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WHO declares mpox a global public health emergency


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WHO declares mpox a global public health emergency for second time in two years

 
Updated Aug. 14, 2024 11:52 a.m. MDT
Published Aug. 14, 2024 11:28 a.m. MDT
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The World Health Organization on Wednesday declared mpox a global public health emergency for the second time in two years, following an outbreak of the viral infection in the Democratic Republic of Congo that has spread to neighbouring countries.

Mpox can spread through close contact. Usually mild, it is fatal in rare cases. It causes flu-like symptoms and pus-filled lesions on the body.

Determining a disease outbreak as a "public health emergency of international concern" or PHEIC — the WHO's highest level of alert — can accelerate research, funding and international public health measures and co-operation to contain a disease.

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The outbreak in Congo began with the spread of an endemic strain, known as clade I. But a new variant, clade Ib, appears to spread more easily through routine close contact, including sexual contact. It has spread from Congo to neighboring countries, including Burundi, Kenya, Rwanda and Uganda, triggering the action from the WHO.

"It's clear that a coordinated international response is essential to stop these outbreaks and save lives," said WHO Director-General Tedros Adhanom Ghebreyesus.

Earlier this week, Africa's top public health body declared an mpox emergency for the continent after warning that the viral infection was spreading at an alarming rate.

More than 17,000 suspected mpox cases and 517 deaths have been reported on the African continent so far this year, a 160 per cent increase in cases compared to the same period last year, the Africa Centres for Disease Control and Prevention said. A total of 13 countries have reported cases.

A different form of the mpox virus — clade IIb - spread globally in 2022, largely through sexual contact among men who have sex with men. This prompted the WHO to declare a public health emergency then, which it ended 10 months later.

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And in Canada:

Toronto Public Health warns of spike in mpox following downtown festivals

As of July 31, Toronto has recorded 93 cases of mpox in 2024, up from 21 during the same period last year.

Updated 4 hrs ago
Aug. 13, 2024
2 min read
 

Mpox particles, red, are shown in a colourized electron microscope handout image.

National Institute of Allergy and Infectious Diseases
 
 

Toronto Public Health is urging eligible residents to get vaccinated against mpox amid a sharp rise in cases in the city.

Officials say reported cases of mpox — formerly known as monkeypox — increased in late June and July and that the spike has followed major events and festivals, including those celebrating Pride Month.

As of July 31, Toronto has recorded 93 cases of mpox in 2024. That compares to 21 cases reported during the same period last year.

 

Dr. Rita Shahin, an associate medical officer of health at Toronto Public Health, said Tuesday’s alert “is to reach people who might be at risk, who haven’t yet been immunized.”

Of the 93 cases reported in Toronto this year, almost three-quarters have not received any doses of the vaccine, she said. Provincewide, only about 35 per cent of those who received one dose of vaccine have received both doses of the two-dose series, according to the most-recent data from Public Health Ontario.

Dr. Darrell Tan, a clinician-scientist in the division of infectious diseases at St. Michael’s Hospital, a part of Unity Health Toronto, said there has been a noticeable rise in mpox cases in recent weeks.

“Just today, for example, I got four referrals (of patients with mpox),” he said. “It’s definitely on the rise and very concerning.”

Mpox causes symptoms similar to smallpox but is generally less severe. Of the cases recorded in Toronto in 2024, Shahin said one required hospitalization but has since recovered.

On Tuesday, the African CDC declared that continent’s ongoing mpox outbreak a public health emergency; on Wednesday, a World Health Organization emergency committee will meet to determine whether to reinstate a global public health emergency. A previous emergency declaration for mpox by the WHO was made in 2022.

Mpox cases have been spreading in at least 13 countries in Africa, with nearly 3,000 confirmed cases and more than 500 deaths this year, according to the African CDC.

Shahin said the cases in Africa are a different strain of the virus and that it would be very unlikely to see that strain imported into Canada. In 2024, few Toronto cases of mpox have been linked to travel, she said.

The virus spreads between people through contact with infected lesions, skin blisters, body fluids or respiratory secretions, and can also be transmitted through contact with contaminated materials such as clothes or bedding, Toronto Public Health said.

It said mpox is currently spreading mostly between people who have close, intimate or sexual contact with a person who has the virus. The health unit said that gay, bisexual and other men who have sex with men are most affected.

Shahin said the reported increase in infections following Toronto’s summer festivals is not surprising, as these events increase opportunities to meet new individuals and are times when people potentially meet more sexual partners.

“It’s a reminder to people: ‘If you are at risk, come out and get the vaccine.’”

Shahin said mpox cases in Toronto are concentrated in the downtown core and that travel is not a significant factor among current cases.

She said the health unit is working with community partners, including the Gay Men’s Sexual Health Alliance, to raise awareness about the importance of improving access to the vaccine and getting eligible residents vaccinated.

Tan pointed to data showing mpox cases among people who have not had any doses of the vaccine.

 
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The federal government’s webpage dedicated to sharing information about mpox showed that there were 1,515 confirmed cases in Canada as of September 2023, with nine provinces or territories that reported cases. There were 45 hospitalizations as of August 2023. No deaths were reported. However, the data does not include the most recent outbreak.

Mpox (monkeypox): Outbreak update - Canada.ca

image.thumb.png.291707825dbf43636a5ee80ed010f4e6.png

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27 minutes ago, deicer said:

Isn't this following the same spread of covid?  Prepare to get jabbed again...

 

I would expect the voluntary uptake to be much less and any hint of "mandate" to meet fierce resistance.

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1 hour ago, Seeker said:

I would expect the voluntary uptake to be much less and any hint of "mandate" to meet fierce resistance.

Yes, until they need hospitalization.

It will follow the same pattern as last time.

Darwinism.

 

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and if you are going to Africa

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Travellers advised to consider mpox vaccine

1 day ago
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Michelle Roberts
Digital health editor, BBC News
Reuters Mpox rashReuters
 
Mpox causes flu-like symptoms and a distinctive rash

Travellers should consider getting vaccinated against mpox if they will be visting affected areas in Africa, new advice says.

The European Centre for Disease Prevention and Control (ECDC) has updated its recommendations in response to outbreaks of a new strain of the virus. Other continents, including Europe, can expect some cases too, it says.

ECDC says the risk of it spreading everywhere is low, despite the World Health Organization recently declaring the mpox situation a global emergency.

The disease - formerly known as monkeypox - can be passed on by close contact with anyone with the infection.

 

Those who have been vaccinated against mpox in the past might only need one-top up dose, rather than two shots.

Booster vaccine doses are typically recommended every two to 10 years if a person remains at continued risk for exposure.

Mpox has killed at least 450 people in the DRC in recent months, linked to a new type or Clade called 1b.

 

What's known about mpox

Mpox can be passed on from person to person through:

  • any close physical contact with mpox blisters or scabs (including during sexual contact, kissing, cuddling or holding hands)
  • touching clothing, bedding or towels used by someone with mpox
  • the coughs or sneezes of a person with mpox when they're close to you

It causes flu-like symptoms, skin lesions and can be fatal for some.

 

Experts say there is still a lot to learn about 1b, but it may be spreading more easily, causing more serious disease.

Pamela Rendi-Wagner from the ECDC said: "As a result of the rapid spread of this outbreak in Africa, ECDC has increasd the level of risk for the general population in the EU/EEA and travellers to affected areas. Due to the close links between Europe and Africa we must be prepared for more imported Clade 1 cases."

Currently, there are no cases of Clade 1b mpox confirmed in the UK but experts say cases can spread if international action is not taken.

A case of mpox has also been detected in Sweden after a person became infected during a stay in an area of Africa where the disease is spreading.

The ECDC recommends that public health authorities plan and prepare for quick detection of any more cases that may reach Europe.

A previous mpox public health emergency, declared in 2022, was caused by a different, milder strain called Clade 2.

Despite having effective vaccines against mpox, too few doses are currently getting to where they are needed most.

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A doctor shows a sore on a patient´s hand caused by mpox at the Arzobispo Loayza hospital in Lima, Peru, Tuesday, Aug. 16, 2022.
A doctor shows a sore on a patient´s hand caused by mpox at the Arzobispo Loayza hospital in Lima, Peru, Tuesday, Aug. 16, 2022.© AP Photo/Martin Mejia

 

The World Health Organization declared mpox a global health emergency
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Mpox has been declared a global public health emergency and while immunologists say more research is needed to determine how contagious it is, cases are being reported across communities and the virus is impacting not only adults but children as well.

Known as clade 1b mpox, the strain has been spreading across much of Africa since being first detected in the Kamituga region of the Democratic Republic of the Congo. Last week, a case was reported in Sweden in someone who had travelled to an affected African country, the first diagnosed outside of the continent.

 

David Kelvin, a professor in Dalhousie University's department of microbiology and immunology and one of the lead researchers studying the Kamituga mpox strain, told Global News that what is "worrisome" is who it has impacted compared to 2022.

"Clade 2b started in a very defined social group and it moved through that social group," he said. "Whereas this clade 1 is not defined to a single social group, it's throughout the entire community."

Clade 2b was the strain that caused a public health emergency in 2022, with concerns emerging at the time that it could stigmatize the LGBTQ2 community, as gay, bisexual and other men who have sex with men (MSM) between the ages of 18 and 49 were disproportionately affected.

Kelvin said the initial study showed some of the first cases being from heterosexual contact, however since discovery last year, he said a number of cases have been found in children as well.

 

Dr. Don Vinh, an infectious diseases specialist at McGill University Health Centre, told Global News that much like in 2022, caution should be taken on categorizing this latest form of mpox.

"As wrong as it is to say that the 2022 outbreak was a gay disease, which was completely wrong, that same logic would say that the clade 1b outbreak should be a straight disease, which of course is equally wrong," Vinh said.

According to the Public Health Agency of Canada, evidence suggests that Clade I — of which clade 1b is a variant — is more transmissible and could potentially cause more severe disease than Clade 2. According to the U.S. Centers for Disease Control and Prevention, some outbreaks have killed up to 10 per cent of those who became sick, though recent outbreaks have had lower rates.

Earlier this year, the city of Bukavu, which is nearby Kamituga, had about six cases. That's now grown to about 4,000.

 

The primary method of mpox spread is close contact, typically skin-to-skin, with an infected person and the rash or scabs brought on by the virus. This can include sexual activities, but kissing and other social activities that are from close contact can also spread the virus.

Kelvin told Global News one reported case involved a hairdresser who was infected and who spread the virus when in close contact with clients while cutting their hair.

 

 
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That close contact is also a worry with children as schools can be relatively crowded, including in regions of Africa where the virus is spreading.

"Children in close contact would be touching each other, spreading saliva, things like this," he said.

Contact with saliva, respiratory secretions like snot and mucus, or bodily fluid or lesions around the genital area can also spread the virus. As well, the CDC notes that prolonged face-to-face interactions like talking or breathing in close proximity can also spread mpox, though it says this is due to respiratory droplets, not airborne spread.

 

More on Canada

Video: Warnings from doctors as Mpox Declared Global Health Emergency

Vinh said that while sexual contact may be one part of the spread, there could also be spread among household contacts, and in addition to that, there could even be cases of animal to human transmission — the CDC defines mpox as a zoonotic disease.

"So the combination of potentially sexual networks, non-sexual close contact networks and potentially even animal exposures, has us scratching our heads as to what the main drivers of transmission are," he said.

People should also be wary of indirect contact, in which surfaces that have come in contact with an infected person and not been adequately disinfected could potentially infect someone else, Vinh said.

 

The Clade 1 and clade 1b variant has not been detected in Canada as of Aug. 19, but there are still precautions that people can take.

The first is that should you decide to travel to one of the affected areas of Africa where mpox is endemic, stay away from crowded areas and use good public health measures like handwashing.

If you have no plans to travel, Vinh and Kelvin note the risk is low for infection but both say people eligible for the mpox vaccine should get it.

Kelvin said those at higher risk, such as due to immunodeficiencies or comorbidities, are among those he would recommend get the vaccine.

But Kelvin added that while there are indications this strain and its variant of mpox are more transmissible and thus potentially more contagious, more still needs to be done.

"We still need a lot of studies in order to handle this," Kelvin said. "And with the surprising nature in how rapidly it can expand within a geographical location and then move to other geographical locations, we should probably be vigilant about seeing cases pop up."

 with files from Global News' Ella MacDonald and Katie Dangerfield

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Ah, here we go again, Covid worked pretty well now let's see what we can do with Mpox.

Now we just need the WEF to step in saying we need to send millions/billions to Africa and other low-income countries to solve this impending doom.

They will keep trying the Cloward Piven Strategy until they have ruined every first world country.

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