WHO is investigating if monkeypox is a ‘global health emergency’. Here is all you need to know

The World Health Organisation will be meeting on June 23 to decide if monkeypox should be declared a global health emergency. Unlike Covid-19, which was declared one two years ago, monkeypox is not a new disease and has been around for a while. But the pace at which new monkeypox cases have been registered have raised a few eyebrows.

WHO chief Tedros Adhanom Gebreyesus said this “global outbreak of monkeypox is clearly unusual and concerning”.

According to the WHO, this year's monkeypox outbreak has been characterised by varying symptoms among those affected, with many cases "not presenting with the typically recognised clinical picture for monkeypox," such as fever, swollen lymph nodes, and rashes in the face and upper extremities.


Monkeypox cases
More than 30 countries where monkeypox is not endemic have reported outbreaks of the viral disease as confirmed cases approach 1,900, most of them in Europe.

Monkeypox, which spreads through close contact and was first found in monkeys, mostly occurs in west and central Africa and only very occasionally spreads elsewhere.

In 2022, there were 72 confirmed cases of monkeypox-related deaths, all in Africa; no cases have been reported in the newly impacted nations.

“Europe remains the epicenter of this escalating outbreak, with 25 countries reporting more than 1,500 cases, or 85% of the global total,” WHO's Europe director, Dr. Hans Kluge noted.

Vaccines for monkeypox
Some African experts questioned why the U.N. health agency has never proposed using vaccines in central and West Africa, where the disease is endemic.

“The place to start any vaccination should be Africa and not elsewhere,” Dr. Ahmed Ogwell, acting director of the Africa Centers for Disease Control and Prevention, said.

Vaccination against smallpox is known to provide cross-protection against monkeypox, but WHO notes that any immunity from such shots will only be present in people over the age of 42-50 years old, as smallpox vaccination programmes were discontinued worldwide in 1980 following the disease's eradication.

According to the WHO, these first-generation vaccinations should not be used since they do not match current safety requirements. Instead, it advises second and third-generation smallpox vaccines, as well as one vaccine (MVABN) that has been authorised especially for monkeypox.

The WHO stated that while a significant number of cases in the current outbreak have been linked to men who have sex with men (MSM), the modes of transmission during sexual contact remain unknown, and "it is not clear what role sexual bodily fluids, including semen and vaginal fluids, play in the transmission of monkeypox."

Experts and health organisations have been quick to point out that sexual preferences have nothing to do with the spread of monkeypox, and that the high number of cases among MSM populations only demonstrates that transmission is widespread among close contacts of an infected person.

The fear of stigma associated with infectious diseases, as witnessed with HIV/AIDS and, more recently, Covid- 19, has been a concern with monkeypox as well. So much so that WHO is said to be working on a new name for monkeypox in response to scientist appeals for a "non-discriminatory and non-stigmatizing" moniker for the virus.

However, because the supply of new vaccinations is limited, WHO has stated that mass vaccination is not currently recommended and that "decisions about the use of smallpox or monkeypox vaccines should be based on a complete assessment of the risks and benefits in each situation."