Experts warn of continued spread of monkeypox as hundreds of cases are discovered worldwide

Enlarge / A negatively stained electron micrograph of a monkeypox virus virion in human vesicular fluid.

The multinational monkeypox outbreak continues to pose a low risk to the general public and, at this time, cases appear unlikely to develop into a global pandemic, according to the World Health Organization and the Centers for Disease. United States Control and Prevention.

But, experts fear the virus could continue to spread and transmission could escape containment without an urgent and thorough public health response.

The number of outbreaks continues to rise rapidly, with hundreds of cases now reported in at least 23 countries. In an update released on Sunday, May 29, the WHO reported 257 confirmed cases and around 120 suspected cases in 23 countries. These figures are already largely exceeded. On Monday, Our World in Data reported 555 confirmed cases worldwide. On Tuesday, the UK reported 190 cases, compared to 106 reported by the WHO on Sunday. Likewise, the US total has risen to 15 cases, from 10 reported last week.

During a press briefing last Thursday, CDC Director Rochelle Walensky said the agency presumes there is community spread of the virus in the United States.

Yet in a public presentation guiding clinicians last week, Agam Rao, a CDC infectious disease specialist and poxvirus expert, pointed out that the monkeypox virus does not spread easily. The virus is related to smallpox but causes relatively mild illness with a telltale rash and is usually accompanied by flu-like symptoms. Transmission requires close and prolonged contact, with the highest risk of spread to health care workers and family members and sexual partners of those infected. “The monkeypox virus does not have pandemic potential,” Rao said succinctly.

So far, many cases appear to be in men who have sex with men (MSM) and the virus appears to be spread through sexual networks. But health officials are careful to avoid instilling stigma or a false sense of security. The virus can spread to anyone, and it is not specifically a sexually transmitted infection.

Moderate risk and continued spread

In its risk assessment on Sunday, the WHO said “the risk to the general public appears to be low” and that “the overall global public health risk is assessed as moderate” as widespread cases occur. cluster in countries other than West and Central Africa, where the virus is endemic in animals.

“The risk to public health could become high if this virus exploits the opportunity to establish itself as a human pathogen and spread to groups at higher risk of severe disease such as young children and immunocompromised people. “, said the WHO.

In a public webinar on Monday, the WHO’s technical lead for monkeypox, Rosamund Lewis, expanded on that assessment, saying: “At this time, we are not concerned about a global pandemic…We are concerned that individuals could contract this infection through high-risk exposure if they do not have the information they need to protect themselves,” she added. “And we are concerned that because the global population has not been immune to orthopoxviruses since the end of smallpox eradication, the virus may try to exploit a niche and spread between people more easily. “

Health officials are now racing to raise awareness and ramp up outreach programs ahead of Pride Month celebrations in June. The spread of the virus has already been linked to major events and celebrations in Europe as pandemic restrictions have eased, WHO Regional Director for Europe Hans Henri Kluge noted in a statement on Tuesday. The virus is believed to have been circulating unrecognized for weeks or more. Upcoming festivals and major holidays could provide new opportunities for epidemic amplification.

“We don’t know yet if we can completely contain its spread,” Kluge said. “For this, we need a significant and urgent reduction in exposures through clear communication, community-led action, isolation of cases during the infectious period, and effective contact tracing and surveillance.”

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