WHO warns of monkeypox spread to vulnerable groups

GENEVA • The World Health Organisation (WHO) has appealed for vigilance to ensure that monkeypox does not spread among more vulnerable groups, such as children.

Fighting the virus requires "intense" efforts, said the WHO on Wednesday, calling for broad data collection and sharing on how well vaccines work against the virus.

Experts have detected a surge in the number of monkeypox cases since May outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in western Europe.

"I am concerned about sustained transmission because it would suggest that the virus is establishing itself and it could move into high-risk groups, including children, the immunocompromised and pregnant women," WHO chief Tedros Adhanom Ghebreyesus told reporters. "We are starting to see this, with several children already infected." There are two cases aged under 18 in Britain.

WHO chief scientist Soumya Swaminathan called for "very careful studies of the vaccine in different population groups... so that we get data that's broadly applicable, and also to ensure that children, pregnant women and the immunosuppressed are considered for inclusion in these trials".

As at June 22, 3,413 laboratory-confirmed monkeypox cases and one death have been reported to the WHO, from 50 countries.

The countries with three-figure case numbers are Britain (793), Germany (521), Spain (520), Portugal (317), France (277), Canada (210), the Netherlands (167) and the United States (142).

The vast majority of cases so far have been observed in men who have sex with men, of young age, chiefly in urban areas, in "clustered social and sexual networks", according to the WHO.

There have also been more than 1,500 cases and 66 deaths this year in countries where the infection more usually spreads.

Last week, the UN health agency convened an emergency committee of experts to decide if monkeypox constitutes a so-called Public Health Emergency of International Concern, the highest alarm that the WHO can sound.

But a majority of the experts found the situation had not yet crossed that threshold. Nonetheless, "they acknowledged the emergency nature of the event and that controlling the further spread requires intense response efforts", Dr Tedros said.

The WHO chief also called for equitable access to counter-measures such as vaccines and antivirals and the systematic collection of clinical data to inform future recommendations.

WHO emergencies director Michael Ryan said that countries with stockpiles of vaccines, led by the US, had shown willingness to share them. However, the vaccines have largely been licensed only for use against monkeypox's far more severe relative, smallpox, which is also caused by an orthopoxvirus and which is the only disease successfully eradicated through vaccination.

"It's really important as we encourage the sharing of these products that we also collect the necessary clinical efficacy data," said Dr Ryan.

He said the chief intervention in controlling monkeypox should be reducing transmission through education and taking steps to avoid infection, and then targeted use of available vaccines and antivirals.

Currently, vaccines are in short supply and are broadly limited to health workers exposed to higher risk while tracing contacts of cases, said Dr Ryan.

He said some countries were beginning to consider offering vaccines to individuals "engaged in high-risk activities or at particular risk of being exposed".

AGENCE FRANCE-PRESSE, REUTERS