The World Health Organization has announced that it will hold an emergency meeting with outside experts next Thursday, June 23, to assess whether the monkeypox outbreak represents a public health emergency of international concern, the highest alert that the WHO can issue. Currently, this designation only applies to the ongoing COVID-19 pandemic and polio.
The number of confirmed and suspected monkeypox infections continues to increase day by day in non-endemic countries around the world despite the lack of travel links and connections to clusters known to have been exported from Africa. Many public health experts have urged the World Health Organization (WHO) to respond more urgently.
At a press conference on Tuesday, WHO Director-General Tedros Adhanom Ghebreyesus acknowledged that the virus had behaved unpredictably and said that with the number of affected countries rapidly increasing, international coordination was needed. to fight the epidemic. He noted: “I think it is now clear that there is an unusual situation.”
The cumulative number of cases, including both confirmed and suspected cases, reached nearly 1,800 as of June 14, 2022. The seven-day average of new cases (over 80) has increased steadily since the first case was detected in England on May 6. 2022, in a British citizen returning from Nigeria, where the virus is endemic.
According to a monkeypox data visualization created by Antonio Caramia, there have been 1,688 confirmed cases and 99 suspected cases. The following 50 countries and territories have confirmed or suspected cases: Argentina, Australia, Austria, Bahamas, Bolivia, Brazil, Canada, Cayman Islands, Czech Republic, Denmark, England, Finland, France, French Guiana, Germany, Ghana, Gibraltar, Greece, Haiti, Hungary, Iceland, Iran, Ireland, Israel, Italy, Kosovo, Latvia, Malta, Mexico, Morocco, Netherlands, Northern Ireland, Norway, Pakistan, Paraguay, Poland, Portugal, Romania, Scotland, Slovenia, Spain, Sudan, Sweden, Switzerland, Uganda, United Arab Emirates, United States, Uruguay, Venezuela and Wales.
England leads the world with the highest number of confirmed cases, with 452. Spain ranks second with 313 confirmed cases and 32 suspected cases. Portugal are third with 209. Germany have 188 confirmed and one suspect. Canada has 123 confirmed and 24 suspected, France 91 confirmed and the United States seventh with 65.
In addition, monkeypox is endemic in ten West and Central African countries: Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ghana (identified in animals only), Ivory Coast, Liberia, Nigeria, Republic of Le Congo and Sierra Leone.
According to the World Health Organization (WHO), since January 2022, there have been 59 confirmed cases and 1,536 suspected cases, including 72 deaths, in the WHO African Region. Of the 1,366 monkeypox infections in the Democratic Republic of Congo, there have been 64 deaths. In this country, the deadliest clade from the Congo Basin is dominant, while the less virulent clade from West Africa is currently driving the global epidemic. The case fatality rate associated with the West African clade would be around 1%.
Although the WHO has not officially acknowledged any deaths with the current outbreak, a recent report from Brazil cites a possible monkeypox-related death of a 41-year-old man who was admitted to the medical center. Uberlandia, a private hospital in Minas. State of Gerais. The cause of death is currently under investigation. According to local news reports, the infection may have been exacerbated by other illnesses.
Director-General Ghebreyesus also announced that an expert working group would propose changing the name to monkeypox, in light of concerns about stigma and racism surrounding the virus causing the global outbreak. He said the WHO is “working with partners and experts around the world to change the name of the monkeypox virus, its clades and the disease it causes.”
The announcement follows a statement to the United Nations health agency of more than 30 international scientists, stating an “urgent need for a non-discriminatory and non-stigmatizing nomenclature for the monkeypox virus”.
They wrote: “As of June 8, 2022, at least 1,111 human cases of MPXV [monkeypox virus] have been confirmed or suspected, and cases have been detected in 44 countries. MPXV infection is normally caused by events of spread to humans from animals such as rodents, squirrels, and non-human primates. The virus can also be transmitted from person to person through close contact with wounds, body fluids, respiratory droplets and contaminated materials. Case numbers and epidemiological patterns suggest that the current global epidemic is sustained by human-to-human transmission.
The authors added:
The prevailing perception in international media and scientific literature is that MPXV is endemic in populations of some African countries. However, it is well established that nearly all outbreaks of MPXV in Africa prior to the 2022 outbreak have been the result of transfer from animals to humans, and there have only rarely been reports of sustained human-to-human transmissions. In the context of the current global epidemic, the continued reference and nomenclature of this virus as African is not only inaccurate, but also discriminatory and stigmatizing. The most obvious manifestation of this is the use of photos of African patients to depict smallpox lesions in mainstream media in the North. Recently, the Foreign Press Association Africa released a statement urging global media to stop using images of Africans to highlight the outbreak in Europe.
Although the origin of the new global outbreak of MPXV is still unknown, there is growing evidence that the most likely scenario is that cryptic human transmission across the continent has been going on for longer than previously thought. However, there is a growing narrative in the media and among many scientists who attempt to link the current global outbreak to Africa or West Africa, or Nigeria. Additionally, the use of geographic labels for MPXV strains, in particular, references to the 2022 outbreak as belonging to the “West Africa” or “East Africa” clade, strain or genotype. ‘West “. We therefore believe that a neutral, non-discriminatory and non-stigmatizing nomenclature will be more appropriate for the global health community.
The authors are correct to suggest that as the epidemic continues to grow, just as former President Trump had made disparaging and inflammatory references to the virus that causes COVID by calling it the “Chinese virus” and the ” Kung flu”, the association of geographical names for diseases and viruses has the ability to politically weaponize these terms.
Instead, the collaborative working group proposed a new classification based on the order of detection: “MPXV clades 1, 2 and 3”. Clade 1 would correspond to the Congo Basin clade. In contrast, clades 2 and 3 would correspond to the West African clade. They wrote: “These three clades represent deep MPXV diversity, accumulated over many years of evolution in the animal reservoir. Further sequencing of MPXV from the animal reservoir can potentially uncover other clades 4, 5, 6, etc.
Additionally, they recommended that viruses that were sequenced from samples obtained between 2017 and 2019 in the UK, Israel, Nigeria, USA and Singapore, as well as the 2022 global outbreak , are given a new name. “Given that viruses of this clade are transmitted from person to person in dozens of countries and potentially over several years, we propose that this represents a separate route of transmission from that of previous cases of MPXV in humans and should receive a distinct name so that it can be mentioned specifically both in scientific discourse and in the general media.
Even the term “monkeypox” is a misnomer, as the most common animal-human crossover is through the consumption of infected rodents. But the virus was detected for the first time in history in macau monkeys brought to a laboratory in Europe.
Whatever decision the WHO and emergency committee make in the next week or two, it is clear that even a declaration of a public health emergency of international concern will only be met with sensationalism in the media. Vaccine nationalism is well underway as countries plan to stockpile smallpox vaccines for their citizens. (The smallpox vaccine is quite effective against monkeypox, a related disease).
Scientists and public health experts will lobby for funding for research, global public surveillance and tracking of infectious diseases with pandemic potential and emerging threats. But low-income countries like Africa, where the monkeypox virus poses a far greater threat, will hardly receive media attention, let alone the resources needed to help their public health and medical infrastructure.
The current global epidemic of monkeypox infections, like the COVID pandemic, is fundamentally not just a public health crisis, but a crisis of capitalism. The profit system is no more able to mobilize the resources and public health strategy needed to fight monkeypox than it is to fight SARS-CoV-2. Instead, it diverts vital funds to escalating imperialist wars in Ukraine and elsewhere.
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