The WHO Declaration of Monkeypox as a Global Public Health Emergency

Nuzzo, Jennifer B.; Borio, Luciana; Gostin, Lawrence O.

doi:10.1001/jama.2022.12513

Cited by 178 publications

(154 citation statements)

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“…On 23 July 2022, the World Health Organization (WHO) Director-General declared the ongoing human monkeypox (HMPX) multi-country outbreak as a public health emergency of international concern (PHEIC) [ 1 , 2 ]. This statement came in light of monkeypox virus (MPXV) rapid spread to many non-endemic countries for the first time, with an evident risk of further expansion internationally [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

et al. 2022

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The ongoing multi-country human monkeypox (HMPX) outbreak was declared as a public health emergency of international concern. Considering the key role of healthcare workers (HCWs) in mitigating the HMPX outbreak, we aimed to assess their level of knowledge and their confidence in diagnosis and management of the disease, besides the assessment of their attitude towards emerging virus infections from a conspiracy point of view. An online survey was distributed among HCWs in Jordan, a Middle Eastern country, during May–July 2022 using a questionnaire published in a previous study among university students in health schools in Jordan. The study sample comprised 606 HCWs, with about two-thirds being either physicians (n = 204, 33.7%) or nurses (n = 190, 31.4%). Four out of the 11 HMPX knowledge items had <50% correct responses with only 33.3% of the study respondents having previous knowledge that vaccination is available to prevent HMPX. A majority of study respondents (n = 356, 58.7%) strongly agreed, agreed or somewhat agreed that the spread of HMPX is related to a role of male homosexuals. Confidence in the ability of diagnosis based on the available monkeypox virus diagnostic tests was reported by 50.2% of the respondents, while the confidence levels were lower for the ability to manage (38.9%) and to diagnose (38.0%) HMPX cases based on their current level of knowledge and skills. Higher confidence levels for HMPX diagnosis and management were found among physicians compared to nurses. The endorsement of conspiracy beliefs about virus emergence was associated with lower HMPX knowledge, the belief in the role of male homosexuals in HMPX spread, and with lower diagnosis and management confidence levels. The current study highlighted the gaps in knowledge regarding HMPX among HCWs in Jordan as well as the lack of confidence to diagnose and manage cases among physicians and nurses. Raising the awareness about the disease is needed urgently considering the rapid escalation in the number of cases worldwide with reported cases in the Middle East. The attitude towards male homosexuals’ role in HMPX spread necessitates proper intervention measures to prevent stigma and discrimination among this risk group. The adoption of conspiratorial beliefs regarding virus emergence was widely prevalent and this issue needs to be addressed with proper and accurate knowledge considering its potential harmful impact.

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Section: Introductionmentioning

confidence: 99%

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

et al. 2022

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“…12 Most recent infections also documented cases without experiencing prodromal symptoms such as fever or lethargy, which sets this outbreak different from the classic MPXV presentation and may delay diagnosis and isolation of those who are infected. 12 The disease has a CFR ranging from 0 to 11 % among the general population in the monkeypox endemic regions but has been higher among young children. 8 Although the current monkeypox outbreak is mostly associated with the lower CFR WA clade, increased disease severity could occur among individuals with weakened immune systems.…”

Section: Clinical Features and Disease Severity Of Human Monkeypoxmentioning

confidence: 98%

“…12 While the majority of patients are presented with rash, some cases exhibit fewer clinically apparent lesions. 12 Most recent infections also documented cases without experiencing prodromal symptoms such as fever or lethargy, which sets this outbreak different from the classic MPXV presentation and may delay diagnosis and isolation of those who are infected. 12 The disease has a CFR ranging from 0 to 11 % among the general population in the monkeypox endemic regions but has been higher among young children.…”

Section: Clinical Features and Disease Severity Of Human Monkeypoxmentioning

confidence: 99%

“…The WHO has declared a PHEIC six times since the International Health Regulations (IHR) were revised in 2005 following the SARS outbreak: for H1N1 influenza, polio, Zika, COVID-19, and twice for Ebola. 12 Currently, WHO has three active PHEIC globally, namely COVID-19, polio, and monkeypox. 24 The multi-country outbreak of monkeypox meets all the three criteria defining a PHEIC under the International Health Regulations-(i) being an extraordinary event (since nontravel-related cases have never been identified outside endemic regions of Central or Western Africa), (ii) a public health risk to other States (MPXV has spread to more than 70 countries in 6 WHO regions), and (iii) a potential need to require a coordinated international response (MPXV cases are escalating globally).…”

Section: Conclusion and Global Health Implicationsmentioning

confidence: 99%

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Monkeypox in Pregnancy: Susceptibility, Maternal and Fetal Outcomes, and One Health Concept

et al. 2022

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An overlooked endemic zoonosis in Africa, monkeypox infection, which has spread to multiple non-endemic countries since early May 2022, was declared a Public Health Emergency of International Concern by the World Health Organization on July 23, 2022. As of August 8, 2022, over 28,000 confirmed and probable monkeypox cases were reported globally, including 6 deaths from the African continent and 4 deaths from the non-endemic regions. Although the current outbreak mostly belongs to the West African clade, which has a lower-case fatality ratio of <1%, there is limited data among immune-weakened individuals infected with monkeypox. It is still unknown if pregnant people are more susceptible to monkeypox. In addition, it is unclear whether having monkeypox increases the risk of birth defects. This commentary addresses reported cases of monkeypox infection in pregnancy and the possible maternal and fetal outcomes, including congenital monkeypox, miscarriage, or stillbirth. Factors behind the escalating global monkeypox outbreak, as well as the prevention and control of monkeypox via the One Health approach, are discussed to shed light on curbing the continuous emergence of monkeypox. Copyright © 2022 Najimudeen et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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“…Due to the increasing number of MPXV cases, WHO declared it a Public Health Emergency of International Concern (PHEIC) on July 23, 2022 [19]. As of August 26, 2022, more than 46, 679 confirmed cases (Figure 1C), of which the majority correspond to cases in the Americas and Europe [20].…”

Section: Introductionmentioning

confidence: 99%

Viral Adaptation, Vulnerable Health Care Systems and Health Inequities: Monkeypox as an emerging threat in the Global Health Agenda

Paulino-Ramírez

Freitas

2022

IAJMH

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Due to the increasing number of monkeypox virus (MPXV) cases, WHO declared it a Public Health Emergency of International Concern (PHEIC). The transmission of monkeypox has been described during this outbreak associated with close sexual contact through the skin with infectious lesions. It is not very clear whether this virus is better adapting to human-human transmission, we do not know if the case fatality rate is being lower during the current global spread due to genetic changes in the virus or as an effect of a better understanding of the actual number of mild cases of infections. The emergence of pathogens, particularly the spillover of zoonotic viruses, is not a totally unpredictable phenomenon, the current monkeypox multi-country outbreak was preceded by a progressive increase in the number of cases in recent decades and changes in the epidemiological profile in affected areas of Africa. We must resume the conversation with civil society organizations, bring a more sex-positive health discourse through a healthy and stigma-free scientific dialogue.

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The WHO Declaration of Monkeypox as a Global Public Health Emergency

Abstract: This Viewpoint examines the ongoing monkeypox outbreak and the recent decision by the director-general of the World Health Organization to declare a Public Health Emergency of International Concern.

Cited by 178 publications

References 4 publications

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

Monkeypox in Pregnancy: Susceptibility, Maternal and Fetal Outcomes, and One Health Concept

Viral Adaptation, Vulnerable Health Care Systems and Health Inequities: Monkeypox as an emerging threat in the Global Health Agenda

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