LONDON ( Associated Press) – As the World Health Organization’s emergency committee convened on Thursday for a second time within weeks whether to declare monkeypox a global crisis, some scientists said outbreaks in Africa and developed countries have been increasing. The striking difference between would complicate any coordinated response. ,
African officials say they are already treating the continent’s pandemic as an emergency. But experts say the milder version of monkeypox in Europe, North America and beyond makes an emergency declaration unnecessary, even if the virus cannot be stopped. British officials recently downgraded their assessment of the disease, given its lack of severity.
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WHO Director-General Tedros Adhanom Ghebreyesus told the emergency committee, “I am concerned about the number of cases that are being reported in the growing number of countries.”
He said it was “pleasing” to note falling numbers of monkeypox cases in some countries, but the virus was still on the rise elsewhere and last week six countries reported their first infections.
Monkeypox has been raging for decades in parts of central and western Africa, where diseased wild animals sometimes infect relatively epidemic people in rural areas. The disease has spread to gay and bisexual men in Europe, North America and beyond since at least May. The epidemic in wealthy countries was likely triggered by sex in two waves in Spain and Belgium.
Some experts worry these and other differences could potentially deepen existing medical disparities between poor and wealthy countries.
There are now over 15,000 cases of monkeypox worldwide. While the United States, Britain, Canada and other countries have bought millions of vaccines, none have gone to Africa, where the more severe version of monkeypox has already killed more than 70 people. Rich countries have not yet reported deaths from monkeypox.
“What is happening in Africa is almost completely different from outbreaks in Europe and North America,” said Dr Paul Hunter, a professor of medicine at the University of East Anglia, UK, who previously advised the WHO on infectious diseases.
The UN health agency said this week that outside Africa, 99% of all cases of monkeypox are in men and 98% of them are in men who have sex with other men. However, the disease can infect anyone in close, physical contact with a monkeypox patient, regardless of their sexual orientation.
Hunter said, “In these very active gay sex networks, you have men who really don’t want people to know what they’re doing and themselves don’t always know who they’re having sex with. “
Some of those men may be married to women or their families may be unaware of their sexual activity, which “makes contact tracing extremely difficult and even asking people to come forward for testing.” things like saying” Hunter said, explaining why vaccination may be the most effective way to stop the outbreak.
This is probably not the case in Africa, where limited data suggests monkeypox is mainly jumping into people from infected animals. Although African experts acknowledge they may be missing cases among gay and bisexual men, given the limited surveillance and stigma against LGBTQ people, authorities have relied on standard measures such as isolation and education to control the disease. .
Dr Plaside Mbala, a virologist who directs the Department of Global Health at the Congo Institute of National Biomedical Research, said there are also noticeable differences between patients in Africa and the West.
“We see here (in the Congo) very early, after three to four days, visible sores in people who have been exposed to monkeypox,” Mabala said, in public of someone with so many visible sores. is unlikely to go out, thus preventing further transmission.
But in countries including Britain and the US, doctors have seen some infected people with only one or two sores, often in their genitals.
“You won’t notice if you’re with that person in the taxi or the bar,” Mabala said. “So in the West, people without these visible wounds are silently spreading disease.”
He said containing the global outbreak would require different approaches in different countries, making it challenging to adopt a single worldwide response strategy for Ebola and COVID-19.
Dr. Dimi Ogoina, a professor of medicine at Nigeria’s Niger Delta University, said he feared the world’s limited vaccine supply would result in a recurrence of the problems arising in the coronavirus pandemic, when poor countries were evacuated after rich countries hoarded The hand was abandoned. most doses.
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“It doesn’t make sense to just control the outbreak in Europe and America, because even then you would still have a (animal) source of outbreak in Africa,” Ogoina said.
This week, US officials said more than 100,000 monkeypox vaccine doses were being sent to states over the next few days, and several million more were being ordered for months to come. The US has so far registered over 2,000 cases, with hundreds more cases being added every day.
Some US public health experts have begun to wonder whether the outbreak is becoming so widespread that monkeypox will become a new sexually transmitted disease.
Declaring monkeypox as a global emergency may also inadvertently worsen the rush for vaccines, although most countries are seeing milder cases of the disease.
Dr. Hugh Adler, who treats monkeypox patients in the UK, said there are not many serious cases or infections beyond gay and bisexual men. Still, he said it was disappointing that more vaccines weren’t available, as the outbreak in the UK was doubling every two weeks.
“If by reclassifying monkeypox as a global emergency (vaccines will be available), that’s probably what needs to be done,” he said. “But in an ideal world, we should be able to make necessary interventions without a declaration of emergency.”v