Global health emergency and monkeypox

Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, has declared that the increase in mpox cases in the Democratic Republic of the Congo (DRC) and several other African countries is a public health emergency of international concern (PHEIC) according to the International Health Regulations (2005) (IHR).

In announcing the PHEIC, Dr. Tedros stated, "The rise of a new mpox clade, its swift spread in eastern DRC, and the reported cases in several neighboring countries are deeply concerning. Given the ongoing outbreaks of other mpox clades in DRC and across Africa, it is evident that a coordinated international response is essential to control these outbreaks and protect lives."

In July 2022, the multi-country mpox outbreak was declared a PHEIC due to its swift transmission through sexual contact in countries where the virus had previously not been detected. This PHEIC was concluded in May 2023 after a consistent decrease in global cases.

Mpox has been reported in the DRC for over a decade, with a steady increase in cases each year. Last year saw a significant rise in reported cases, and this year’s total has already surpassed last year's figures, reaching over 15,600 cases and 537 deaths.

The emergence and rapid spread of a new strain, clade 1b, in the DRC last year is particularly alarming. This strain, which appears to be spreading primarily through sexual networks, has also been detected in neighboring countries, contributing to the PHEIC declaration.

In the past month, more than 100 laboratory-confirmed cases of clade 1b have been reported in four neighboring countries—Burundi, Kenya, Rwanda, and Uganda—that had not previously reported mpox. Experts believe the actual number of cases is likely higher, as many clinically compatible cases have not been tested.

Various outbreaks involving different mpox clades have occurred in different regions, each with distinct transmission modes and risk levels.

The two vaccines currently available for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization and are approved by WHO-listed national regulatory authorities and individual countries, including Nigeria and the DRC. Read more

ADVICE FOR TRAVELLERS

Closely related to the smallpox virus, monkeypox has its origins in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People travelling in endemic countries can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk in those regions. More recently, monkeypox has spread person-to-person around the globe, primarily through large respiratory droplets, but also via direct contact with skin lesions or body fluids (i.e. close or intimate contact) and indirect contact by way of contaminated bedding, clothes etc.

VACCINE ELIGIBILITY AND ACCESS 

There is a globally limited supply of the JYNNEOS® vaccine and high international demand.

As per the Australian Department of Health and Aged Care Read more

"Given vaccine supply is limited, access to vaccines will initially be prioritised to support strong outbreak management, and this may include those who are:

  • Close physical contacts of people infected with mpox, such as intimate partners and people who live in the same household.
  • Population groups who might be at higher risk of exposure or further transmission, such as gay, bisexual, or other men who have sex with men who have a high number of sexual contacts or are travelling to countries where mpox is present, or those where mpox is more likely to result in serious illness.
  • People whose occupations might put them at increased risk, including laboratory staff and healthcare workers.

States and territories are responsible for administration of the vaccine in their jurisdiction. This includes how and where it will be available and who will be prioritised to receive the vaccine. These decisions will be informed by local risk factors, such as local outbreaks and vaccine supply.

State and territories will provide further advice on how the vaccine can be accessed within their jurisdiction".

Read more on the first case detected in Europe: Read more  

Read more from the Centres of Disease Control and Prevention (CDC) on the current outbreaks of monkeypox and frequently asked questions (including vaccine eligibility).