Drawing attention to the recent surge in cases of Monkeypox in areas previously not known to occur, the Duke-NUS Centre for Outbreak Preparedness held a global health webinar on the “Global status on Monkeypox and how Asia can be prepared” on 15 September 2022 in Singapore.
The WHO declared Monkeypox as a Public Health Emergency of International Concern (PHEIC) on 23 July 2022. Soon thereafter, cases of Monkeypox rose to over 50000 with the present level of detection seen in over 90 countries, where it was not previously seen.
A panel discussion comprising experts in infectious diseases and global health discussed the epidemiology, latest updates in therapeutics and vaccines for Monkeypox. They also deliberated on ways in which Asia could bebetter prepared to face this outbreak through effective utilization of global and regional public health systems.
The Incident Manager plus Programme Area Manager (Infectious Hazard Management), Health Emergency Programme for WHO’s Regional Office for Southeast Asia (SEARO) on behalf of the WHO, was the keynote speaker and a panelist at the webinar. Other panelists were from the National Centre for Infectious Diseases, Singapore, Nigeria Centre for Disease Control, DSO National Laboratories and Lee Kong Chian School of Medicine of the Nanyang Technological University (NTU), Singapore.
Global trends
The experts opined that though globally cases had been increasing since 22 May 2022, a decline was observed since early September 2022. Nearly 99% of reported cases over the four weeks prior to the date of the webinar were geographically distributed in Europe and Americas regions, while nearly 10 countries accounted for about 88% of total cases. Since 01 Jan 2022, cases that were reported to WHO included 103 (1 new) Member States / territories across all six WHO regions. As of 12 September 2022, nearly 57607 laboratory confirmed cases (4602 new) including 22 deaths (4 new) were reported and the number of new weekly cases had decreased by 8.5% compared to the previous week.
The disease was reported mainly among young males in the age group of 18–44 years and the proportional morbidity of child cases was very low at 0.6%. Of all reported types of transmission, a sexual encounter was predominant at 91.3% and of all settings in which cases were likely to have been exposed, the most common was a party setting with sexual contacts.
Understanding the nature of infection and its spread
The focus of countries where Monkeypox was observed entailed stopping human-to-human spread and protecting vulnerable groups. Key strategies included enhanced disease surveillance, contact tracing, risk communication and community engagement (RCCM) and implementation of risk reduction measures. Another important point that was emphasized was that although the current outbreak was disproportionately affecting gay and/or bisexual men and other men who have sex with men, Monkeypox happens to be no more a “gay disease” than it is an “African disease” and to that extent, it can affect anyone.
The WHO advised countries to focus on improving their understanding of how the virus is spread by sticking to facts and avoiding speculation. Also, by reinforcing, supporting and amplifying advice targeting affected communities and challenging stigma and discrimination and misinformation – including stigma related to men who have sex with men. The Organization is encouraging more groups, especially faith leaders to become advocates by joining calls for equitable urgent access to vaccines, antivirals and other services, listening to people’s experiences and partnering with affected communities.
Next steps
Importantly, there are also increasing efforts to consider lessons learned from HIV, COVID-19 and other disease responses. Further, as part of RCCM, teams across countries are working with festival and Pride organizers, launching Google ad campaigns and messaging through EPI-WIN networks to reach correct information to health workers, youth, and religious leaders. Further, infodemic monitoring which was refined during the COVID-19 pandemic is being used for Monkeypox too and is helping shape general advisories.