mpox has been endemic in many low-income countries in Africa for many years.

    Even as it recedes in countries that have not seen major outbreaks before, this global outbreak must spur more sustained investment in addressing this disease everywhere.

    Going forward, we must sustain efforts for surveillance, prevention and care; vaccination of high-risk populations;

    improving equitable access to diagnostics, vaccines and treatment for all who need them;

    and continuing to fight stigma and discrimination, and ensure respect for human rights.

    Over the longer-term, mpox programmes and services should be integrated into surveillance and control programmes for HIV and other sexually transmitted infections.

    In a few moments my colleagues will provide technical updates on the current epidemiological situation.

    My thanks once again to you, Dr Okwo-Bele, for your leadership.

    And my thanks to each of the committee members and advisors for sharing your expertise, and for your dedication and commitment.

    As always, the International Health Regulations will be your guide.

    I wish you a productive discussion, and I look forward to your recommendations.

    I thank you.


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  • sharon sanders
    replied
    bump this

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at the media briefing – 14 December 2022

    14 December 2022
    ...
    The global outbreak of mpox – a disease that was mostly unknown outside of Africa – took the world by surprise.

    More than 82,000 cases have been reported from 110 countries, although the mortality rate has remained low, with 65 deaths.

    Thankfully, the number of weekly reported cases has declined more than 90% since I declared a public health emergency of international concern in July.

    If the current trend continues, we are hopeful that next year we will also be able to declare an end to this emergency.
    ...

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at the media briefing – 9 November 2022

    9 November 2022
    ...

    Now to the global monkeypox outbreak.

    The number of weekly cases of monkeypox reported to WHO has declined 80% from the peak in August, although there was a small rise last week, with 19 countries reporting an increase.

    This week, WHO signed an agreement with SIGA Technologies, the developer of the antiviral tecovirimat, also known as TPOXX, for a donation of 2,500 treatment courses.

    In the coming days, WHO will invite low- and middle-income countries to express interest in receiving tecovirimat free of charge.

    While this treatment is not approved in most countries, WHO has published a protocol that researchers can use to design and conduct clinical trials of this and other medicines.

    In situations where trials are not in place, WHO recommends that tecovirimat be considered for use under a different protocol to promote the collection of data on the drug’s effectiveness.

    ===

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  • Pathfinder
    replied
    Transmission dynamics of monkeypox in the United Kingdom: contact tracing study
    ...

    Implications

    We found that shorter serial intervals are more common than short incubation periods for monkeypox, which suggests considerable pre-symptomatic transmission. This has also been observed for other viral infections1112 and is a consequence of transmission during the pre-symptomatic period. Previous research has not found evidence of transmission and substantial shedding of monkeypox virus before symptom onset, which is reflected in guidance from WHO and the European Centre for Disease Prevention and Control.2333 Assuming statistical independence between the serial interval and incubation period, we found that 53% (95% credible interval 43% to 62%) of transmission occurs in the pre-symptomatic phase. However, since serial intervals depend on the incubation period this finding is an approximation of the proportion of infections due to pre-symptomatic transmission. This finding is consistent with the proportion of pre-symptomatic transmission among the subset of case-contact pairs where transmission can be identified relative to the date of symptom onset after exposure. Data for both the serial interval and the incubation period are similarly distributed across the monkeypox outbreak in the UK, so temporal changes in reporting should affect both distributions comparably (see supplementary material C).

    The identification of pre-symptomatic transmission might be indicative of changes to the primary route of transmission. Pre-symptomatic transmission may be facilitated by specific types of high intensity interactions (eg, sexual contacts) where lower pre-symptomatic viral loads are infectious. This pre-symptomatic transmission could also be transmission before symptoms are detected rather than before clinical symptom onset because individuals could have lesions of which they are unaware—this might be more important for internal lesions. From the perspective of public health policy, this transmission before the detection of symptoms is equivalent to pre-symptomatic transmission, as it concerns when individuals might become aware of their infection. If a substantial proportion of secondary transmission occurs before symptom onset, the implications will be that many infections cannot be prevented by isolating individuals with symptoms. Furthermore, the effectiveness of contact tracing will be affected because when contacts are traced, they might already have generated secondary cases. Therefore, backward contact tracing strategies should account for a pre-symptomatic infectious period when trying to find the contacts of confirmed cases. The maximum time before symptoms that transmission was detected for patients who could be linked through personal identifiable infection was four days.

    Conclusions

    The global transmission of the monkeypox virus has been on a scale not previously seen outside of Central Africa. The shorter median estimate for the serial interval relative to the incubation period suggests that pre-symptomatic transmission might be more substantial than was previously thought, which is further supported by linked patient level data. The 95th centile of the serial interval ranged from 23 to 41 days, which suggests a potential for long infectious periods that are consistent with research of earlier clades. In the present study the incubation period, ranging from 16 to 23 days after exposure, would be adequate to identify 95% of infected individuals, so would be the required length of post-exposure isolation policies.
    ...

    Link to study:
    CCBYNC Open access Research Special Paper Transmission dynamics of monkeypox in the United Kingdom: contact tracing study BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-073153 (Published 02 November 2022)Cite this as: BMJ 2022;379:e073153 Linked Research (https://www.bmj.com/content/379/bmj-2022-073153) Transmission

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at Member State Information Session on COVID-19 and other issues – 27 October 2022

    27 October 2022
    ...
    Moving to monkeypox.

    More than 76 000 cases in 109 countries have now been reported to WHO, with 36 deaths.

    We continue to work with countries around the world to get vital information to those most at-risk, along with increasing surveillance, testing and diagnostic capacities, supporting immunization and medical care.

    On the monkeypox situation, the good news is that it is globally on the decline, but we still should not give room to complacency.

    ===

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  • Pathfinder
    replied
    Monkeypox cases are plummeting. Scientists are debating why
    ...
    26 OCT 202211:35 AMBYKAI KUPFERSCHMIDT

    When monkeypox cases in Europe began to decline this summer, researchers’ first question was: Is it real? Some worried that people might not be getting tested because of receding fears of the virus, coupled with strict isolation requirements for patients. “They might be reluctant to be confirmed and be told not to go out at all,” says Catherine Smallwood, monkeypox incident manager at the World Health Organization’s (WHO’s) Regional Office for Europe.

    But the decline is now unmistakable. WHO Europe, which reported more than 2000 cases per week during the peak in July, is now counting about 100 cases weekly. In the Americas, the other major epicenter of the outbreak, numbers have dropped by more than half (see graphic, right). “We’re seeing a true decline,” Smallwood says.

    Vaccines, behavior change among the most affected group—men who have sex with men (MSM)—and immunity after natural infection are all playing a role in that decline, says Erik Volz, an infectious disease modeler at Imperial College London, but how much each factor has contributed is unclear. “This is something we’ve debated a lot internally.”
    ...
    In the United Kingdom, at least, vaccination campaigns have played a minor role, according to a model published as a preprint this month by Samuel Brand, an infectious disease modeler at the University of Warwick. Monkeypox’s reproductive number—the average number of new infections triggered by an infected person—began to drop by mid-June, even though campaigns only started in July, Brand notes. Several other European countries saw the same pattern.

    That leaves behavior change and immunity from natural infections. A survey conducted by the U.S. Centers for Disease Control and Prevention among MSM in August found about half had reduced their number of sexual contacts. As awareness of the disease increased, people also became more likely to seek diagnosis and treatment early and to avoid sex while they were infectious. The UK Health Security Agency has presented data suggesting syphilis and other sexually transmitted infections declined as well—which would bolster the case for behavior change—although that signal is “suggestive but not conclusive,” Volz says.

    Immunity acquired through infections in the most sexually active men may be the biggest factor, however. Monkeypox has been affecting mostly MSM and their sexual networks because parts of those networks are densely connected, with some people having a large number of sexual contacts. Rising immunity in that group could limit the viru’s ability to spread, says Jacco Wallinga, chief epidemic modeler at the Dutch National Institute for Public Health and the Environment.
    ...



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  • Pathfinder
    replied
    Translation Google

    Monkey pox: the epidemic is receding but has not yet disappeared

    Since mid-July, the contamination curve has fallen very sharply in Western Europe and North America. However, some countries in Central and Latin America are still experiencing an increase in the number of cases.

    Article written by
    franceinfo with AFP
    France Televisions
    Postedon 10/21/2022 08:51
    Updateon 21/10/2022 09:45

    "We're coming to the end, but we're not there yet." The monkey pox epidemic is in full decline, virologist Jean-Claude Manguara told AFP on Friday, October 21. With more than 70,000 cases in a hundred countries since May, "an epidemic of 'monkeypox' so important in such a short time is unheard of" , recalled this head of the environment and infectious risks unit. at the Pasteur Institute.

    If since mid-July, the contamination curve has dropped very significantly in Western Europe and North America, certain countries in Central and Latin America are still experiencing an increase. In addition, at present, monkeypox is "endemic" in about ten African countries. In these areas, the epidemic, which is more lethal, stems mainly from contact with wildlife in rural areas.

    "The African source remains present and, in a context where there may be population movements, we may have new exported cases and a new epidemic wave at any time" , warns Steve Ahuka Mundeke, head of the virology department at the Biomedical Research Institute of the Democratic Republic of Congo and member of an IRD-Inserm team. In recent months, "we have again seen that global strategies are only deployed when the countries of the North are affected, which does not at all clear the African health authorities ", he notes.

    Behavior change and vaccination

    Where the epidemic is declining, experts point to the decisive role of changing behavior within communities at risk, in particular thanks to the role "of associations, perhaps more listened to than the authorities and closer to the field" , suggests Jean- Claude Manuguerra. Surveys show that more than half of men who have sex with men have reduced their number of sexual encounters.

    As for vaccination, "it has helped, but the number of vaccines available remains low" , reminds AFP Carlos Maluquer de Motes, professor of virology at the British University of Surrey. The vaccine is still recommended for prevention and post-exposure. Its clinical effectiveness is not yet supported by "hard data" , according to the European Center for Disease Prevention and Control, but it is showing positive preliminary results.

    In any case, “significant uncertainties remain about the evolution of the epidemic”, underlines the European agency, which draws four scenarios. Heads: rebound of the epidemic, linked in particular to the return of risky behavior, or reduced circulation of the virus with sporadic outbreaks. Tails: persistent decline in the epidemic, even elimination of the disease in Europe.

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  • Pathfinder
    replied
    WHO Director-General's opening remarks at media briefing – 19 October 2022

    19 October 2022
    ...
    On monkeypox, the Emergency Committee will meet tomorrow to discuss the outbreak and make recommendations.

    The number of reported cases globally has now dropped for eight weeks in a row, but as with COVID-19, risks and uncertainties remain, and some countries are still seeing increasing transmission.

    I look forward to the Emergency Committee’s recommendations.

    ===

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  • sharon sanders
    replied

    Helen Branswell



    7h • 5 tweets • 4 min read Bookmark Save as PDF My Authors

    1. Two fascinating reports from 2 different @CDCgov journals today on #monkeypox acquisition via needlestick injuries. The takeaway message for me: If you are a HCP & you have a sharps injury involving MPX, you probably want to get vaccinated right away.

    2. The first report came out in #MMWR. A Florida nurse who was using a syringe to extract fluid from a suspected #monkeypox lesion pricked her finger, drawing blood. She got the first of 2 doses of Jynneos within 15 hours & only developed 1 lesion.

    Monkeypox virus Infection Resulting from an ...This report describes the first occupationally acquired monkeypox infection in a health worker in the United States.https://www.cdc.gov/mmwr/volumes/71/...cid=mm7142e2_w

    3. The 2nd report, in @EIDjournal, is about a Portuguese doctor who had a similar needlestick injury while sampling a suspected #monkeypox lesion. There was no bleeding, he thought his glove was intact, and he didn't report the exposure. He was not vaccinated.

    4. When the Portuguese doctor developed his first #monkeypox lesion — at the site of the injury — it was determined it was too late to vaccinate. He went on to have lesions on his scalp, neck, forearm, both hands, ankle and scrotum. wwwnc.cdc.gov/eid/article/28…

    5. Another takeaway, highlighted in the @EIDjournal article, is that people shouldn't be using sharps to sample #monkeypox lesions.
    This is the 3rd such report I've seen. There was another published last month in @EIDjournal, from Brazil. wwwnc.cdc.gov/eid/article/28…
    • • •

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  • sharon sanders
    replied



    Jason Kindrachuk, PhD

    @KindrachukJason
    ·
    58m
    Shared with permission from Dr. Thierry Kalonji. Waiting to see the results in published form but these observations highlight the need for sustained investment in #monkeypox and emerging zoonotic virus surveillance through #OneHealth approaches

    1
    3
    8
    Jason Kindrachuk, PhD

    @KindrachukJason
    ·
    51m
    I’ll also highlight the last sentence from Thierry’s post regarding resource limitations. This is critically important. My hat’s off to all of my colleagues across Africa that have continued to find ways to do this work and rapidly share their results

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