Updated 7/23/2022 11:00am ET: The World Health Organization on Saturday declared the multinational monkeypox outbreak a Public Health Emergency of International Concern (PHEIC), the agency’s highest alert level.
On Thursday, the WHO convened an emergency committee of experts to assess the situation. The committee failed to reach a consensus on whether to declare a PHEIC, WHO Director-General Tedros Adhanom Ghebreyesus said in a news conference Saturday morning.
But Tedros, who described himself as a “tie-breaker,” noted that the International Health Regulations required him to consider several elements in addition to the Emergency Committee assessment to decide whether to declare a PHEIC. These elements included scientific unknowns, human health risks, and risks of further international spread.
“In short,” Tedros said, “we have an outbreak that has spread rapidly around the world through new modes of transmission, about which we know too little, and that meets the criteria of the International Health Regulations. For all of these reasons, I have decided that the worldwide outbreak of monkeypox constitutes a public health emergency of international concern.”
With the PHEIC statement, Tedros released a four-tier set of recommendations for countries. The recommendations address issues such as coordinating efforts to end transmission, engaging affected communities, stepping up surveillance, improving infection control in hospitals and clinics, accelerating research on vaccines and therapeutics, and managing international travel.
“We believe this [PHEIC] will mobilize the world to act together. It takes coordination and it takes… solidarity,” Tedros said. He ended the press conference by stressing that stigma and discrimination can be as dangerous as any virus.
In addition to this development, the US Centers for Disease Control and Prevention announced Friday afternoon that it had identified the first two cases of monkeypox in children. One case involved a toddler living in California. The other was with an infant who is not a US resident but was diagnosed in Washington, DC while the family was traveling. Both children should be fine. In contrast to the child case reported from the Netherlands and described below, the two US child cases appear to be explained by transmission from infected household members that have links to transmission in the male-having-sex-male community.
Original story 7/22/2022 1:03 pm ET: The World Health Organization is currently debating whether to declare the booming multinational monkeypox outbreak a Public Health Emergency of International Concern (PHEIC), the agency’s highest alert level.
The consultations come as the global number of monkeypox cases tops 16,000 – and a new report of an unexplained case in a child in the Netherlands raises alarm about the possible spread of the virus.
On Thursday, the WHO Emergency Committee met for seven hours to assess the status of the outbreak. It was the second time that WHO Director-General Tedros Adhanom Ghebreyesus convened the group of international experts. At the previous meeting, almost a month ago, the committee expressed concern about the situation, but overall concluded that it had not yet progressed to the level of a PHEIC.
That June decision drew criticism from some members of the public health community, who felt the committee “stungCritics also feared that the decision would undermine the ability of a PHEIC declaration to forestall a nascent outbreak of infectious diseases.
Global cases
The outcome of yesterday’s meeting is still unclear. The committee is now finalizing a report to the director-general, and the agency told Ars there is no firm timeline for when the result will be announced.
It looks like the WHO has received reports of more than 16,000 cases from 71 member states, spanning all six world regions designated by the WHO. The epicenter of the outbreak continues to be Europe. Five people have died in the multinational outbreak, three in Nigeria and two in the Central African Republic.
Although some countries are beginning to report declining trends in cases, Tedros noted, other countries are just beginning to identify cases. Six countries reported their first cases just last week, he said in a news conference on Wednesday.
The vast majority of cases continue to be identified in men who have sex with men (MSM).
“This transmission pattern presents both an opportunity to implement targeted public health interventions and a challenge as affected communities face life-threatening discrimination in some countries,” Tedros said at the start of Thursday’s emergency committee meeting.
The continued spread of the virus, particularly in countries where people face significant barriers to supply, only increases the risk of the virus spreading further and to more vulnerable populations such as pregnant women and children, health experts fear.
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