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Disease experts call on WHO, governments for more action on monkeypox

A section of skin tissue, harvested from a lesion on the skin of a monkey, that had been infected with monkeypox virus, is seen at 50X magnification on day four of rash development in 1968. CDC/Handout via REUTERS

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GENEVA, May 28 (Reuters) – Some prominent infectious disease experts are pushing for faster action from global health authorities to contain a growing monkeypox outbreak that has spread to at least 20 countries.

They are arguing that governments and the World Health Organization should not repeat the early missteps of the COVID-19 pandemic that delayed the detection of cases, helping the virus spread.

While monkeypox is not as transmissible or dangerous as COVID, these scientists say, there needs to be clearer guidance on how a person infected with monkeypox should isolate, more explicit advice on how to protect people who are at risk, and improved testing and contact tracing.

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“If this becomes endemic (in more countries), we will have another nasty disease and many difficult decisions to take,” said Isabelle Eckerle, a professor at the Geneva Centre for Emerging Viral Diseases in Switzerland.

The WHO is considering whether the outbreak should be assessed as a potential public health emergency of international concern (PHEIC), an official told Reuters. A WHO determination that an outbreak constitutes a global health emergency – as it did with COVID or Ebola – would help accelerate research and funding to contain a disease.

“It is always under consideration, but no emergency committee as yet (on monkeypox),” Mike Ryan, director of the WHO’s health emergencies programme, said on the sidelines of the agency’s annual meeting in Geneva.

However, experts say it is unlikely the WHO would reach such a conclusion soon, because monkeypox is a known threat the world has tools to fight. Discussing whether to set up an emergency committee, the body that recommends declaring a PHEIC, is just part of the agency’s routine response, WHO officials said.

Eckerle called for the WHO to encourage countries to put more coordinated and stringent isolation measures in place even without an emergency declaration. She worries that talk of the virus being mild, as well as the availability of vaccines and treatments in some countries, “potentially leads to lazy behaviour from public health authorities.”

NOT THE SAME AS COVID

More than 300 suspected and confirmed cases of monkeypox, a usually mild illness that spreads through close contact, causing flu-like symptoms and a distinctive rash, have been reported this month.

Most have been in Europe rather than in the Central and West African countries where the virus is endemic. No deaths have been reported in the current outbreak.

However, global health officials have expressed alarm over the growing outbreak in non-endemic countries. The WHO has said it expects numbers to rise as surveillance increases.

Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, wrote on Twitter that monkeypox was different to SARS-CoV-2, the novel coronavirus, but “we are making some of the same mistakes with regard to responding decisively with the tools at hand.”

On Friday, the WHO reiterated that the monkeypox virus is containable with measures including the quick detection and isolation of cases and contact tracing. read more

People who are infected – and in some cases their close contacts – are advised to isolate for 21 days, but it is not clear to what extent people would adhere to such a long time away from work or other commitments. The lab capacity to test for monkeypox is also not yet widely established, said Eckerle, meaning rapid diagnosis can be difficult.

Mass vaccination is not considered necessary but some countries, including Britain and France, are offering vaccines to healthcare workers and close contacts. read more

Other experts say the current response is proportionate and that deeming monkeypox a global health emergency and declaring a PHEIC would be inappropriate at this stage.

“This is reserved for threats with the highest level of risk based on infectivity, severity and international risk of escalation,” said Dale Fisher, chair of the Global Outbreak Alert and Response Network (GOARN) and a professor of medicine in Singapore.

Beyond labels, experts said the most important lesson of the last two years is that preventing pandemics once they have started spreading is too late.

“It is always disappointing when the world wakes up to a new disease only when it hits high-income countries,” said Piero Olliaro, a professor of poverty-related infectious diseases at Oxford University and monkeypox expert.

To prepare for pandemics, “you have to do that where the diseases are now,” he said.

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Reporting by Jennifer Rigby; Aditional reporting by Emma Farge; Editing by Josephine Mason, Michele Gershberg and Daniel Wallis

Our Standards: The Thomson Reuters Trust Principles.

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Monkeypox Is Here and COVID Truthers Are Losing It

Public health experts and most mainstream media outlets have spent much of the last week or two assuring people that monkeypox is not the new COVID-19.

Sure, the global outbreak of a couple hundred cases of a disease usually confined to clusters in Africa is odd and not yet well understood, and after two years of COVID, news of a virus potentially doing something new inevitably has people on edge. But unlike the novel coronavirus, several experts on the disease told The Daily Beast, monkeypox is a known entity. It doesn’t spread all that easily between humans, nor, to experts’ current understanding, asymptomatically. So few see any cause for widespread concern—and no actual experts or officials of any note appear to be calling for COVID-style control measures.

As Grant McFadden, a poxvirus expert at Arizona State University, put it, “For a virologist, this transmission is worth study, and it’ll probably teach us a few new things about monkeypox. But for the average person, on a worry meter from 0 to 10, it’s probably below a 1.”

But over in the bizarro world of pandemic truthers and far-right conspiracy theorists, many folks have been spreading a drastically different message: Monkeypox is clearly “Covid 2.0.” Naturally, this crowd baselessly believes, global elites will soon enact a new wave of supposedly inane and harmful mass lockdowns, vaccinations, and more.

“Soon: Just 2 weeks to flatten the monkeypox curve,” a member of a conspiratorial Reddit group with over 1.7 million users posted last week. “Msm [mainstream media] will push monkeypox lockdowns within the next month……….here we go again,” reads another post from Monday.

Or, as one recent article in a popular truther publication put it, “We might be in for an epic summer of scare-mongering, panic-buying & bucket loads of cringe…”

The contrast between experts’ measured accounts of the realities of this strange—yet likely manageable—outbreak and the conspiracists’ frenzied predictions about a pandemic repeat is striking. But according to several experts on anti-vaxxers, pandemic truthers, and conspiracy theorists The Daily Beast spoke to for this article, it’s hardly surprising. After all, these communities have spent years now arguing that the pandemic is the centerpiece of a grand (if vague) sinister plot, and finding ways to shoehorn anything and everything they find suspicious or distasteful into those narratives.

…within hours of reports on Biden’s statements on the outbreak, Donald Trump Jr. tweeted out, “How long till the WHO and CDC lock us down again for the coming #Monkeypoxalypse?”

As Michael Barkun, an expert on conspiracy thinking at Syracuse University, put it, “People who see the world through this lens would never accept that monkeypox is a separate disease. For them, it necessarily has to be part of a larger picture that includes COVID.”

Pandemic truthers started jumping on every story about a new or unusual disease last year, tagging them all as a potential new chapter in the so-called pandemic madness that had supposedly grappied the world.

Twice in 2021, figures in this space actually latched onto isolated cases of monkeypox detected in America, among people who’d recently traveled to Africa.

“Monkeypox plandemic coming soon?” a truther Telegram channel with over 95,000 followers wrote last July, linking to a mainstream story about a man who traveled from Lagos to Dallas and then wound up in the hospital with the disease.

A few days later, the channel noted that the FDA had just, as of 2019, approved a vaccine for use in protection against monkeypox, suggesting that this was potentially suspicious, given the obscurity of the disease in America. Over the last few weeks, truthers have revived this point, and cited other recent developments in monkeypox research and vaccine procurement deals as major red flags.

It’s worth noting that, no, recent monkeypox product developments and purchases are actually not odd. As David Evans, a University of Alberta poxvirus researcher, explained to The Daily Beast, experts have long known that smallpox vaccines are about 85 percent effective against monkeypox, too. (Both are members of the same family of viruses.) Large-scale smallpox vaccination stopped after humanity eradicated the disease in the wild. However, vials still exist in a few labs; some workers at these facilities still need regular precautionary vaccinations. And public health and security experts have long feared that an accident, terror attack, or something else could re-release the disease. So limited smallpox vaccine production never stopped.

Alex Jones, left, and Donald Trump Jr. have both amplified conspiracy theories about monkeypox. Memes and videos about the origins and severity of the virus have also made their way around far right parts of the internet.

Photo Illustration by Luis G. Rendon/The Daily Beast/Getty/Twitter/TikTok

But old smallpox treatments had what Evans called “nasty” side effects; they killed one in a million recipients. So researchers also never stopped developing new and potentially safer smallpox treatments and cures, which governments routinely purchase to maintain strategic stockpiles. Researchers also noticed a steady increase in the frequency and spread of monkeypox outbreaks starting several years ago, a phenomenon likely partially explained by the slow fade-out of smallpox vaccine immunity in the general population. So the niche world of poxvirus experts has had its eye on monkeypox for years, and folks developing a treatment or vaccine against smallpox have started explicitly angling their products towards that disease, as well.

Of course, this context never seems to find its way into truther- and conspiracy-theorist posts about this pox.

Truther posts about monkeypox cases in 2021 never took off. (Although a few folks now point to them as supposed proof that the mainstream media was, as one Telegram channel recently put it, “seeding the monkeypox narrative last year.”) Observers monitoring this space suspect that’s due to the fact that these well-isolated cases never turned into a larger story they could latch onto. Meanwhile, there were still plenty of novel COVID developments for them to fixate on.

In recent weeks, however, “the public has tried to unmask and get back to engaging in normal activities,” noted Kathleen Hall Jamieson, an expert on misinformation and conspiracy theories at the University of Pennsylvania who monitors pandemic-skeptical chatter online. It’s unclear if this return to a sense of normalcy will last in the face of an apparent surge of cases, and the ever-present threat of a new strain ripping across the nation. But as COVID slowly fades out of the headlines for now, while conspiracy theorists’ darkest prophecies of a dystopian future remain unfulfilled, some have seemingly started to scramble to identify a new pandemic that they can paint as the next phase in, or a second attempt at advancing, a sinister elite master plan.

The truther sphere has a penchant for jumping on any issue that sparks a critical mass of state, media, or popular attention, Matthew Motta, an Oklahoma State University expert on conspiracy thinking, pointed out. So by the time President Joe Biden addressed monkeypox last weekend, flagging it as a cause for concern, the story was so big it was probably inevitably going to get sucked into wild COVID narratives.

Sure enough, within hours of reports on Biden’s statements on the outbreak, Donald Trump Jr. tweeted out, “How long till the WHO and CDC lock us down again for the coming #Monkeypoxalypse?”

But Jamieson suggested that the portrayal of monkeypox as “Covid 2.0” has spread particularly quickly and gained notable traction within pandemic conspiracy circles because it lines up with many elements of COVID-19 they’ve fixated on over the last two years. It’s a disease that jumped from animals to humans—and then acted weird. Some nations are talking about isolating affected people and vaccinating those at risk of transmissions. Which, to be clear, are tried-and-true containment tactics; America employed them to contain a major monkeypox outbreak that hit the Midwest in 2003. And they don’t come anywhere near the sorts of measures instituted to control COVID-19.

Conspiracy theorists even zeroed in on reports about a simulation, run by the Nuclear Threat Initiative in March 2021 for health and security experts, modeling a strange outbreak of monkeypox spreading across the globe starting in mid-May 2022.

Marjorie Taylor Greene has jumped on the monkeypox truther bandwagon.

Photo Illustration by Luis G. Rendon/The Daily Beast/Getty/Twitter

To many truthers, this last link seemed like a direct repetition of Event 201, a simulation of a novel coronavirus outbreak run in late 2019 that conspiracy theorists paint as a smoking gun showing that elites knew about or planned COVID-19 before it broke out. “The timeline for the (((pandemic))) in the pdf literally matches” the current monkeypox outbreak, one of many truther Telegram channels that shared stories about the 2021 exercise wrote in a post last weekend. (Those parentheses are a well known anti-Semitic dog whistle, meant to subtly yet clearly imply Jewish involvement or leadership in some sort of vague monkeypox-related plot.)

In truth, the NTI’s exercise was one of many biosecurity games held every year.

Jaime Yassif, one of the individuals at NTI involved in the scenario, told The Daily Beast that they picked an arbitrary near-future starting date for the scenario. And while many such exercises focus on smallpox, as it’s a classical concern in the field, NTI opted for monkeypox because they “wanted to present a novel scenario,” while still focusing on a known health concern.

Neither their timeline nor the details actually line up as well with the current monkeypox outbreak as conspiracists insist. Notably, the scenario outlines a bio-terror attack in a fictional nation using a genetically modified version of a different strain of monkeypox than the one circulating now. Although some conspiracy theorists insist the current outbreak involved genetic engineering, or a lab leak (and a few have even tried to link it back to the Wuhan lab implicated in COVID conspiracy theories), there is no evidence for these claims. In fact, the circulating virus looks like a standard strain of West African monkeypox, several experts who’ve reviewed its genome, recently sequenced from a sample collected from a patient, told The Daily Beast. The virus involved in this outbreak also isn’t spreading anywhere near as fast, nor causing as many or as severe of cases, as the fictive one outlined in the NTI exercise.

But as Webster University conspiracy-theory expert Daniel Hellinger noted, details rarely matter to conspiratorial communities. They’re just hunting for cherry-picked “evidence” they can use to confirm their narratives. In this case, they seem to feel it’s particularly easy to find threads from monkeypox to COVID; they’ve made a slew of other cases for apparent connections, which it’d take a monograph to unpack in detail. Suffice it to say each is more spurious than the last.

Beyond these supposed resonances, Jamierson pointed out that monkeypox has a few unique characteristics that may appeal to truthers: Notably, it involves a striking rash that they can use to stir up fear.

Its name also allows them to make memes featuring monkeys, animals Americans usually think of as silly, playing into the running truther notion that COVID plots are all obvious and absurd. The truther sphere is currently awash in weird memes, like an orangutan on a tricycle, labeled “Monkeypox,” chasing a screaming child labeled, “The 11 People Who Still Believe The Media.”

For all the consensus in truther world that monkeypox is “Covid 2.0,” no one seems to agree on what that label actually means, nor the implications of a new pandemic.

Notably, many truthers claim monkeypox is clearly a hoax or a minor issue blown out of proportion by global elites to sow chaos they can exploit. “As inflation soars and the cost of living crisis only gets worse, it’s probably handy for them to have a new ‘public health’ reason to ban protests and clampdown on civil unrest,” a major truther blog recently suggested.

However, others argue monkeypox is real and dangerous, and is being deployed in the wake of weaknesses created by COVID or the COVID vaccines to depopulate the globe. “They are progressing to stage 2 where they drop an ACTUALLY dangerous virus. Except [sic] 10x the death toll of COVID,” a poster in a large conspiratorial Reddit community recently argued.

Others still claim monkeypox is actually a side effect of the COVID vaccines being passed off as a new condition, making it a direct COVID sequel. “‘Monkeypox’ is just the new name given to shingles side effects caused by the covid injections,” a truther Telegram channel recently argued. (It’s not.) Or that monkeypox is a distinct condition, but people are only getting it now because vaccines weakened their immune systems. (They didn’t.) “If you never took the covid shot you have nothing to worry about,” a conspiratorial Telegram channel recently noted within a post speculating about potential dire effects of the supposedly imminent monkeypox pandemic.

It’s also unclear how long these discordant theories will maintain their prominence within truther spaces. As Jamieson noted, they gained rapid traction and are “now circulating… among people who have potentially substantial reach.” Alex Jones and Marjorie Taylor Greene have notably jumped on the monkeypox panic bandwagon. But truther attention is fickle, experts on the space agreed. Even a big story can fade quickly in these spheres, if it doesn’t gain the traction its proponents hoped for, or find the right fuel within mainstream reporting to sustain itself.

A few members of conspiratorial communities online have already started raising concerns about whether they’re putting too much focus on monkeypox—perhaps more than the mainstream media that their theories often accuse of overhyping the outbreak as part of a mission to foment fear. “If Monkeypox turns out to be nothing, will this sub collectively agree that we are the only place freaking out about it?” a poster in a major Reddit conspiracy group recently asked.

However, even if the current monkeypox is Covid 2.0 theories collapse as the outbreak fades and internecine squabbles over their details and validity expand, every expert The Daily Beast spoke to for this story suspects conspiracy theorists will just find something new to paint as the new pandemic. Because undergirding this conspiracy theory is one underlying, universal, unshakable belief. As a popular conspiratorial blog wrote on its Telegram channel in a post speculating about how monkeypox might unfold, “One thing is for sure, they aren’t done with us just yet.”

As ever, it’s unclear who “they” refers to.

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Monkeypox no cause for panic

According to the Harvard Medical School’s website, monkeypox is an infection caused by a virus in the same family as smallpox. It causes a similar, but less severe, illness and is most common in central and western Africa. “Certain squirrels and rats found in Africa are among other animals that harbor this virus,” it says. The new trend is that it is “spreading fast” outside of Africa.

The early symptoms of monkeypox are flulike, and include fever, fatigue, headache and enlarged lymph nodes. In some cases, appearance of rash on some of those infected has been reported. The report says that although the symptoms are usually mild, “complications can include pneumonia, vision loss due to eye infection, and sepsis, a life-threatening infection.”

In the UAE, authorities reported few days ago the first case, a 29-year-old woman arriving from West Africa. The Ministry of Health and Prevention said she was receiving the necessary medical treatment.

The ministry assured the public that its teams are fully prepared to deal with any circumstances. “The technical advisory team for pandemic control has prepared a comprehensive guide for surveillance, early detection of the disease, management of clinically infected patients and precautionary measures.”

The public however is urged to be careful, for the sake of their safety and of their loved ones. There is absolutely no need to panic.

As reported by the World Health Organisation (WHO), mass vaccinations, similar to COVID-19 measures, are unlikely to be needed against the monkeypox.

But with the confusion and lack of enough information, it is necessary to observe good hygiene and practice safe sex to help control its spread. Also, one needs to avoid contact with people suspected of being infected, avoid contact with sick animals that could be carrying the virus, keep santizing, and only eat meat that is cooked thoroughly.

COVID-19 remains the main threat to health globally. The monkeypox seems a minor hazard in comparison. But it is a threat nevertheless that has the potential to infect more people if necessary preventive measures are ignored.

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Monkeypox outbreak could be just ‘the peak of the iceberg’, WHO warns | Monkeypox

The World Health Organization has warned that 200 monkeypox cases found in recent weeks outside countries where the virus usually circulates could be just the beginning.

“We don’t know if we are just seeing the peak of the iceberg [or] if there are many more cases that are undetected in communities,” Sylvie Briand, WHO’s epidemic and pandemic preparedness and prevention chief, acknowledged on Friday in a briefing to countries.

Since the UK first reported a confirmed monkeypox case on 7 May, nearly 200 cases have been reported to the UN health agency in countries far from the states where the virus is endemic.

The European Centre for Disease Prevention and Control has put the number of such cases at 219.

Endemic in a number of west and central African nations, monkeypox cases have suddenly been detected in more than 20 other countries around the world, including the US, Australia, the United Arab Emirates and nearly a dozen EU countries.

The Spanish health ministry said on Friday that 98 cases had been confirmed there so far, while the UK currently counts 90 verified infections.

Portugal has meanwhile registered 74 confirmed cases, health authorities said on Friday, adding that all the occurrences are in men, mainly aged below 40.

Argentina confirmed the first two cases of monkeypox in Latin America on Friday.

“We are still at the very, very beginning of this event,” Briand told member state representatives attending the World Health Assembly in Geneva. “We know that we will have more cases in the coming days,” she said, but stressed there was no need to panic.

“This is not a disease the general public should be worried about. It is not Covid or other diseases that spread fast.”

Monkeypox is related to smallpox, a deadly disease that was eradicated in 1980. But monkeypox is much less severe, with a fatality ratio of 3-6%. Most people recover within three to four weeks.

The initial symptoms include a high fever, swollen lymph nodes and chickenpox-like rash.

There is not much in the way of treatment, but some antivirals developed against smallpox exist, including one that was recently approved by the European Medicines Agency against smallpox, Briand pointed out.

Vaccines developed for smallpox have also been found to be about 85% effective in preventing monkeypox.

However, since smallpox has not posed a threat in more than four decades, most people under the age of 45 have not received the vaccine, and the supplies of the jabs are today very limited.

Briand said experts were trying to determine what had spurred this “unusual situation”, saying preliminary investigations did not seem to indicate that the virus that causes monkeypox had changed or mutated.

She voiced hope that the spread could be halted. “We have a good window of opportunity to stop the transmission now,” she said. “If we put in place the right measures now, we probably can contain this easily.”

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CDC publishes guidelines on monkeypox vaccine

The CDC on Friday published recommendations by its group of independent experts on a smallpox vaccine that limit its use to only people who work closely with viruses such as monkeypox. (Tami Chappell, Reuters)

Estimated read time: 2-3 minutes

WASHINGTON — The U.S. Centers for Disease Control and Prevention on Friday published recommendations by its group of independent experts on a smallpox vaccine that limit its use to only people who work closely with viruses such as monkeypox.

The Jynneos vaccine, made by Bavarian Nordic, will be available for certain health care workers and laboratory personnel at a time when monkeypox infections has spread in Europe, the United States and beyond.

The vaccine was approved in the United States in 2019 to prevent smallpox and monkeypox in high-risk adults aged 18 and older.

CDC officials earlier this week said they were in the process of releasing some doses of the Jynneos vaccine for people in contact with known monkeypox patients.

Officials said there were over 100 million doses of an older smallpox vaccine called ACAM2000, made by Emergent BioSolutions, which has significant side effects.

Monkeypox is a mild viral infection that is endemic in certain parts of Africa, but the recent outbreak in countries where the virus doesn’t usually spread has raised concerns.

So far, there are about 300 confirmed or suspected cases in around 20 countries where the virus was not previously circulating. The Salt Lake County Health Department two confirmed cases of monkeypox in Utah on Wednesday. The World Health Organization has called for quick action from countries to contain the monkeypox spread.

The CDC said its experts’ recommendations are meant for clinical laboratory personnel performing diagnostic tests for orthopoxviruses such as smallpox and monkeypox, laboratory people doing research on the viruses and health care workers who administer the ACAM2000 vaccine or care for patients infected with orthopoxviruses.

The publication of the vote by the CDC’s Advisory Committee on Immunization Practices, which took place in November last year, formalizes the recommendations.

Both ACAM2000 and Jynneos are available for prevention of orthopoxvirus infections among at-risk people, the CDC said on Friday.

Contributing: Amruta Khandekar

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Colorado identifies second presumptive case of monkeypox

A second presumptive monkeypox case has been identified in Colorado.

The case is awaiting Centers for Disease Control and Prevention confirmation, according to a Colorado Department of Public Health and Environment news release.

“The new presumptive case is a young adult male who sought care in the Denver area and is improving and isolating at home,” the CDPHE said.

The first possible case in the state was announced by health officials on Thursday. That patient is described as a young man from the Denver area who had traveled to Canada, which is dealing with a monkeypox outbreak.

Friday’s presumptive case is a close contact of the state’s first presumptive case, health officials said.

“The person who acquired the virus was a close contact of a person known to public health as a presumptive case of monkeypox,” the CDPHE said.

Monkeypox often begins with a fever, headache, muscle aches, swollen lymph nodes, and exhaustion, the CDPHE said. A rash typically develops within one to three days after the onset of fever, often beginning on the face and spreading to other parts of the body.

Health officials say that the monkeypox risk to the public remains low and that there is an effective vaccine available, that can be administered soon after exposure, to minimize the illness. It is rarely fatal.

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Second suspected monkeypox case discovered in Northern California

Sacramento County public health officials said Friday they have identified a second suspected case of monkeypox.

The case comes just days after the county reported its first case of the monkeypox virus in an individual who had just returned from travel in Europe, where cases of monkeypox have been reported. The Centeres for Disease Control and Prevention completed their testing of the initial sample, where they confirmed the monkeypox diagnosis, health officials said.

This second individual was a close contact of the initial patient and the connection was made through contact tracing, health officials said. That specimen will be sent to the CDC to confirm the diagnosis.

Both individuals were isolating in their homes and are not in any contact with other people, health officials said.

Symptoms of monkeypox, which is similar to smallpox but less severe, include fever, headache, muscle aches, backaches, swollen lymph nodes, chills, and exhaustion. An infected person will usually develop a rash, beginning on the face and spreading to other parts of the body, within one to three days after spiking a fever.

The incubation period of monkeypox is usually seven to 14 days but can range shorter or longer, and the illness overall can last anywhere from two to four weeks, health officials said. The virus can kill up to 10% of those infected, health officials said.


Annie Vainshtein (she/her) is a San Francisco Chronicle staff writer. Email: avainshtein@sfchronicle.com

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WHO: Nearly 200 cases of monkeypox in more than 20 countries

LONDON (AP) — The World Health Organization says nearly 200 cases of monkeypox have been reported in more than 20 countries not usually known to have outbreaks of the unusual disease, but described the epidemic as “containable” and proposed creating a stockpile to equitably share the limited vaccines and drugs available worldwide.

During a public briefing on Friday, the U.N. health agency said there are still many unanswered questions about what triggered the unprecedented outbreak of monkeypox outside of Africa, but there is no evidence that any genetic changes in the virus are responsible.

“The first sequencing of the virus shows that the strain is not different from the strains we can find in endemic countries and (this outbreak) is probably due more to a change in human behaviour,” said Dr. Sylvie Briand, WHO’s director of pandemic and epidemic diseases.

Earlier this week, a top adviser to WHO said the outbreak in Europe, U.S., Israel, Australia and beyond was likely linked to sex at two recent raves in Spain and Belgium. That marks a significant departure from the disease’s typical pattern of spread in central and western Africa, where people are mainly infected by animals like wild rodents and primates, and outbreaks haven’t spilled across borders.

Although WHO said nearly 200 monkeypox cases have been reported, that seemed a likely undercount. On Friday, Spanish authorities said the number of cases there had risen to 98, including one woman, whose infection is “directly related” to a chain of transmission that had been previously limited to men, according to officials in the region of Madrid.

U.K. officials added 16 more cases to their monkeypox tally, making Britain’s total 106. And Portugal said its caseload jumped to 74 cases on Friday.

Doctors in Britain, Spain, Portugal, Canada, the U.S. and elsewhere have noted that the majority of infections to date have been in gay and bisexual men, or men who have sex with men. The disease is no more likely to affect people because of their sexual orientation and scientists warn the virus could infect others if transmission isn’t curbed.

WHO’s Briand said that based on how past outbreaks of the disease in Africa have evolved, the current situation appeared “containable.”

Still, she said WHO expected to see more cases reported in the future, noting “we don’t know if we are just seeing the peak of the iceberg (or) if there are many more cases that are undetected in communities,” she said.

As countries including Britain, Germany, Canada and the U.S. begin evaluating how smallpox vaccines might be used to curb the outbreak, WHO said its expert group was assessing the evidence and would provide guidance soon.

Dr. Rosamund Lewis, head of WHO’s smallpox department, said that “there is no need for mass vaccination,” explaining that monkeypox does not spread easily and typically requires skin-to-skin contact for transmission. No vaccines have been specifically developed against monkeypox, but WHO estimates that smallpox vaccines are about 85% effective.

She said countries with vaccine supplies could consider them for those at high risk of the disease, like close contacts of patients or health workers, but that monkeypox could mostly be controlled by isolating contacts and continued epidemiological investigations.

Given the limited global supply of smallpox vaccines, WHO’s emergencies chief Dr. Mike Ryan said the agency would be working with its member countries to potentially develop a centrally controlled stockpile, similar to the ones it has helped manage to distribute during outbreaks of yellow fever, meningitis, and cholera in countries that can’t afford them.

“We’re talking about providing vaccines for a targeted vaccination campaign, for targeted therapeutics,” Ryan said. “So the volumes don’t necessarily need to be big, but every country may need access to a small amount of vaccine.”

Most monkeypox patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.

____

Ashifa Kassam contributed to this report from Madrid.

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Monkeypox can be contained if we act now, WHO says

  • No need for mass vaccination currently, body says
  • More data sharing needed on vaccine stockpiles
  • Some 300 cases reported outside Africa so far

GENEVA, May 27 (Reuters) – Countries should take quick steps to contain the spread of monkeypox and share data about their vaccine stockpiles, a senior World Health Organization official said on Friday.

“We think that if we put in place the right measures now we probably can contain this easily,” Sylvie Briand, WHO director for Global Infectious Hazard Preparedness, told the U.N. agency’s annual assembly.

Monkeypox is a usually mild viral infection that is endemic in parts of west and central Africa.

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It spreads chiefly through close contact and until the recent outbreak, was rarely seen in other parts of the world, which is why the recent emergence of cases in Europe, the United States and other areas has raised alarms.

So far, there are about 300 confirmed or suspected cases in around 20 countries where the virus was not previously circulating. read more

“For us, we think that the key priority currently is trying to contain this transmission in non-endemic countries,” Briand told a technical briefing for member states.

Needed measures included the early detection and isolation of cases and contact tracing, she added.

Member states should also share information about first generation stockpiles of smallpox vaccines which can also be effective against monkeypox, Briand said. read more

“We don’t know exactly the number of doses available in the world and so that’s why we encourage countries to come to WHO and tell us what are their stockpiles,” she said. A slide of her presentation described global supplies as “very constrained”.

Currently, WHO officials are advising against mass vaccination, instead suggesting targeted vaccination where available for close contacts of people infected.

“Case investigation, contact tracing, isolation at home will be your best bets,” said Rosamund Lewis, WHO head of the smallpox secretariat which is part of the WHO Emergencies Programme.

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Editing by Andrew Heavens

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How UK missed all the monkeypox warnings: scientists warned about virus THREE YEARS ago

Scientists have been raising the alarm about monkeypox’s potential to spill out of Africa and fill a gap left by smallpox since 2018.

But the warnings went unheeded. 

A British scientist at a level four biosecurity lab – which works with smallpox-like viruses – first warned about its epidemic-causing potential four years ago.

They warned how the emergence of monkeypox could have ‘potentially devastating consequences’ due to declining smallpox vaccination rates leaving the majority of the world’s population completely unprotected from the virus.    

The following year a group of international experts estimated that 70 per cent of the world was vulnerable to monkeypox because they had not been jabbed against smallpox.

It comes as another 12 Britons were diagnosed with the tropical illness on Thursday bringing the UK total to 90. The virus has been spotted in 19 countries outside of it usual range so far, making it the widest ranging outbreak ever. 

Previously monkeypox has only ever been spotted in a handful of cases outside of central or western Africa and experts say they are surprised by the current outbreak.

But a World Health Organization report also warned about the tropical illness in 2020, saying the ‘epidemic potential’ of monkeypox was increasing with modern farming techniques and rising populations, which increase the chance of animal-to-human transmission.

Then, in November last year, experts ran a hypothetical scenario that found a genetically engineered version of the disease could kill 300 million people. 

The final warning came in February this year — just weeks before the fresh outbreak.

A review conducted by smallpox vaccine manufacturer Bavarian Nordic warned that cases were rising rapidly in Africa.

Here MailOnline details the five crucial warnings that were missed: 

September 2018: Porton Down scientist warns of potential ‘devastating consequences’ of monkeypox 

Allen Roberts first raised the alarm about monkeypox in September 2018.

The scientist was working with ‘high consequence pathogens’ at the level four biosecurity lab Porton Down in Salisbury at the time.

This Government research site is used to work with smallpox and other viruses with biological warfare potential. 

In the paper, he said the emergence of monkeypox would have ‘devastating consequences’.

Titled ‘Approaches to Handling High Consequence Pathogens’, he wrote that declining rates of smallpox vaccination had left the vast majority of world’s population vulnerable. 

‘Only a fraction of the world’s population now retains immunity from previous vaccination, leaving the remainder of the population susceptible to this disease,’ he said. 

‘Consequently, the risk of deliberate reintroduction of smallpox in a bioterrorism event, as well as the emergence of monkeypox, would have potentially devastating consequences.’

 In 2018 a scientist working at Porton Down said the emergence of monkeypox could have ‘devastating consequences’ due to declining rates of smallpox vaccination across the globe

He also discussed the process of using monkeypox for conducting tests on potential smallpox vaccines on primates. 

Tests on new vaccines to combat smallpox are tested on the closely related monkeypox due to the former being eradicated by a global health campaign and scientists considering it too risky to bring it back even for research purposes. 

June 2019: Coalition of experts warn 70% of world is vulnerable to monkeypox

Dozens of British and international experts met at Chatham House in London to discuss how monkeypox ‘might fill the epidemiological niche vacated by smallpox’.

Members of the meeting included British and Nigerian virologists and experts on tropical medicine, as well as Public Health England, scientists from Porton Down, the US’s Center for Disease Control, and smallpox vaccine maker Bavarian Nordic.

Their meeting came after a series of monkeypox cases in the UK, Israel, and Singapore in 2018 and 19 which spread from travellers infected in Nigeria.

At what was described as an ‘ad-hoc conference’, the experts also warned how the eradication of smallpox left the world vulnerable to monkeypox. 

Smallpox vaccines provide 85 per cent protection against monkeypox as the diseases come from the same family of viruses, called orthopoxvirus.

But with smallpox being eradicated just over 40 years ago, routine vaccination against it ended shortly after. In Britain, the last smallpox vaccines were given in 1971. 

Publishing the results of the discussion in the journal Vaccine in 2020, experts said this meant 70 per cent of the world’s population is no longer protected against smallpox, and therefore, monkeypox.

‘Monkeypox is now a re-emerging disease,’ they wrote.

‘Vaccination and protective Variola minor [a minor smallpox strain] exposure contributed to smallpox eradication and likely reduced the number of other human orthopox infections.’

Dozens of scientists from around the world met in the UK in 2019 to discuss how monkeypox might fill the ‘niche’ left behind by the now eradicated smallpox

Concluding their paper, they called for more research on how monkeypox spreads and how to prevent it, including the development of vaccines and antiviral treatments, warning it had increasing potential to spread beyond central Africa.

‘With the cessation of widespread smallpox vaccination, increased study of the monkeypox virus, the human disease it causes, and its epidemiology are important,’ they said.

‘Global travel and easy access to remote and potentially monkeypox-endemic regions are a cause for increasing global vigilance.’ 

The experts highlighted how sex was a potential avenue of monkeypox transmission. 

‘Sexual transmission has been hypothesised for some cases with genital and groin lesions,’ they said. 

September 2020:  WHO warns ‘epidemic potential’ of monkeypox is rising

Two years ago, a paper published by the WHO warned the ‘epidemic potential’ of monkeypox was increasing.

The article warned the end of routine smallpox vaccination could lead to the rise of monkeypox in people.

‘In a population with diminishing herd immunity against orthopoxvirus species, the epidemic potential of monkeypox will continue increasing,’ they said. 

Mathematical modelling by the authors found monkeypox immunity in the Democratic Republic of the Congo (DRC), where the disease is endemic, fell from 85 per cent in the early 1980s to 60 per cent in 2012. 

The authors of the WHO paper concluded their work by saying declining immunity as a result of the end of routine smallpox vaccination meant the virus posed ‘an ever-increasing threat for health security’

Smallpox vaccination ended in the DRC in 1980, but monkeypox cases have been rising since then with entire parts of the country now considered endemic for the disease. 

The authors added previous flare-ups in Britain showed imported monkeypox cases could go on to infect others, as happened to a healthcare worker in 2018.

However, they said such cases were unlikely to lead to an epidemic as long as stringent infection prevention and control measures were followed.

But they also said rises in international travel could make dealing with monkeypox outbreaks increasing costly and a ‘poorly effective strategy’ to prevent disease. 

They concluded: ‘With declining immunity to orthopoxvirus species, monkeypox can pose an ever-increasing threat for health security.

The study was written by experts from Institut Pasteur in France and published in the Bulletin of the World Health Organization.

November 2021: Monkeypox pandemic model warns virus could kill 300million

A pandemic/bioterroism preparation exercise ran a hypothetical scenario where a bioengineered monkeypox virus goes on to kill 300million in about 18 months.

The exercise was run by the Nuclear Threat Initiative (NTI), a nonprofit organisation that campaigns for greater controls on nuclear and biological threats, coincidentally chose May 15 this year as the start date for the pandemic.

This date has been seized by conspiracy theorists have seized as ‘proof’ monkeypox has been unleased intentionally.

The fact ex-Microsoft head and philanthropist Bill Gates, a favourite target of conspiracies about the Covid pandemic, made a $250,000 (£213,000) donation to the NTI back in 2018 further fuelled these unproven claims. 

However, the NTI scenario was radically different from the current outbreak.

It used a fictional and a far more deadly monkeypox strain intentionally genetically altered to be resistant to vaccines.

Experts met in November 2021 to discuss how the world would respond to a hypothetical pandemic caused by monkeypox. The exercise included fake news reports on how the fictional virus was spreading in May 2022

The timeline of the Nuclear Threat Initiative’s fictional pandemic. In a statement this week, NTI said their choice of monkeypox for the exercise was based on recommendations from experts on potentially pandemic causing pathogens

In the scenario, terrorists managed to convince a scientist working at a virology lab to develop this virus and then go on to unleash in a fictional country.

A variety of other nations then go on to adopt different strategies in response as to the rapidly escalating pandemic. 

By the end of the scenario, dated December 1, 2023, the new monkeypox virus had gone on to infect 3.2billion people, killing 271million of them.

The NTI issued a statement following the real monkeypox outbreak, explaining the scenario was one of many ‘worst-case’ exercises created to raise awareness about potential global threats.

They claim it was used to highlight gaps in national and international biosecurity and pandemic preparation.

They said there is no current evidence the real monkeypox outbreak is anything like their fictional scenario.  

‘We have no reason to believe that the current outbreak involves an engineered pathogen, as we have not seen any compelling evidence that would support such a hypothesis,’ they said.

‘We also do not believe that the current outbreak has the potential to spread as rapidly as the fictional, engineered pathogen in our scenario or to cause such a high case fatality rate.’

NTI said they chose monkeypox for their scenario from a range of potential pandemic pathogens put forward by their health advisers. 

Monkeypox was eventually selected due to it being such a different virus compared to Covid, which NTI said ‘encouraged exercise participants to consider issues beyond those that have already been highlighted by the current pandemic.’

February 2022: Scientists say monkeypox is a disease in ‘resurgence’ 

A monkeypox research review in the Neglected Tropical Diseases journal published just a few months before the current outbreak warned of a ‘escalation’ in cases, and of a disease in ‘resurgence’.

The team of European and American experts analysed 66 studies which covered both the West African monkeypox clade – responsible for the current outbreak – and the more deadly Central African strain.

They found that cases had increased 10-fold since the 1970s.

This map, published in the study, details the number of confirmed, probable, and/or possible monkeypox cases in the world between 1970–1979

And this map details the number of confirmed, probable, and/or possible monkeypox cases in the world between 2010-2019, demonstrating not only the rise in the number of cases but how far they had spread. DRC figure reflects suspected cases

‘There are mounting concerns about the geographical spread and further resurgence of monkeypox,’ they said.

‘Over the past five decades, monkeypox outbreaks have been reported in 10 African countries and four countries outside of Africa.’

They theorized the end of regular smallpox vaccination and deforestation leading to closer contact between humans and infected animals could be two factors behind the rise. 

‘At the time when smallpox was rampant, no cases of monkeypox were reported,’ they said.

‘In our review of the literature, we found that unvaccinated individuals accounted for approximately 80–96 per cent of monkeypox cases.’ 

They concluded: ‘The waning population immunity associated with discontinuation of smallpox vaccination has established the landscape for the resurgence of monkeypox.’

‘This is demonstrated by the increases in number of cases and median age of individuals acquiring monkeypox as well as the re-emergence of outbreaks in some countries after an absence of 30–40 years.

‘The appearance of cases outside of Africa highlights the risk for geographical spread and the global relevance of the disease.’ 

The authors called for increased international support for the surveillance and detection of monkeypox cases. 

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