During a public briefing on Friday, the U.N. 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.
Earlier this week, a top adviser to WHO said the outbreak in
Europe, U.S., Israel, Australia and beyond was likely linked to sex at two
recent raves 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, and outbreaks
haven’t spilled across borders.
Although WHO said nearly 200 monkeypox cases have been
reported, that seemed a likely 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, according to officials in the region of Madrid.
U.K. officials added 16 more cases to their monkeypox tally,
making Britain’s total 106, while Portugal said its caseload jumped to 74
cases. And authorities in Argentina on Friday reported a monkeypox case in a
man from Buenos Aires, marking Latin America’s first infection. Officials said
the man had traveled recently to Spain and now had symptoms consistent with
monkeypox, including lesions and a fever.
Doctors in Britain, Spain, Portugal, Canada, the U.S. and
elsewhere have noted that the majority of infections to date have been in gay
and bisexual men, or men who have sex with men. The disease is no more likely
to affect people because of their sexual orientation and scientists warn the
virus could infect others if transmission isn’t curbed.
WHO’s Briand said that based on how past outbreaks of the
disease in Africa have evolved, the current situation appeared “containable.”
Still, she said WHO expected to see more cases reported in
the future, noting “we don’t know if we are just seeing the peak of the iceberg
(or) if there are many more cases that are undetected in communities,” she
said.
As countries including Britain, Germany, Canada and the U.S.
begin evaluating how smallpox vaccines might be used to stem the outbreak, WHO
said its expert group was assessing the evidence and would provide guidance
soon.
Dr. Rosamund Lewis, head of 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 WHO
estimates that smallpox vaccines are about 85% effective.
She said countries with vaccine supplies could consider them
for those at high risk of the disease, like close contacts of patients or
health workers, but that monkeypox could mostly be controlled by isolating
contacts and continued epidemiological investigations.
Given the limited global supply of smallpox vaccines, WHO’s
emergencies chief Dr. Mike Ryan said the agency would be working with its
member countries to potentially develop a centrally controlled stockpile,
similar to the ones it has helped manage to distribute during outbreaks of
yellow fever, meningitis, and cholera in countries that can’t afford them.
“We’re talking about providing vaccines for a targeted
vaccination campaign, for targeted therapeutics,” 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. -AP