The World Health Organization will reconvene its expert monkeypox committee on Thursday to decide whether the outbreak now constitutes a global health emergency—the highest alarm it can sound.
A second meeting of the WHO’s emergency committee on the virus will be held to examine the evidence on the worsening situation, with nearly 14,000 cases reported from more than 70 countries.
A surge in monkeypox infections has been reported since early May outside the West and Central African countries where the disease has long been endemic.
On June 23, the WHO convened an emergency committee of experts to decide if monkeypox constitutes a so-called Public Health Emergency of International Concern (PHEIC) – the UN health agency’s highest alert level.
But a majority advised the WHO’s chief Tedros Adhanom Ghebreyesus that the situation, at that point, had not met the threshold.
Now a second meeting will be held, with case numbers rising and spreading to six more countries in the past week.
If the committee advises Tedros that the outbreak constitutes a PHEIC, it will propose temporary recommendations on how to better prevent and reduce the spread of the disease and manage the global public health response.
But there is no timetable for when the outcome will be made public.
Ninety-eight percent of reported cases “are among men who have sex with men (MSM) – and primarily those who have multiple recent anonymous or new partners,” Rosamund Lewis, the WHO’s technical lead for monkeypox, told a press conference on Wednesday.
They are typically of young age and chiefly in urban areas, according to the WHO.
The committee will look at the latest trends and data, how effective the countermeasures are and make recommendations for what countries and communities should do to tackle the outbreak.
Regardless of the committee’s PHEIC decision, the “WHO will continue to do everything we can to support countries to stop transmission and save lives,” Tedros told the press conference.
He said the WHO was validating, procuring and shipping tests to multiple countries, but said one of the most powerful tools in the fight against monkeypox was information.
“That’s why WHO is continuing to work with patients and community advocates to develop and deliver information tailored to the affected communities,” Tedros said.
WHO emergencies director Michael Ryan said the LGBTQ community was one of the most engaged and responsible, having worked hard over decades to combat HIV, “so therefore we have full confidence that this community can, and will, and is, engaging very closely.”
A viral infection resembling smallpox and first detected in humans in 1970, monkeypox is less dangerous and contagious than smallpox, which was eradicated in 1980.
Monkeypox, so called because it was first discovered in a monkey, is related to the deadly smallpox virus, which was eradicated in 1980, but is far less severe.
The strain currently circulating outside Africa is the milder of two known versions.
1970: First case in humans
Human monkeypox was first identified in 1970 in Zaire (now the Democratic Republic of Congo) in a nine-year-old boy. It becomes endemic in the tropical rainforests of central and west Africa, where 11 countries report cases. The virus is transmitted through close contact with infected animals, mostly rodents, or humans.
2003: First outbreak outside Africa
In June 2003, the disease surfaced in the United States – the first time it had been detected outside Africa. The illness is believed to have spread after rodents, imported into the US from Ghana, infected prairie dogs. The US Centers for Disease Control and Prevention (CDC) reports 87 cases but no fatalities.
2017: Epidemic in Nigeria
2017 brings a major outbreak in Nigeria, with more than 200 confirmed cases and a fatality rate of around three percent, according to the WHO. Over the next five years, sporadic cases are reported around the world in travellers arriving from Nigeria, notably in Britain, Israel, Singapore and the United States.
May 2022: Surge outside Africa
In May 2022, a flurry of cases was detected in countries outside Africa, in people with no travel links to the region. Most of those affected are gay men. Europe is the epicenter of the new outbreak. By May 20, Britain has recorded 20 cases, mostly among gay men. On the same date, the WHO counts 80 confirmed cases around the world, including in Australia, Belgium, Canada, France, Germany, Italy, Portugal, Spain and Sweden.
Late May: Vaccinations start
On May 23, the United States said it is preparing to administer smallpox vaccines, which are effective against monkeypox, to people who have been in close contact with monkeypox patients. Three days later, the European Union says it is working on centralizing purchases of vaccines, as it did for COVID-19.
June: More than 1,000 cases
In early June, WHO chief Tedros Adhanom Ghebreyesus says that more than 1,000 confirmed cases of monkeypox have been reported to WHO from 29 countries where the virus is not usually present. On June 21, Britain announces plans to offer vaccines to gay and bisexual men with multiple sexual partners. WHO experts meet on June 23 to discuss the threat but decide that monkeypox does not constitute a global public health emergency.
July: 14,000 cases, 70 countries
On July 8, health authorities in France also launches pre-emptive jabs for people considered at risk, including gay men, trans people and sex workers. On July 14, the US CDC reported more than 11,000 confirmed cases in some 60 countries where monkeypox is not usually found. Most of the cases are in Europe, the United States and Canada. The number of infections in New York doubles in under a week to several hundred. People stand in line for vaccines, which are in short supply. On July 20, Tedros announced that almost 14,000 confirmed cases have been reported to the WHO this year, from more than 70 countries, with five deaths, all in Africa.