WHO: Still Many Unknowns About Monkeypox

LONDON — The World Health Organization’s top monkeypox expert said she doesn’t expect the hundreds of cases reported to date to turn into another pandemic, but acknowledged there are still many unknowns about the disease, including how exactly it’s spreading and whether the suspension of mass smallpox immunization decades ago may somehow be speeding its transmission.

In a public session on Monday, WHO’s Dr. Rosamund Lewis said it was critical to emphasize that the vast majority of cases being seen in dozens of countries globally are in gay, bisexual or men who have sex with men, so that scientists can further study the issue. Her advice was to caution those who are at greatest risk.

“It’s very important to describe this because it appears to be an increase in a mode of transmission that may have been under-recognized in the past,” said Lewis.

“At the moment, we are not concerned about a global pandemic,” she said. “We are concerned that individuals may acquire this infection through high-risk exposure if they don’t have the information they need to protect themselves.”

She said that everyone is susceptible to the disease regardless of sexual orientation. Experts have also suggested that this may not be an accidental diagnosis. The disease could spread quickly to other sexual orientations if left untreated.

Learn More Monkeypox: What is it and should you be worried?

Last week, WHO said 23 countries that haven’t previously had monkeypox have now reported more than 250 cases. The U.K. reported another 71 cases of monkeypox on Monday.

Lewis said it’s unknown whether monkeypox is being transmitted by sex or just the close contact between people engaging in sexual activity and described the threat to the general population as “low.”

When Monkeypox comes into contact with infected persons, their clothes or beddings, it is well-known that the disease can spread.

The doctor also cautioned that there are a greater number of cases with lesions in the genital area, making it difficult to see.

“You may have these lesions for two to four weeks (and) they may not be visible to others, but you may still be infectious,” she said.

A top WHO adviser said last week that the recent monkeypox epidemic in Europe, America, Israel and Australia was probably linked to two raves held in Spain and Belgium. That marks a significant departure from the disease’s typical pattern of spread in central and western Africa, where people are mainly infected by animals like wild rodents and primates.

The 2003 electron microscope photo by the Centers for Disease Control and Prevention depicts mature oval-shaped monkeypox virus virions (left) and immature, spherical virions (right), taken from human skin samples.

Cynthia S. Goldsmith/CDC via AP

Monkeypox in Africa

Scientists haven’t yet determined whether the monkeypox outbreak in rich countries can be traced to Africa, but the disease continues to sicken people on the continent.

Authorities in Congo reported Monday that nine monkeypox victims had died in the country. Chief of Sankuru’s health division in Congo Dr. Aime Togethero also stated that 465 cases had been confirmed. This makes Congo one of the most affected countries in West Africa and Central Africa.

Nigerian authorities confirmed the country’s first monkeypox death this year, in addition to six more cases. WHO estimates that thousands of cases from Nigeria and Congo are reported each year.

Monkeypox sufferers experience only mild symptoms like fever, body aches and chills, as well as fatigue. For those with more severe illnesses, a rash or lesions may appear on the hands and face. This can spread to the rest of the body. The current epidemic has not affected anyone outside of Africa.

WHO’s Lewis also said while previous cases of monkeypox in central and western Africa have been relatively contained, it was not clear if people could spread monkeypox without symptoms or if the disease might be airborne, like measles or COVID-19.

Learn More There’s Already a Monkeypox Vaccine. You may not need it.

Monkeypox has milder symptoms than smallpox. Smallpox was eradicated by 1980. Countries stopped mass immunizations. This may have contributed to monkeypox’s spread. Also, smallpox vaccinations can protect monkeypox.

Lewis explained that smallpox immunity is still a possibility for people who had been previously vaccinated, even though this was more than 40 years ago. She said WHO’s priority was to stop the current spread of monkeypox before the disease became entrenched in new regions.

“If we all react quickly and we all work together, we will be able to stop this,” she predicted. “We will be able to stop it before it reaches more vulnerable people and before it establishes itself as a replacement for smallpox.”

Chinedu Asadu from Abuja (Nigeria) contributed to the report

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