The last we heard of the official advice for Monkeypox was – uh – to avoid casual group sex with gay men or LGBTQ+ festivals that involve shagging between strangers. Cases of Monkeypox have since been extremely small and almost exclusively contained to gay men presenting at healthcare clinics.
The World Health Organisation updated its public health guidance to this effect. Public health advice for gay, bisexual, and other men who have sex with men on the recent outbreak of Monkeypox.
As of July 19, Australia had reported 41 cases (both confirmed and probable) of Monkeypox. 22 in New South Wales, 15 in Victoria, 2 in the Australian Capital Territory, 1 in Queensland, and a final case in South Australia.
Monkeypox has never reached Australia before, but the transfer of the disease is not unexpected, given the increased travel of people in and out of Africa where Monkeypox is endemic.
It is generally agreed that the threat to the wider population is very low. This is probably why the decision to declare the emergency was debated.
Globally, there are 14,000 suspected cases with 5 deaths (although the WHO lists this as 16,000 cases). Most of these cases are in Europe while the deaths were reported in Africa. The UK has reported 2,137 of these cases, leading the UK Health Security Agency to top up their existing 30,000 Bavarian Nordic’s Smallpox/Monkeypox vaccine with 100,000 extra doses.
MVA-BN or Modified Vaccinia Ankara-Bavarian Nordic is a non-replicating Smallpox vaccine developed in collaboration with the US government to ensure supply of a Smallpox vaccine for the entire population, including immunocompromised individuals who are not recommended vaccination with traditional replicating Smallpox vaccines. The vaccine was approved by the European Commision in 2013.
Traditional Smallpox vaccines are based on replicating vaccinia virus strains. Although these vaccines have been effective in preventing the disease, their use may be associated with an increased risk of adverse events, including death and severe disability.
MVA-BN is injected like other modern vaccines rather than pricked into the skin with a bifurcated needle. While the MVA-BN virus is highly attenuated and is thus incapable of replicating in the body, it is still capable of eliciting a potent immune response and does so without producing the post-vaccination complication associated with traditional Smallpox vaccines.
In America, New York and California are reporting the highest incidence of Monkeypox so far.
Despite almost all cases (particularly in the West) being mild – resulting in rashes and legions which resolve themselves, Director-General of the World Health Organisation, Tedros Adhanom Ghebreyesus, has today declared Monkeypox a public health emergency of international concern.
— World Health Organization (WHO) (@WHO) July 23, 2022
Part of the declaration includes the acceleration of vaccine research for Monkeypox.
‘Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners. That means that this is an outbreak that can be stopped with the right strategies in the right groups,’ said Tedros.
It almost sounds like the pandemic in the West could be stopped if people gave shagging a rest for a couple of weeks and then tighter controls were placed on flights in and out of Africa.
The thread from the WHO started getting a little strange after that, with the hashtag #SolidarityNotStigma and a stern caution not to stigmatise people about catching Monkeypox. It’s nice advice that would have been useful when the unvaccinated were being demonised and wrongly blamed for the spread of Covid.
— World Health Organization (WHO) (@WHO) July 23, 2022
So far, the response appears to be a mix of annoyance, ambivalence, and a good dose of ‘bugger off’ as if people are growing tired of a new emergency popping up each week.
Perhaps it’s time to take bets on whether or not the WHO has the balls to propose a ‘sex ban’ on the LGBTQ+ community for the sake of public health? ‘No monkey business until we’re all safe!’
At least we won’t have to wear masks for this one.
Good morning, good afternoon and good evening.
A month ago, I convened the Emergency Committee under the International Health Regulations to assess whether the multi-country Monkeypox outbreak represented a public health emergency of international concern.
At that meeting, while differing views were expressed, the committee resolved by consensus that the outbreak did not represent a public health emergency of international concern.
At the time, 3040 cases of Monkeypox had been reported to WHO, from 47 countries.
Since then, the outbreak has continued to grow, and there are now more than 16 thousand reported cases from 75 countries and territories, and five deaths.
In light of the evolving outbreak, I reconvened the committee on Thursday of this week to review the latest data and advise me accordingly.
I thank the committee for its careful consideration of the evidence, and issues.
On this occasion, the committee was unable to reach a consensus on whether the outbreak represents a public health emergency of international concern.
The reasons the committee members gave for and against are laid out in the report we are publishing today.
Under the International Health Regulations, I am required to consider five elements in deciding whether an outbreak constitutes a public health emergency of international concern.
First, the information provided by countries – which in this case shows that this virus has spread rapidly to many countries that have not seen it before;
Second, the three criteria for declaring a public health emergency of international concern, which have been met;
Third, the advice of the Emergency Committee, which has not reached consensus;
Fourth, scientific principles, evidence and other relevant information – which are currently insufficient and leave us with many unknowns;
And fifth, the risk to human health, international spread, and the potential for interference with international traffic.
WHO’s assessment is that the risk of Monkeypox is moderate globally and in all regions, except in the European region where we assess the risk as high.
There is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment.
So in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations.
For all of these reasons, I have decided that the global Monkeypox outbreak represents a public health emergency of international concern.
Accordingly, I have made a set of recommendations for four groups of countries:
First, those that have not yet reported a case of Monkeypox, or have not reported a case for more than 21 days;
Second, those with recently imported cases of Monkeypox and that are experiencing human-to-human transmission.
This includes recommendations to implement a coordinated response to stop transmission and protect vulnerable groups;
To engage and protect affected communities;
To intensify surveillance and public health measures;
To strengthen clinical management and infection prevention and control in hospitals and clinics;
To accelerate research into the use of vaccines, therapeutics and other tools;
And recommendations on international travel.
The third group of countries is those with transmission of Monkeypox between animals and humans;
And the fourth is countries with manufacturing capacity for diagnostics, vaccines and therapeutics.
My full recommendations are laid out in my statement.
I thank the Emergency Committee for its deliberations and advice. I know this has not been an easy or straightforward process, and that there are divergent views among the members.
The International Health Regulations remains a vital tool for responding to the international spread of disease.
But this process demonstrates once again that this vital tool needs to be sharpened to make it more effective.
So I’m pleased that alongside the process of negotiating a new international accord on pandemic preparedness and response, WHO’s Member States are also considering targeted amendments to the International Health Regulations, including ways to improve the process for declaring a public health emergency of international concern.
Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners.
That means that this is an outbreak that can be stopped with the right strategies in the right groups.
It’s therefore essential that all countries work closely with communities of men who have sex with men, to design and deliver effective information and services, and to adopt measures that protect the health, human rights and dignity of affected communities.
Stigma and discrimination can be as dangerous as any virus.
In addition to our recommendations to countries, I am also calling on civil society organizations, including those with experience in working with people living with HIV, to work with us on fighting stigma and discrimination.
But with the tools we have right now, we can stop transmission and bring this outbreak under control.
I thank you.
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