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Monkeypox cases in Europe have tripled in the last two weeks

Microscope image of monkeypox virions
The World Health Organization calls on European countries to take stronger measures to stop the spread of monkeypox.
(Cynthia S. Goldsmith, Russell Regner / U.S. Centers for Disease Control and Prevention )
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The World Health Organization’s Europe chief warned Friday that monkeypox cases in the region have tripled in the last two weeks and urged countries to do more to ensure that the previously rare disease does not become entrenched on the continent.

Dr. Hans Kluge said in a statement that increased efforts are needed despite the United Nations health agency’s decision last week that the escalating outbreak did not yet warrant being declared a global health emergency.

“Urgent and coordinated action is imperative if we are to turn a corner in the race to reverse the ongoing spread of this disease,” Kluge said.

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To date, more than 5,000 monkeypox cases have been reported from 51 countries worldwide, according to the U.S. Centers for Disease Control and Prevention. Kluge said the number of infections in Europe represents about 90% of the global total, noting that 31 countries in the WHO’s European region have now identified cases.

Kluge said data reported to the WHO show that 99% of cases have been in men and that the majority have been in men who have sex with men. But he said there were now “small numbers” of cases among household contacts, including children. Most people reported symptoms including a rash, fever, fatigue, muscle pain, vomiting and chills.

Scientists warn that anyone who is in close physical contact with someone who has monkeypox or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. Vulnerable populations like children and pregnant women are thought to be more likely to suffer severe disease.

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Los Angeles County officials have reported limited local transmission of monkeypox, with some recent cases involving people who attended large events and infected people who haven’t traveled out of state.

About 10% of patients were hospitalized for treatment or isolation, and one person was admitted to an intensive care unit. No deaths have been reported.

Kluge said the problem of stigmatization in some countries might make some people wary of seeking healthcare and said the WHO was working with partners, including organizers of gay pride events.

In Britain, which has the biggest monkeypox outbreak beyond Africa, officials have noted that the disease is spreading in “defined sexual networks of gay, bisexual, or men who have sex with men.” British health authorities said there were no signs suggesting sustained transmission beyond those populations.

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A leading WHO advisor said in May that the spike in cases in Europe was likely tied to sexual activity among men at two rave parties in Spain and Belgium, speculating that the disease’s appearance in the gay and bisexual community was a “random event.” British experts have said most cases in Briain involve men who reported having sex with other men in venues such as saunas and sex clubs.

Riverside and Santa Clara counties reported their first probable cases of monkeypox this week while the number of confirmed cases continues to grow throughout California.

Ahead of gay pride events in Britain this weekend, London’s top public health doctor asked people with symptoms of monkeypox, such as swollen glands or blisters, to stay home.

Kluge appealed to countries to scale up their surveillance and genetic-sequencing capacities for monkeypox so that cases can be quickly identified and measures taken to prevent further transmission. He said the procurement of vaccines “must apply the principles of equity.”

The main vaccine being used against monkeypox was originally developed for smallpox, and the European Medicines Agency said earlier this week that it was beginning to evaluate whether the shot should be authorized for monkeypox. The WHO has said supplies of the vaccine, made by Bavarian Nordic, are extremely limited.

Some countries including Britain and Germany have already begun vaccinating people at high risk of monkeypox; Britain recently widened its immunization program to offer the shot mostly to gay and bisexual men who have multiple sexual partners and are thought to be most vulnerable.

Although the monkeypox virus can affect anyone, some gay and bisexual men are worried about being once again branded as carriers of an exotic disease.

Until May, monkeypox had never been known to cause large outbreaks beyond Africa, where the disease is endemic in several countries and mostly causes limited outbreaks when it jumps to people from infected wild animals.

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To date, there have been about 1,800 suspected monkeypox cases, including more than 70 deaths in Africa. Vaccines have never been used to stop monkeypox outbreaks in Africa.

The WHO’s Africa office said this week that countries with vaccine supplies “are mainly reserving them for their own populations.”

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