Scientists advising the World Health Organization (WHO) on monkeypox say the window is closing to stop its spread, with cases currently doubling every two weeks, raising concerns that it will take several months for the outbreak to peak.
WHO Europe has forecast just over 27,000 monkeypox cases in 88 countries by Aug. 2, up from 17,800 cases in nearly 70 countries at the latest count.
Making predictions beyond that are complex, scientists around the world told Reuters, but there is likely to be sustained transmission for several months and possibly longer, they said.
“We have to get in front of this,” said Anne Rimoin, an epidemiology professor at the University of California, Los Angeles.
“It’s clear the window of opportunity for doing so is closing,” added Rimoin, a member of the WHO expert committee on monkeypox that met last week to determine whether the outbreak constituted a global health emergency.
A majority of committee members voted against the move and, in an unprecedented step, WHO Director-General Dr Tedros Adhanom Ghebreyesus declared an emergency anyway.
Action stemming from that declaration needs to be urgent, including increased vaccination, testing, isolation for those infected and contact tracing, global health experts said.
“Transmission is clearly unchecked,” said Antoine Flahault, director of the Institute of Global Health at the University of Geneva, who chairs the WHO Europe advisory group.Jimmy Whitworth, a professor at the London School of Hygiene and Tropical Medicine, said he expected that cases would not plateau for at least the next four-to-six months, or until the those at highest risk of infection have been either vaccinated or infected. Sexual health organizations recently estimated that could be around 125,000 people in the UK.
Monkeypox has been a globally neglected public health problem in parts of Africa for decades, but cases began to be reported outside countries where it is endemic in May.
It generally causes mild to moderate symptoms, including fever, fatigue and the hallmark painful skin lesions, that resolve within a few weeks. Five people have died in the current outbreak, all of them in Africa.
Beyond Africa, monkeypox is spreading chiefly in men who have sex with men, putting sexual health clinics on alert for new cases.
“I remember clearly … saying that ‘I think I’m going to die,’ because I can’t eat, I can’t drink. I can’t even swallow my own spit,” said Harun Tulunay, 35, a sexual health advocate who was hospitalized with monkeypox in London earlier this month but has since recovered.
‘SUSTAINED TRANSMISSION’
While monkeypox is not causing large numbers of deaths globally, an unpleasant virus establishing itself in new populations is still bad news, scientists said.
Flahault’s group has modeled three scenarios for the coming months, all of which include “sustained transmission,” either between men who have sex with men; beyond these groups and possibly into more vulnerable populations, like children, or between humans and animals.
The latter scenario risks the establishment of a monkeypox reservoir in animals in new countries, as it has in parts of west and central Africa, said Flahault.
Ongoing transmission could also lead to mutations that make the virus more efficient at spreading in humans, scientists said.
On Tuesday, German scientists released a study ahead of peer review that found mutations in one of the 47 cases they sequenced that could help monkeypox spread in people more easily.
“The alarm bell was going off (in Africa) but we kept hitting the snooze button. Now it’s time to wake up and do something about it,” Rimoin said. “An infection anywhere is potentially an infection everywhere.”
FACTBOX-Monkeypox cases around the world:
Below is a list of non-endemic countries that have reported monkeypox cases:
ASIA-PACIFIC
* AUSTRALIA had confirmed 44 cases as of July 25.
* INDIA had reported four cases as of July 24.
* JAPAN detected its first case on July 25.
* NEW ZEALAND reported its second case on July 12.
* SINGAPORE had confirmed nine cases as of July 25.
* SOUTH KOREA reported two cases on June 22.
* TAIWAN confirmed its first case on June 24.
* THAILAND confirmed its first case on July 21.
EUROPE
* AUSTRIA had confirmed 99 cases as of July 22.
* BELGIUM had detected 312 cases by July 20.
* BOSNIA reported its first case on July 13.
* BULGARIA had confirmed four cases as of July 22.
* CROATIA had reported ten cases by July 25.
* CZECH REPUBLIC had confirmed 16 cases as of July 22.
* DENMARK had confirmed 60 cases by July 26.
* ESTONIA had confirmed four cases by July 18.
* FINLAND had confirmed 13 cases as of July 11.
* FRANCE had confirmed 1,567 cases by July 25.
* GEORGIA confirmed its first case on June 15.
* GERMANY had reported 2,410 cases by July 26.
* GIBRALTAR had confirmed five cases as of July 20.
* GREECE had confirmed 20 cases by July 25.
* HUNGARY had confirmed 33 cases by July 25.
* ICELAND had reported nine cases as of July 25.
* IRELAND had confirmed 69 cases as of July 20.
* ITALY had detected 407 cases as of July 22.
* LATVIA had confirmed three cases as of July 25.
* LUXEMBOURG had confirmed 14 cases as of July 20.
* MALTA had confirmed 17 cases as of July 20.
* The NETHERLANDS had confirmed 818 cases as of July 25.
* NORWAY had reported 46 cases by July 20.
* POLAND had reported 40 cases by July 20.
* PORTUGAL had confirmed 588 cases as of July 21.
* ROMANIA had confirmed 20 cases as of July 25.
* RUSSIA confirmed its first case on July 12.
* SERBIA had reported five cases as of July 20.
* SLOVENIA had reported 26 cases as of July 20.
* SLOVAKIA had confirmed two cases as of July 20.
* SPAIN had confirmed 3,125 cases by July 19.
* SWEDEN had confirmed 77 cases by July 21.
* SWITZERLAND had confirmed 234 cases as of July 25.
* The UNITED KINGDOM had 2,208 confirmed cases as of July 21, including 2,115 in England, 54 in Scotland, 15 in Northern Ireland and 24 in Wales.
MIDDLE EAST & AFRICA
* ISRAEL had reported 121 cases as of July 26.
* LEBANON had reported four cases as of July 21.
* MOROCCO reported first case on June 2.
* SAUDI ARABIA detected its first case on July 14.
* SOUTH AFRICA confirmed its third case on July 11.
* The UNITED ARAB EMIRATES had reported 13 infections as of June 15.
* TURKEY reported first case on June 30.
AMERICAS
* ARGENTINA had confirmed 18 cases as of July 21.
* The BAHAMAS confirmed its first case on June 24.
* BARBADOS confirmed its first case on July 21.
* BERMUDA confirmed its first case on July 21.
* BRAZIL had confirmed 696 cases as of July 22.
* CANADA had confirmed 681 infections as of July 21.
* CHILE had reported 39 cases as of July 21.
* COLOMBIA had reported 11 cases as of July 24.
* COSTA RICA confirmed its first case on July 21.
* DOMINICAN REPUBLIC confirmed its third case on July 21.
* ECUADOR had confirmed three cases as of July 23.
* JAMAICA confirmed its first case on July 6.
* MEXICO had confirmed 52 cases as of July 21.
* PANAMA confirmed its first case on July 4.
* PERU had confirmed 208 cases by July 26.
* PUERTO RICO had confirmed 13 cases as of July 22.
* The UNITED STATES had confirmed 3,487 cases by July 26.
* VENEZUELA confirmed its first case on June 12.
