Almost 200 monkeypox cases in 20 countries, WHO says

Officials say there is no need for mass vaccination

The World Health Organisation said there are still many unanswered questions about what triggered the unprecedented outbreak of monkeypox outside of Africa. AP

About 200 cases of monkeypox have been reported in more than 20 countries not usually known to have outbreaks of the unusual disease, the World Health Organisation said on Friday, describing the epidemic as “containable.”

During a public briefing on Friday, the UN health agency said there are still many unanswered questions about what triggered the unprecedented outbreak of monkeypox outside of Africa, but there is no evidence that any genetic changes in the virus are responsible.

“The first sequencing of the virus shows that the strain is not different from the strains we can find in endemic countries and [this outbreak] is probably due more to a change in human behaviour,” said Dr Sylvie Briand, WHO’s director of pandemic and epidemic diseases.

But officials noted the spread of the disease was “unusual”.

“We don't know if we are just seeing the peak of the iceberg,” said Dr Briand.

Endemic in a number of West and Central African nations, monkeypox cases have suddenly been detected in more than 20 other countries around the world, including the US, Australia, the UAE and nearly a dozen European countries.

Although the WHO said about 200 monkeypox cases have been reported, this is likely an undercount.

On Friday, Spanish authorities said the number of cases there had risen to 98, including one woman, whose infection is “directly related” to a chain of transmission that had been previously limited to men, officials in the region of Madrid said.

UK officials added 16 more cases to their monkeypox tally, making Britain’s total 106. And Portugal said its caseload jumped to 74 on Friday.

Dr Briand said that based on how past outbreaks of the disease in Africa have evolved, the current situation appeared “containable”.

A man's hands are covered in a rash caused by the monkeypox virus that swept through the Democratic Republic of the Congo from 1996 to 1997. Reuters

An image taken during an outbreak of monkeypox in the Democratic Republic of the Congo in 1996 and 1997 shows the arms and torso of a patient with skin lesions due to monkeypox. Reuters

This 2003 electron microscope image made available by the Centres for Disease Control and Prevention shows a monkeypox virion, obtained from a sample associated with the 2003 prairie dog outbreak. AP

Images issued by the UK Health Security Agency show the stages of monkeypox. UK Health Security Agency

The Massachusetts Department of Public Health confirmed a single case of monkeypox in an adult male who had recently travelled to Canada. EPA

Roman Woelfel, head of the Institute of Microbiology of the German Armed Forces in Munich, gets to work after Germany detected its first case of monkeypox. Reuters

As countries including Britain, Germany, Canada and the US begin evaluating how smallpox vaccines might be used to curb the outbreak, the WHO said its expert group was assessing the evidence and would provide guidance soon.

Dr Rosamund Lewis, head of the WHO’s smallpox department, said that “there is no need for mass vaccination”, explaining that monkeypox does not spread easily and typically requires skin-to-skin contact for transmission.

No vaccines have been specifically developed against monkeypox, but the WHO estimates that smallpox vaccines are about 85 per cent effective.

She said countries with vaccine supplies could consider them for those at high risk of the disease, such as close contacts of patients or health workers, but that monkeypox can mostly be controlled by isolating contacts and continuing epidemiological investigations.

Given the limited global supply of smallpox vaccines, the WHO’s emergencies chief Dr Mike Ryan said the agency would be working with member countries to potentially develop a centrally controlled stockpile, similar to the ones it has helped to distribute during outbreaks of yellow fever, meningitis and cholera in countries that cannot afford them.

“We’re talking about providing vaccines for a targeted vaccination campaign, for targeted therapeutics,” Dr Ryan said.

“So the volumes don’t necessarily need to be big, but every country may need access to a small amount of vaccine.”

Most monkeypox patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.