who health emergency over monkeypox outbreakstuart weitzman returns

Customize your JAMA Network experience by selecting one or more topics from the list below. July 23, 2022. All Rights Reserved. In an unusual move, WHO Director-General Tedros Adhanom Ghebreyesus made the declaration even though a committee of experts he had convened to study the issue did not advise him to do so, having failed to reach a consensus. Access unmatched financial data, news and content in a highly-customised workflow experience on desktop, web and mobile.

et al. July 22, 2022. Currently, WHO has declared 3 emergencies worldwide (COVID-19, polio, and monkeypox), placing major strains on national health systems. To prepare for potential deliberate biological threats, the US has stockpiled 100 million ACAM2000 doses and 36000 JYNNEOS doses and is seeking to amass more. The recommendations call on people to avoid travel if they are experiencing monkeypox symptoms or are under health monitoring because of an exposure to someone who is infected. Hollie Adams/Getty Images read more. Rosamund Lewis, technical lead for monkeypox at the WHO Health Emergencies Program, said monkeypox appears to be concentrated among men who have sex with men because they have more frequent social gatherings and participate in events involving intimate contact with multiple partners. During a Washington Post Live interview Friday, CDC Director Rochelle Walensky said inconsistent data inhibits the agencys ability to observe trends in race and ethnicity, sexual behavior and vaccination. Transmission among patients other than MSM may be underrecognized due to a lower index of suspicion among clinicians and less frequent testing. This is a situation where there is obviously more skin-to-skin, person-to-person contact, Lewis said. The WHOs move is not likely to have a direct effect on the U.S. response. In the UK, the drug had to be discontinued in some patients being treated for monkeypox due to liver toxicity.10. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. Multi-country monkeypox outbreak: situation update. That means that this is an outbreak that can be stopped with the right strategies in the right groups, Tedros said. Adler WHO declares monkeypox a global health emergency as infections soar, From Dry January to Fake Cocktails, Inside the New Temperance Movement. Since May, more than 17300 confirmed and suspected cases of monkeypox have been identified in all 6 WHO regions.2 Outbreaks have been identified primarily among men who have sex with men (MSM).3 As of July 25, CDC reported 3487 confirmed monkeypox/orthopoxvirus cases in the US, but cases are probably significantly underreported.4 The rapid identification of cases across such a large geographic area differentiates current outbreaks from earlier clusters, posing a risk monkeypox virus (MPXV) could become entrenched beyond endemic areas. The declaration comes even though the WHO emergency committee considering whether or not to issue the emergency declaration had failed to reach a consensus. Public health advocates hailed the WHOs decision to label monkeypox a global emergency. Vaccines and immunization for monkeypox: interim guidance 14 June 2022. Exclusive analysis of biotech, pharma, and the life sciences. Monkeypox infections lead to painful lesions and rashes, including vesicles forming on the palms.

Conflict of Interest Disclosures: Dr Borio reported being a venture partner at Arch Venture Partners, receiving fees from Resilience Corp, and serving on the board for the Coalition for Epidemic Preparedness Innovations, Eagle Pharmaceuticals, and Insulet Corp. No other disclosures were reported. Two antiviral drugs, tecovirimat and brincidofovir, have activity against orthopoxviruses. According to the U.S. Department of Health and Human Services, 191,000 doses have thus far been delivered to states and city health departments. P, Identify all potential conflicts of interest that might be relevant to your comment. The WHO Declaration of Monkeypox as a Global Public Health Emergency. Indiscriminate use could lead to the emergence of resistant strains. HHS says the federal government will have close to 7 million doses by mid-2023. Raj Panjabi, director of the White House pandemic preparedness office, said a "coordinated, international response is essential" to stop the spread of the disease and protect communities at the greatest risk of contracting it. Our Standards: The Thomson Reuters Trust Principles. Due to the stigma associated with monkeypox, WHO has begun a process to change the name of the virus. Current clusters represent an extraordinary event as nontravel-associated cases have never been reported outside endemic areas of central and west Africa.1 Given the spread of MPXV to more than 70 countries in 6 WHO regions, this outbreak clearly constitutes a public health risk to other States through the international spread of disease. Given the pace with which cases are being detected and the global scope, the risk that MPXV will become entrenched globally is increasing and a coordinated international response is essential. Thus far, the outbreak has been concentrated largely among gay, bisexual, and other men who have sex with men, with many occurring in men who have had multiple recent sex partners a fact that the WHO believes increases the chances the outbreak can be brought under control. Accurate case identification requires expanded and streamlined access to testing in clinical settings. WHO officials also said higher rates of health-seeking behavior among gay and bisexual men and a culture of public health in the community shaped by the AIDS crisis can help end the outbreak. Its an ongoing but a very active conversation at HHS.. Here's what authorities are doing to stop it. Since the role of the committee is to advise, I then had to act as a tie-breaker.. All quotes delayed a minimum of 15 minutes. Failure to ensure equitable access will further erode trust in the international system. National public health authorities have historically controlled outbreaks of MPXV since it was first identified in humans in 1970. Please allow up to 2 business days for review, approval, and posting. Accessed July 25, 2022. WHO. WHO plans to create a mechanism for equitable distribution, but multilateral vaccine sharing platforms like COVAX can be undermined by bilateral purchase agreements and export restrictions. Reuters, the news and media division of Thomson Reuters, is the worlds largest multimedia news provider, reaching billions of people worldwide every day.

Members of an expert committee that met on Thursday to discuss the potential recommendation were split on the decision, with nine members against and six in favour of the declaration, prompting Tedros himself to break the deadlock, he told reporters. But infections during the latest outbreak have surged in countries that have not historically reported monkeypox. July 20, 2022. The move to label the outbreak a Public Health Emergency of International Concern, the highest level of alert the WHO can issue, is expected to marshal new funding to fight the outbreak and to pressure governments into action. The industry leader for online information for tax, accounting and finance professionals. But the director general took the unusual step of not heeding the advice of the committee and declaring an emergency, anyway. Four of the six were in men who have sex with men. hide caption.

Public health communication must include specific, nonstigmatizing guidance for the MSM community to recognize and seek care for MPXV symptoms and to reduce transmission risks during sexual encounters. Monkeypox has spread across the world at an unprecedented rate in the last two months. Josie Golding, head of epidemics and epidemiology at Britains Wellcome Trust, said this outbreak should be a wake-up call for world leaders to shore up the globes capacity to deal with infectious diseases outbreaks. The zoonotic virus, which causes flu-like symptoms and rashes that spread across the body, has been around for decades and is endemic in parts of Africa. Some experts and public health advocates had criticized the earlier decision not to issue the highest alert in late June, saying a declaration at that time would have improved global coordination to contain the virus. Date Lab: They both agree that he is definitely a talker. To date, no confirmed monkeypox-related deaths have been reported and only 8% of patients in Europe have been hospitalized for isolation or treatment.7 However, increased disease severity could occur if the virus reaches more vulnerable populations, such as children, pregnant individuals, or those with immunosuppressive conditions. It is exceptionally important that the existence of a public health emergency of international concern and the intensification of surveillance and control efforts are not used as a means of coercive surveillance or for imposition of measures that would impede the dignity and human rights of the people affected, said Mike Ryan, who leads the WHOs Health Emergencies Program. The decision should help contain the spread of the viral disease, said Josie Golding, head of epidemics and epidemiology at the Wellcome Trust. Preventing the virus from spreading to more vulnerable populations is important to limit illness, prevent death, and avoid further strain on health systems. Ensuring equitable access to vaccines to protect those at highest risk of severe illness is essential. Spain leads the world in confirmed cases, with more than 3,100 infections, according to tracking by the U.S. Centers for Disease Control and Prevention. The WHO labeled the coronavirus pandemic a global crisis early in 2020. WHO officials said the global risk of monkeypox is moderate, but that it is high in Europe, where most of the infections have been recorded in an outbreak that ignited in the spring. I think with public health emergencies its always important to ask very specific questions about what exactly would that allow us to be able do differently than were doing now, and would that make it easier to be able to respond to this outbreak, Jha said. U.S. monkeypox missteps mirrors early coronavirus response, experts say. Public health control must include measures to identify and contain the spread of MPXV within and outside MSM populations. Updated July 22, 2022. And in fact on Thursday, Dutch researchers reported a case in a boy under the age of 10 who had no discernible link to any other infected individuals. To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2022 American Medical Association. On Saturday, the CDC issued a statement supporting the WHOs emergency declaration, as it can serve to galvanize the international community to more quickly and effectively respond to and combat this virus.. Buprenorphine treatment for veterans with opioid use disorder increased as care shifted to telehealth during Covid, study finds, No magic bullet: For drugmakers and the FDA, clinical trials on ultra-rare diseases pose thorny challenges, Four brain-computer interface companies you should watch (other than Neuralink), Researchers tried to calculate the impact of health tech companies. Many infections are not linked to other known cases, which indicates links in transmission chains are not being identified. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. read more. The same committee met just one month ago and declined to declare a public health emergency of international concern, or PHEIC. Colorized transmission electron micrograph of monkeypox virus particles. This is an outbreak that can be stopped with the right strategies in the right groups, Tedros said. EM, Rao Genomic analyses have identified multiple circulating viral strains, indicating several points of entry for the virus into nonendemic countries and undetected viral spread. One of the key issues driving a reassessment was whether cases would spread to other groups, particularly children or others who have been vulnerable to the virus in past outbreaks in endemic countries. The emergency declaration came after a second meeting of the International Health Regulations Emergency Committee, which declined to take the step a month ago. Surveillance is expanding, but considerable heterogeneity in case finding among nonendemic countries impairs understanding of true incidence. Monkeypox virus infection in humans across 16 countries: April-June 2022. Since the International Health Regulations (IHR) were revised in 2005 in the aftermath of SARS, WHO has declared a PHEIC 6 times: for H1N1 influenza, polio, Zika, COVID-19, and Ebola (twice). . On Saturday, the National Coalition of STD Directors urged the Biden administration to follow WHOs lead and declare monkeypox a national public health emergency. High-income countries are already negotiating with manufacturers to procure additional vaccine doses, reminiscent of the COVID-19 pandemic. Accessed July 24, 2022. WHO. On June 22, the CDC announced authorization of 5 commercial laboratories to conduct testing for MPXV and the agency has begun shipping test kits to these companies. The United States has recorded nearly 2,900 cases. , Thornhill The United States has the second-highest tally, at nearly 2,900 cases, with Germany and Britain each reporting more than 2,200 infections. In short, we have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little, WHO Director General Tedros Adhanom Ghebreyesus told reporters Saturday. There was an error saving your display name. Ideally, clinicians should access the same laboratories used for other routine diagnostic services. Beer It could also rally global coordination for a more unified response. Part of that effort may involve ensuring the more equitable distribution of vaccines and treatments, which are in short supply. But it could put pressure on the Biden administration to declare monkeypox a public health emergency, which could result in increased funding and compel states and local authorities to report more data to the CDC.

He said the risk of monkeypox - which spreads via close contact and tends to cause flu-like symptoms and pus-filled skin lesions - was moderate globally, except in the Europe, where the WHO has deemed the risk as high. REUTERS/Dado Ruvic/Illustration. Limited testing for MPXV is obscuring case detection and undermining prevention and control efforts. Nuzzo JB, Borio LL, Gostin LO. Though the committee does not formally vote, a survey of the members revealed that nine thought a PHEIC should not be declared and six supported a declaration. COVID-19 demonstrated the importance of point-of-need testing to ensure rapid test turnaround and timely isolation and contact tracing, and to allow patients to assess their own risks. When the group met in June, the breakdown was 11 against and three for. Please see our commenting policy for details. At-risk individuals (those with a rash who had recent contact with a person with a similar lesion, or close or intimate contact with individuals in a social network experiencing monkeypox, or recent international travel to countries experiencing outbreaks) should receive education on identifying symptoms and seeking care. WHO officials said on Saturday they were exploring the possibility of the virus spreading via new modes of transmission.

Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox. Tedros said the outbreak is spreading rapidly and there is a "clear risk of further international spread.". The PHEIC (pronounced like fake) gives Tedros certain powers, such as the ability to recommend how countries should respond. 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And yet again, like we were for covid, we are again really challenged by the fact that we at the agency have no authority to receive those data, Walensky said. By continuing to use our site, or clicking "Continue," you are agreeing to our, Monkeypox in 2022What Clinicians Need to Know, JeannetteGuarner,MD; Carlosdel Rio,MD; Preeti N.Malani,MD, MSJ, KristinWalter,MD, MS; Preeti N.Malani,MD, MSJ, Global Monkeypox Outbreaks Spur Drug Research for the Neglected Disease. For Ron Rivera, the judgment starts with winning or losing. Thats progress. The WHO label - a "public health emergency of international concern (PHEIC)" - is designed to trigger a coordinated international response and could unlock funding to collaborate on sharing vaccines and treatments. The global health agency was firm in its insistence that this should not happen. Nine and six is very, very close, Tedros said in a news conference called to announce the decision. The viral disease has been spreading chiefly in men who have sex with men in the recent outbreak, outside Africa where it is endemic. "Stigma and discrimination can be as dangerous as any virus," he added. The global health agencys announcement was accompanied by recommendations to bolster a coordinated global monkeypox response designed to intensify surveillance, accelerate research into vaccines and therapeutics, and strengthen infection control in hospitals. et al. Issuing a Public Health Emergency of International Concern enhances coordination and sharing of resources and information among nations. Countries where MPXV has been endemic for decades are highlighting the failure to marshal lifesaving medical resources for outbreaks occurring in the African region. VB. Some will break your heart, others will enlighten you. Stigma and discrimination can be as dangerous as any virus, Tedros said. This represents an important development, but it is not sufficient. Test tubes labeled "Monkeypox virus positive and negative" are seen in this illustration taken May 23, 2022. Countries with production capacity for drugs and vaccines were urged to increase and share output. Low familiarity with monkeypox among individuals and clinicians, false perceptions that infections are limited to MSM populations, and stigma also hamper case detection. Browse an unrivalled portfolio of real-time and historical market data and insights from worldwide sources and experts. And earlier this month, it was announced that nearly 800,000 more doses of monkeypox vaccine could be ready for distribution in the United States by the end of July following a Food and Drug Administration inspection of a Danish vaccine plant and the expected authorization of the facility. Screen for heightened risk individual and entities globally to help uncover hidden risks in business relationships and human networks. At present, the drug should be reserved for individuals in clinical trials or at high risk for severe disseminated disease. The decision means the world is now confronting two viral diseases that have crossed the extraordinary threshold of being declared health emergencies: covid-19 and monkeypox. On July 23, 2022, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, PhD, declared the current monkeypox outbreak a Public Health Emergency of International Concern (PHEIC), overriding the WHO Emergency Committee, which decided 6-9 against recommending a PHEIC.1 That decision was justified, with cases in more than 70 countries, most of which are nonendemic, many with no clear epidemiological links and milder nonspecific clinical presentation. A systematic review estimated the secondary attack rates among unvaccinated household members to be about 8%.5 A longer incubation period ranging from 5 to 21 days provides additional time to intervene after a known exposure to prevent subsequent cases. Updated July 22, 2022.

Accessed July 24, 2022. The information will be posted with your response. WHO recently issued interim guidance for monkeypox vaccines9 and recommended postexposure prophylaxis ideally within 4 days of initial exposure for close contacts, health workers at risk, laboratory personnel working with orthopoxviruses, laboratory staff performing diagnostic testing, and others at risk under national policy. No clear evidence exists of asymptomatic or long-range airborne transmission. Reporting by Jennifer Rigby and Natalie Grover in London, John Revill in Zurich and Timothy Gardner in Washington; Editing by Helen Popper and Daniel Wallis, Bristol Myers drug combo fails to meet main goal in kidney cancer trial, China reports 564 new COVID cases for July 28 vs 626 day earlier, Merck CEO concerned about proposed drug pricing bill hurting innovation, U.S. can conduct 60,000-80,000 monkeypox tests per week, HHS secretary says, Cheap copies of GSK's HIV prevention drug could be ready in 2026, See here for a complete list of exchanges and delays, Declaration is WHO's highest level of alert, Tedros breaks deadlock on advisory committee, Decision welcomed as way to stem disease's spread. Terms of Use| The role of tecovirimat in ameliorating the course of human infection with monkeypox is unknown, and there is risk of MPXV becoming resistant to the drug. All Rights Reserved. "I have decided that the global monkeypox outbreak represents a public health emergency of international concern," WHO Director-General Tedros Adhanom Ghebreyesus said. A doctor administers a dose of the monkeypox vaccine on Saturday in London. S, But in May, public health officials in London reported six cases in people who had not traveled to endemic countries. While the administration has taken steps to address the monkeypox outbreak including accelerating the distribution of vaccines and allocating critical funding for monkeypox research, it quite simply is not enough, David C. Harvey, the groups executive director, said in a statement. CDC. It sent startups into a tizzy. WHO should rapidly develop a well-resourced global action plan including strengthening national surveillance and response, supporting and mobilizing MSM communities, and facilitating global scientific cooperation. More broadly, some experts have expressed concern that it may be too late to try to contain the outbreak and that monkeypox may become endemic in countries worldwide. On Friday, health authorities reported the first two U.S. cases of monkeypox in children. The organization also called on the government to allocate $100 million in emergency funding. The World Health Organization on Saturday declared the unprecedented monkeypox outbreak that has spread around the world a public health emergency, a decision that will empower the agency to take additional measures to try to curb the viruss spread. The Central African Republic and Nigeria two of the countries were monkeypox is endemic have reported five deaths so far in 2022. The monkeypox virus is spread through close contact, mainly through direct exposure to lesions, to contaminated clothing or linens, or through respiratory droplets. The committee remained divided Saturday on whether the outbreak constituted an emergency, with nine members opposed to such a declaration and six in favor, Tedros said. The monkeypox outbreak is largely among men who have sex with men and have multiple sexual partners. The CDC recommends clinicians consider MPXV in any patient with characteristic rashes, which usually manifest as papules, vesicles, or pustules that become firm, deep-seated, and umbilicated over time. Accessibility Statement, Our website uses cookies to enhance your experience. Infected patients may remain contagious until rashes resolve, up to 4 weeks, which could create challenges for self-isolation, especially if individuals lack adequate housing and income. There are more than 16,000 cases globally and according to the Centers for Disease Control, 2,891 cases have been confirmed in the U.S. On Friday, the United States identified its first two monkeypox cases in children. MPXV has features more amenable to containment than SARS-CoV-2 because MPXV transmission occurs via close contact and after symptom onset. Published Online: July 27, 2022. doi:10.1001/jama.2022.12513. Countries with no cases, for instance, were urged to strengthen their surveillance and be prepared to deal with infections if they occur. See here for a complete list of exchanges and delays. Governments must take this more seriously and work together internationally to bring this outbreak under control.. Monkeypox meets all IHR criteria for a PHEIC. Inequitable Access to Vaccines and Therapeutics. An analysis of 528 cases from 16 countries found MPXV DNA in 29 of 32 patients for whom seminal fluid was analyzed,6 suggesting the virus could also be spreading via sexual transmission. Scarce vaccine and antiviral supplies, and inequitable allocation, have impeded national and global responses. The Department of Health and Human Services is in discussions over whether declaring an emergency would help in the response, Ashish Jha, the White House Covid-19 coordinator, said during a media briefing on the U.S. monkeypox response of Friday. It needs coordination and not only coordination but solidarity, he said. With monkeypox cases continuing to rise and spread to more countries, we now face a dual challenge: an endemic disease in Africa that has been neglected for decades, and a novel outbreak affecting marginalized communities. The virus spreads through other forms of skin-to-skin contact and in households through prolonged respiratory spread and the sharing of contaminated items. Commercial and academic diagnostic test developers could augment testing capacity at public health and commercial laboratories by developing new testing technologies, such as point-of-need tests, as well as tests capable of using other specimen types, such as saliva and urine. July 23 (Reuters) - The rapidly spreading monkeypox outbreak represents a global health emergency, the World Health Organization's highest level of alert, WHO Director-General Tedros Adhanom Ghebreyesus said on Saturday. Monkeypox line list cases. The WHO issued a lengthy list of recommendations on Saturday, broken down into four groups: recommendations for countries that have not yet detected a case of monkeypox; those for countries with ongoing human-to-human transmission; those for countries where the virus is endemic in nature; and those for countries with capacity to produce monkeypox vaccine and therapeutics. JYNNEOS is approved specifically for monkeypox; ACAM2000 is licensed for use against smallpox but may be effective in preventing monkeypox. Reporting from the frontiers of health and medicine, You've been selected! Previously, Tedros has typically endorsed expert committee recommendations, but two sources told Reuters earlier on Saturday said he had likely decided to back the highest alert level due to concerns about escalating case rates and a short supply of vaccines and treatments. . 2,891 cases have been confirmed in the U.S. "We cannot afford to keep waiting for diseases to escalate before we intervene," she said. Most recent infections have milder clinical presentations, making it more difficult to identify and interrupt transmission. S, Hine While most reported cases exhibit a rash, some patients have few visible lesions. The pediatric cases, detected this week in an infant and a toddler, are probably the result of household transmission, according to the CDC. Governments must take this more seriously and work together internationally to bring this outbreak under control, Golding said in a statement.