Monkeypox declared global health emergency: How worried should we be?

The rapidly spreading monkeypox outbreak constitutes a global health emergency, the World Health Organisation's highest alert level, WHO director-general Tedros Adhanom Ghebreyesus declared on Saturday.

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

But reports of a handful of cases in the United Kingdom in early May signalled that the outbreak had moved into Europe.

How dangerous is it?

Monkeypox is a virus than typically causes mild symptoms including fever, aches and pus-filled skin lesions. People tend to recover within 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 spreads primarily via intimate skin-to-skin contact, usually with someone who has an active rash, as well as via contact with contaminated clothes or bedding.

It is not as easily transmitted as the SARS-CoV-2 virus that spurred the Covid-19 pandemic.

“Covid is spread by respiratory route and is highly infectious. This doesn’t appear to be the case with the monkeypox,” said Dr Martin Hirsch of Massachusetts General Hospital.

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

Why is the emergency?

Health officials from several countries had urged the WHO to label monkeypox a public health emergency of international concern due to the quick escalation of cases and concerns it may become endemic in more countries.

The emergency declaration aims to spur global action and collaboration on everything from testing to the production and distribution of vaccines and treatments.

The fatality rate in preceding monkeypox outbreaks in Africa of the strain currently spreading has been around 1%, but so far this outbreak appears to be less lethal in the non-endemic countries, many of which have stronger healthcare infrastructure.

Scientists are trying to determine what caused the initial spate of cases and whether 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 that years of financial neglect has left sexual health clinics — who are on the frontline of the current monkeypox response — ill-prepared to curb further spread.

Protective measures

An antiviral agent called tecovirimat —branded as TPOXX and made by SIGA Technologies — has US and EU approval for smallpox, while its European approval also includes monkeypox and cowpox.