Discussion - Thoughts on a global outbreak of monkeypox

[sharon sanders]

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

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Jason Kindrachuk, PhD

@KindrachukJason
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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

 

[sharon sanders]

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…
• • •

 

[Pathfinder]

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.

===

https://www.who.int/news-room/speec...g-remarks-at-media-briefing---19-october-2022

 

[Pathfinder]

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.

https://www.francetvinfo.fr/sante/m...cule-mais-n-a-pas-encore-disparu_5431210.html

 

[Pathfinder]

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.
...
https://www.science.org/content/article/monkeypox-cases-are-plummeting-scientists-are-debating-why

 

[Pathfinder]

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.

===

https://www.who.int/director-genera...remarks-at-the-media-briefing-27-october-2022

 

[Pathfinder]

Transmission dynamics of monkeypox in the United Kingdom: contact tracing study
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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:
https://flutrackers.com/forum/forum...om-contact-tracing-study-bmj-november-02-2022

 

[Pathfinder]

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.

===
https://www.who.int/director-genera...marks-at-the-media-briefing---9-november-2022

 

[Pathfinder]

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.
...
https://www.who.int/news-room/speec...arks-at-the-media-briefing---14-december-2022

 

[sharon sanders]

bump this

 

[Pathfinder]

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.

https://www.who.int/director-genera...ti-country-outbreak-of-mpox---9-february-2023

 

[Pathfinder]

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.

===

https://www.who.int/director-genera...arks-at-the-media-briefing---15-february-2023

 

[Pathfinder]

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.
...
https://www.who.int/news-room/speec...g-remarks-at-the-media-briefing---11-may-2023

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

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)

https://flutrackers.com/forum/forum...y-outbreak-of-monkeypox-mpox-who-may-11-2023​

 

[Pathfinder]

...
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.
...

https://www.who.int/europe/news/ite...-covid-over-the-first-3-years-of-the-pandemic

 

[Pathfinder]

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.

...​

https://www.who.int/news-room/speec...emarks-at-the-media-briefing---25-august-2023

 

[sharon sanders]

Tedros Adhanom Ghebreyesus

@DrTedros


As a deadlier strain of #mpox spreads to multiple African
countries,@WHO,@AfricaCDC, local governments and partners
are further scaling up the response to interrupt disease
transmission. But more funding and support for a
comprehensive response are needed.

I am considering convening an International Health Regulations
Emergency Committee to advise me on whether the outbreak of
mpox should be declared a public health emergency of
international concern (PHEIC). Thank you @sciencecohen
for spotlighting this important and urgent issue.
https://science.org/content/article/deadlier-strain-mpox-spreads-more-african-countries…
6:10 AM · Aug 4, 2024

·
77.9K
Views​

 

[sharon sanders]

Please see:

Uganda records 2 imported mpox cases from DRC - August 2, 2024

Kenya - Mpox (monkeypox) outbreak 2024​​

Burundi - Mpox (monkeypox) outbreak 2024​

Côte d'Ivoire - Mpox (monkeypox) outbreak 2024​

Mpox cases reported in Africa up 160 percent: Africa CDC​

Central African Republic (CAR) - Mpox (monkeypox) outbreak 2024​

Kenya - Mpox (monkeypox) outbreak 2024

Mpox Outbreak in DRC Novel Clade I Sub-lineage - NYC HAN Update - CDC & WHO Update May 24th - ECDC Risk Statement​

​Research papers library - Poxviridae (including Mpox)


​

 

[Pathfinder]

Deadlier strain of mpox spreads to multiple African countries
...
3 AUG 2024 4:20 PM ETBYJON COHEN

An unprecedented outbreak of mpox that has been raging in the Democratic Republic of the Congo (DRC) over the past several months has, as feared, spread beyond its borders. Sequencing of the mpox viruses in three cases reported earlier this week in Uganda and Kenya has now confirmed all belong to a deadlier variant previously seen only in the DRC.
...
The mpox virus found in the DRC, known as clade 1, has killed about 3% of those infected in the past year. The milder variety of mpox, clade 2, erupted from Nigeria in May 2022, infecting nearly 100,000 people in 116 countries to date and spreading mainly among men who have sex with men (MSM). Only 208 deaths have been reported, a case fatality rate of 0.2%. A rollout of mpox vaccines and aggressive disease surveillance in MSM communities has helped slow that spread.

Sequences of the virus isolated from the recent mpox patients in Uganda and Kenya, which researchers posted in the GISAID database over the past 2 days, show they are linked to a clade 1 virus that first began circulating in the DRC’s South Kivu province, says evolutionary biologist Andrew Rambaut of the University of Edinburgh. Rambaut , who co-authored a paper with Mbala in the 13 June issue of Nature about the South Kivu outbreak, says continued spread in the DRC’s eastern reaches “is sustained human-to-human transmission and thus will be likely to reach other regions and neighboring countries if transmission continues.”

Mpox cases have also recently been reported in two other countries bordering South Kivu province, Rwanda and Burundi. Neither had ever reported a case of mpox, whether clade 1 or 2.
...
It's not clear how soon WHO might convene health experts to decide whether to declare a PHEIC, but Tedros does not want to delay action.
...
https://www.science.org/content/article/deadlier-strain-mpox-spreads-more-african-countries

 

[sharon sanders]

Tedros Adhanom Ghebreyesus

@DrTedros


As a deadlier strain of #mpox spreads to multiple African
countries,@WHO,@AfricaCDC, local governments and partners
are further scaling up the response to interrupt disease
transmission. But more funding and support for a
comprehensive response are needed.

I am considering convening an International Health Regulations
Emergency Committee to advise me on whether the outbreak of
mpox should be declared a public health emergency of
international concern (PHEIC). Thank you @sciencecohen
for spotlighting this important and urgent issue.
https://science.org/content/article/deadlier-strain-mpox-spreads-more-african-countries…
6:10 AM · Aug 4, 2024

·
77.9K
Views​

World Health Organization (WHO)

@WHO


"In light of the spread of #mpox outside #DRC, and the potential for further international spread within and outside Africa, I have decided to convene an Emergency Committee under the International Health Regulations to advise me on whether the outbreak represents a public health emergency of international concern. The committee will meet as soon as possible and will be made up of independent experts from a range of relevant disciplines from around the world"-
@DrTedros
10:48 AM · Aug 7, 2024
·
45K
Views​



Please see:

Uganda records 2 imported mpox cases from DRC - August 2, 2024

Kenya - Mpox (monkeypox) outbreak 2024​​

Burundi - Mpox (monkeypox) outbreak 2024​

Côte d'Ivoire - Mpox (monkeypox) outbreak 2024​

Mpox cases reported in Africa up 160 percent: Africa CDC​

Central African Republic (CAR) - Mpox (monkeypox) outbreak 2024​

Kenya - Mpox (monkeypox) outbreak 2024

Mpox Outbreak in DRC Novel Clade I Sub-lineage - NYC HAN Update - CDC & WHO Update May 24th - ECDC Risk Statement​

​Research papers library - Poxviridae (including Mpox)​

 

[Pathfinder]

WHO Director-General's opening remarks at the media briefing – 7 August 2024

7 August 2024
...
Since the beginning of this year, the Democratic Republic of the Congo has been experiencing a severe outbreak of Mpox, with more than 14 000 reported cases and 511 deaths.

Outbreaks of Mpox have been reported in DRC for decades, and the number of cases reported each year has been increasing steadily.

However, the number of cases reported in the first six months of this year match the number reported in all of last year, and the virus has spread to previously unaffected provinces.

In the past month, about 50 confirmed and more suspected cases have been reported in four countries neighbouring the DRC that have not reported before: Burundi, Kenya, Rwanda and Uganda.

Mpox outbreaks are caused by different viruses called clades.

Clade 1 has been circulating in the DRC for years, while clade 2 was responsible for the global outbreak which began in 2022.

The current outbreak in the Eastern DRC is caused by a new offshoot of clade 1, called clade 1b, which causes more severe disease than clade 2.

Clade 1b has been confirmed in Kenya, Rwanda and Uganda, while the clade in Burundi is still being analysed.

At the same time, cases of clade 1a have been reported this year in DRC, the Central African Republic and the Republic of Congo, while clade 2 has been reported in Cameroon, Côte d’Ivoire, Liberia, Nigeria and South Africa.

WHO is working with the governments of the affected countries, the Africa CDC, NGOs, civil society and other partners to understand and address the drivers of these outbreaks.

Stopping transmission will require a comprehensive response, with communities at the centre.

WHO has Standing Recommendations on mpox which include advice not to impose travel restrictions on affected countries.

WHO has developed a regional response plan, requiring US$ 15 million to support surveillance, preparedness and response activities.

We have released US$ 1 million from the WHO Contingency Fund for Emergencies to support scale-up of the response, and we plan to release more in the coming days.

There are two vaccines for mpox that have been approved by WHO-listed national regulatory authorities, and which are recommended by WHO’s Strategic Advisory Group of Experts on Immunization, or SAGE.

I have triggered the process for Emergency Use Listing of both vaccines, which will accelerate vaccine access particularly for lower-income countries, which have not yet issued their own national regulatory approval.

Emergency Use Listing also enables partners including Gavi and UNICEF to procure vaccines for distribution.

WHO is grateful to Japan, the United States, the European Union and manufacturers for working with us on vaccine donations.

We are working with all partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics and other tools.

In light of the spread of Mpox outside DRC, and the potential for further international spread within and outside Africa, I have decided to convene an Emergency Committee under the International Health Regulations to advise me on whether the outbreak represents a public health emergency of international concern.

The committee will meet as soon as possible and will be made up of independent experts from a range of relevant disciplines from around the world.

===
https://www.who.int/news-room/speec...remarks-at-the-media-briefing---7-august-2024