World Health Organization Declares New Mpox Outbreak a Global Public Health Emergency

The World Health Organization (WHO) has declared that mpox (formerly called monkeypox) is a global public health emergency, according to multiple sources. The viral disease is spreading rapidly in African countries, making it the second time within 3 years that an mpox epidemic was designated as a global emergency by WHO.^1,2

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In July 2022, an mpox outbreak affected nearly 100,000 people—the majority of which were gay and bisexual men—in 116 different countries, killing about 200 individuals. The threat now, according to The New York Times, is more significant, with the Democratic Republic of Congo (DRC) alone reporting more than 14,000 mpox cases and 524 deaths. Those who are most at risk include women and children under the age of 15. The current outbreak has spread through 13 African countries, a few of which had no previously reported cases of mpox. The current viral type has not surfaced outside Africa, and there are over 17,500 presumed and confirmed mpox cases.^1,2

“The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighboring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” said Tedros Adhanom Ghebreyesus, MSc, PhD, director general of WHO.¹

Because WHO designated mpox a public health emergency of international concern, member countries are urged to begin preparing for the virus’s appearance and share vaccines, treatments, and other key resources with underserved countries. Experts note that until recently, mpox spread primarily through the consumption of contaminated meat or close contact with animal or people who were infected. The current version of mpox that has been circulating in Congo is more significant, with a death rate of approximately 3% compared to the 0.2% death rate during the 2022 outbreak.^1,2

Because of the rising numbers, 2 mpox vaccines—LC16 (KM Biologics) and Jynneos (Bavarian Nordic)— were approved in Congo under emergency use listings; however, there is currently no immunization plan established. Additionally, there is only a small fraction of vaccines available (15,000 Jynneos doses were donated) but it is not enough for the 10 million doses needed to sufficiently control the outbreak. As of August 2022, these vaccines were not available in pharmacies.^1-3

“It’s in the interests of the countries, of the continent, and of the world to get our arms around this and stop transmission as soon as we can,” said Nicole Lurie, MD, MSPH, executive director for preparedness and response at the nonprofit Coalition for Epidemic Preparedness Innovations, which finances vaccine development.¹

The CDC has reportedly urged health care providers and the public in the US to be alert for the virus. Symptoms of the infection can include fever, respiratory symptoms, muscle aches, swollen lymph nodes, as well as rashes on the hands, feet, chest, mouth, or genitals. Additionally, it is believed that mpox can spread through skin-to-skin contact via open or oozing wounds related to mpox infection.^1,3

In a Pharmacy Times interview, Michael Ganio, PharmD, MS, BCPS, FASHP, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, discussed the pharmacist’s role during the 2022 mpox public health emergency. He echoed that pharmacists as well as patients should be aware of the symptoms and review resources—such as materials available on the CDC’s website—to be better prepared. Ganio also emphasized that sexual intercourse among men who have sex with men itself is not a primary risk factor, and that the virus can be spread via skin-to-skin contact as well, meaning that women and children may also be infected.³

Ganio explained that the pharmacist’s role primarily lies in education, and that in order to educate patients properly, they must know and understand the virus themselves. He noted that the COVID-19 pandemic helped the preparation and understanding of public health emergencies such as mpox. Pharmacists and pharmacy technicians have since been the driving force of vaccination efforts and in improving the accessibility of vaccines. Ganio expressed hope that leveraging what was learned during the COVID-19 pandemic can be applied to mpox outbreaks.³

“…hopefully with [mpox], we get a little bit more streamlined testing, whether it's through more widespread labs or eventually pharmacies, who were doing tests where they could send it off to have a PCR test done. At some point, we'll likely see point of care tests for [mpox] and that will streamline that diagnosis straight into treatment. And I think pharmacists will be a part of that too, moving forward,” said Ganio during the interview.³

References

1. Mandavilli, A. W.H.O. Declares Global Emergency Over New Mpox Outbreak. The New York Times. August 14, 2024. Accessed August 15, 2024. https://www.nytimes.com/2024/08/14/health/mpox-who-emergency-africa.html

2. United Nations. WHO declares mpox virus a public health emergency of international concern. News release. August 14, 2024. Accessed August 15, 2024. https://news.un.org/en/story/2024/08/1153176

3. Antrim, A. Pharmacists Play Key Role in Counseling Patients About Monkeypox. Pharmacy Times. August 5, 2022. Accessed August 15, 2024. https://www.pharmacytimes.com/view/pharmacists-play-key-role-in-counseling-patients-about-monkeypox