Premature to declare monkeypox a global health emergency, says expert

India’s top epidemiologist Dr Raman Gangakhedkar has called the World Health Organisation’s (WHO) decision to declare monkeypox as a public health emergency of international concern as “premature”.

“I don’t believe that we have sufficient reasons to say that the spread of monkeypox is a public health emergency. I think the WHO wants to be ahead of time this time since the coronavirus pandemic. But I feel its premature to announce monkeypox as a public health emergency because it may not have any bearing on the public health infrastructure of countries,” Dr Gangakhedkar told India Today.

Dr Raman Gangakhedkar, who is the former head scientist of epidemiology and communicable diseases at the Indian Council of Medical Research, believes that emerging evidence from African nations, where the monkeypox outbreak is endemic, is not enough to suggest that it could lead to a global health emergency.

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Though the International Health Regulations Emergency Committee of WHO didn’t reach a consensus, Director-General Tedros Adhanom Ghebreyesus declared monkeypox as a public health emergency and said men and LGBTQ community are more at risk of contracting the virus.

“For the moment, this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners,” the WHO chief said during a media briefing in Geneva. But WHO hasn’t classified monkeypox as a classical sexually transmitted disease only.

“While close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes. Studies are needed to better understand this risk,” said WHO on its website. But, experts believe that evidence to point this out is low.

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“If majority of people are in the category of MSM (men having sex with men) and if we don’t know what the rate of transmission to women is and if the count of bisexual men is three times more within the MSM community, and if it is an STD, then it does have the potential to affect the mainstream population,” Dr Raman told India Today.

“It [monkeypox] is a self-limiting infection, it doesn’t kill you, doesn’t lead to hospitalisation. The only issue is the stigma that, if infected, it is an indirect disclosure of their sexual identity.”

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Dr Raman also said that masks are of no use to counter the monkeypox threat. Starting surveillance among sex workers is key. A random sampling of people having lesions could be done to try and find out if there is a community outbreak of monkeypox, he said.

On May 13, 2022, WHO was notified of two laboratory confirmed cases and one probable case of monkeypox, from the same household, in the United Kingdom. On May 15, four additional laboratories reported confirmed cases amongst Sexual Health Services attendees presenting with a vesicular rash illness in men who have sex with men (MSM).

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