The World Health Organization is currently reconsidering whether to declare the booming multinational monkeypox outbreak a public health emergency of international concern (PHEIC), the agency's highest level of alert.
The deliberations come as the global tally of monkeypox cases tops 16,000—and a new report of an unexplained case in a child in the Netherlands raises alarm over the potential spread of the virus.On Thursday, the WHO's emergency committee convened for seven hours to assess the state of the outbreak. It was the second time that WHO Director-General Tedros Adhanom Ghebreyesus convened the group of international experts. In the previous meeting nearly a month ago, the committee expressed concern about the situation but concluded overall that it had not yet risen to the level of a PHEIC.
That June decision drew criticism from some members of the public health community, who felt the committee had "punted." Critics further worried the decision undermined the ability of a PHEIC declaration to help get ahead of a burgeoning infectious disease outbreak.
Global cases
The outcome of yesterday's meeting is still unclear. The committee is now finalizing a report to the director-general, and the agency told Ars that there is no set timeline of when the outcome will be announced.
As it stands, WHO received reports of more than 16,000 cases from 71 member states that span all six of WHO-designated world regions. The epicenter of the outbreak continues to be Europe. Five people have died in the multinational outbreak, three in Nigeria and two in the Central African Republic.
Though some countries are starting to report declining trends in cases, Tedros noted, other countries are now just beginning to identify cases. Six countries reported their first cases just last week, he said in a press briefing Wednesday.The vast majority of cases continue to be identified in men who have sex with men (MSM).
"This transmission pattern represents both an opportunity to implement targeted public health interventions and a challenge because in some countries, the communities affected face life-threatening discrimination," Tedros said at the outset of Thursday's emergency committee meeting.
The continued spread of the virus, particularly in countries where people face significant barriers to care, only increases the risk that the virus will spread farther and to more vulnerable populations, such as pregnant people and children, health experts fear.
Concerning child case
Those fears were realized Thursday with the publication of a case report of monkeypox in a child in the Netherlands. The boy, between the ages of 5 and 10, developed a rash following a vacation to Turkey and has since recovered. But the Amsterdam-based medical team evaluating him was stumped as to how the boy became infected.
Given that the current outbreak has largely been linked to sexual activity among MSM, the doctors carefully ruled out the possibility of sexual abuse, thoroughly documenting the boy's history and testing him for a slew of other sexually transmitted infections, which consistently came up negative. The boy also did not have monkeypox lesions in his genital area, which has frequently been seen among infected people in the MSM community.The doctors' best—but concerning—guess as to how the boy became infected is via respiratory transmission. To be clear, the monkeypox virus is not an easily transmitted virus like SARS-CoV-2. But it is generally thought to be able to spread through respiratory droplets, typically at close (i.e., face-to-face) range in a sustained interaction, such as during sexual activity.
Notably, as the medical team was investigating the boy's monkeypox case, they found that he had an unexpected IgA deficiency. IgA—Immunoglobulin A—is a class of antibodies that are active on the body's mucosal surfaces, such as those in the respiratory tract. As such, people who have IgA deficiencies are more susceptible to respiratory infections than others.
"Considering that IgA neutralizes the virus at the mucosal level, this suggests that respiratory transmission may have played a role," the authors of the case report conclude. But that's still just a guess, and the authors can't rule out other means of transmission, such as contact with contaminated materials, such as bedding and towels.
Closing window in the US
The boy's case highlights the risk of allowing the outbreak to continue. And experts at WHO caution that more such spread among people outside of the MSM communities may be occurring than is known because response efforts have largely focused on MSM and sexual health clinics. Essentially, we're finding cases where we're looking for them, WHO experts have said. The child case in the Netherlands, for instance, was initially misdiagnosed twice as a fungal skin infection and then a bacterial skin infection before being accurately identified as monkeypox.
Additionally, MSM often have stronger connections to health care providers than other demographics, which may also bias the case reporting to those communities.
The longer the virus is able to spread in communities—any communities—the more likely it is to become entrenched, health experts warn. In the US, there is already concern that health officials have missed their opportunity to contain the virus, given the slow expansion of testing and hampered vaccine distribution.In an interview Sunday on CBS' Face the Nation, former US Food and Drug Administration Commissioner Dr. Scott Gottlieb harshly criticized the Centers for Disease Control and Prevention, saying the agency had made "a lot of the same mistakes" seen at the outset of the COVID-19 pandemic, with limited testing and slow responses. "I think the window for getting control of [monkeypox] and containing it probably has closed," Gottlieb said.
CDC Director Rochelle Walenksy pushed back Monday, telling CNN, "It is true that we have work to do—here and internationally—and are likely to see more monkeypox cases in the near term, but it is possible to significantly decrease the number of cases and contain the current monkeypox outbreak through education and increased testing and access to vaccines—all priorities we've made dramatic progress on."
To date, the CDC has detected 2,593 cases from 44 states and the District of Columbia. The US currently has the second-largest case count of any country in the world, following Spain.
Health - Latest - Google News
July 23, 2022 at 12:03AM
https://ift.tt/PCyToX8
Child’s monkeypox case raises alarm as WHO mulls declaring health emergency - Ars Technica
Health - Latest - Google News
https://ift.tt/xGPMOHb
Bagikan Berita Ini
0 Response to "Child’s monkeypox case raises alarm as WHO mulls declaring health emergency - Ars Technica"
Post a Comment