EXPLANATION-How worried should we be about the global monkeypox health emergency?

(Updates throughout)

By Natalie Grover and Michael Erman

LONDON, July 26 (Reuters) – The fast-spreading monkeypox outbreak is a global health emergency, the World Health Organization’s highest alert level, the WHO director-general said on Saturday. Tedros Adhanom Ghebreyesus.

First identified in monkeys, the virus is transmitted primarily through close contact with an infected person. Until this year, the viral disease has rarely spread outside of Africa where it is endemic.

But reports of a handful of cases in the UK in early May signaled the outbreak had moved to Europe.

Cases have since climbed to more than 16,000 in more than 75 countries. Five deaths, all in Africa, have been reported so far.


Monkeypox is a virus that usually causes mild symptoms, including fever, body aches, and pus-filled skin lesions. People tend to recover in two to four weeks, according to the WHO.

Anyone can spread the virus, but the current outbreak outside of Africa is concentrated almost exclusively among men who have sex with men.

Monkeypox is primarily spread through intimate skin-to-skin contact, usually with someone who has an active rash, as well as through contact with contaminated clothing or bedding. It does not spread as easily as the SARS-CoV-2 virus that triggered the COVID-19 pandemic.

“COVID spreads through the respiratory route and is highly contagious. This does not appear to be the case with monkeypox,” said Dr. Martin Hirsch of Massachusetts General Hospital.

The risk of monkeypox is moderate worldwide, except in Europe, where the WHO has rated the risk as high.


Health officials in several countries had urged the WHO to label monkeypox a public health emergency of international concern due to rapidly escalating cases and fears it could become endemic in other countries.

The emergency declaration aims to spur global action and collaboration on everything from testing to producing and distributing vaccines and treatments.

The death rate in previous outbreaks of monkeypox in Africa of the strain now spreading was around 1%, but so far this outbreak appears to be less deadly in non-endemic countries, many of which have a stronger health care infrastructure.

Scientists are trying to determine what caused the initial surge of cases and if anything about the virus has changed. Increased global travel as well as climate change have generally accelerated the emergence and spread of viruses, experts say.

Infectious disease experts say years of financial neglect have left sexual health clinics – which are on the front lines of the current response to monkeypox – ill-prepared to curb the spread.


Health officials say people should avoid close personal contact with anyone who has an illness who has a distinctive rash or who is unwell. People who suspect they have monkeypox should self-isolate and seek medical attention.

Health officials have also offered monkeypox vaccines to people at high risk and those who have recently been in close contact with an infected person.

Danish company Bavarian Nordic

An older vaccine, currently made by Emergent Biosolutions, is called ACAM2000, but its adoption has been limited due to a severe side effect warning.

Bavarian Nordic says it can produce 30 million doses of its vaccines – including monkeypox – each year, and has brought in a US-based contract manufacturer to boost monkeypox vaccine capacity.


Symptoms of monkeypox often go away on their own within a few weeks. Patients may receive additional fluids and additional treatment for secondary bacterial infections.

An antiviral agent called tecovirimat – branded TPOXX and manufactured by SIGA Technologies – is approved in the US and EU for smallpox, while its European approval also includes monkeypox and cowpox. (Reporting by Natalie Grover in London and Michael Erman in New Jersey; Editing by Michele Gershberg, William Maclean)