WHO Emergency Committee Does Not Declare Monkeypox Public Health Emergency

The World Health Organization (WHO) held an Emergency Committee meeting on Thursday to determine whether the current outbreaks of monkeypox virus should be considered a Public Health Emergency of the International Concern (PHEIC).

The meeting was held in Geneva, Switzerland, and convened by WHO Director-General Tedros Adhanom Ghebreyesus. “The objectives of this meeting are to provide views to the Director-General of WHO on whether the event constitutes a public health emergency of international concern and also on proposed potential Temporary Recommendations,” WHO said in a statement.

The Director-General concurred with the International Health Regulations (IHR) Emergency Committee that multi-country monkeypox outbreak does not presently constitute a PHEIC.

Last week, WHO announced there have been at least 3500 monkeypox infections and 1 fatality. Because monkeypox is most transmissible when symptomatic, and symptoms may take up to 21 days to present, the actual number of infections is likely much higher.

In a presentation to the IHR Emergency Committee, the WHO Secretariat shared that the clinical presentation of these recent monkey pox infections has been atypical, with few legions surrounding the genital, perineal/perianal, or peri-oral areas that do not spread to the rest of the body. Asynchronous rash appears before patients develop lymphadenopathy, fever, or malaise.

There have been a few hospitalizations so far, and 1 death in an immunocompromised individual. The average incubation period is 8.5 days, with a range of 4.2-17.3 days, according to research based in the Netherlands.

The zoonotic virus monkeypox is endemic to Western and Central Africa. Since May 2022, monkeypox outbreaks have been reported in over 50 countries this year. WHO has faced criticism for only holding a monkeypox Emergency Committee meeting after the virus appeared in Western countries.

Ghebreyesus acknowledged this, saying, “This virus has been circulating and killing in Africa for decades. It’s an unfortunate reflection of the world we live in that the international community is only now paying attention to monkeypox because it has appeared in high-income countries.

The communities that live with the threat of this virus every day deserve the same concern, the same care, and the same access to tools to protect themselves.”

WHO is also expected to change the name of monkeypox, after scientists came forward calling the name “discriminatory and stigmatizing.” The WHO Secretariat noted that the initial cases of monkeypox were detected in several countries with no epidemiological links to endemic areas; linking these infections to certain regions of Africa could be erroneous.

Public health officials are also cautioning against stigmatizing monkeypox as a disease that only affects men who have sex with men. Outbreaks in the US and around the world are being reported primarily in these communities, but all people are susceptible to monkeypox infections if exposed.

Monkeypox is the less deadly relative of smallpox, and smallpox vaccines have been deployed to close contacts of confirmed infections to serve as post-exposure prophylaxis (PEP). The US has stockpiled 2 smallpox vaccines, Jynneos and ACAM2000, that can be distributed to treat monkeypox outbreaks as needed.

Last Thursday, New York City announced they would begin administering the Jynneos vaccine to cisgender or transgender men who had sexual relations with multiple male sexual partners in the past 2 weeks.