Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr...ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
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The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will were abundant. This rapidity was also due to the f...act that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
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Monkeypox is an emerging viral zoonosis with symptoms similar to those observed in smallpox patients, although less severe. Since the global eradication of smallpox in 1980, monkeypox has emerged as the most important orthopoxvirus in humans. The Advisory Committee on Variola Virus Research (ACVVR) ...which meets annually to oversee smallpox research has highlighted the importance of diagnostics that could distinguish between variola and other strains of orthopoxviruses, including monkeypox virus. The ACVVR encourages the positive effects of current smallpox research on all orthopoxviruses, specifically monkeypox, such as the development of diagnostic tools.
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Monkeypox virus is an orthopoxvirus that causes human monkeypox, a viral disease with symptoms similar to smallpox, including fever and rash. Following the worldwide eradication of smallpox in 1980, monkeypox emerged as the most significant orthopoxvirus infection in humans. Cases are most often rep...orted from rural areas of Central and West African countries, particularly in regions close to tropical rainforest where people may have contact with infected animals. Someone can become infected through direct contact with respiratory droplets of another person who has monkeypox in the home or in a health facility, or with contaminated materials such as bedding. Although these are the main modes of person-to-person transmission, monkeypox outbreaks tend to occur in small clusters of a few cases without leading to widespread community transmission. For this reason, outbreaks can be easily controlled when responded to rapidly. On several occasions, monkeypox has been reported in other regions due to importation by travelers or infected animals. This course provides a general introduction to the disease through a video and accompanying downloadable presentation that can be reviewed at your own pace. It is intended for health personnel responsible for prevention and control of monkeypox, and for the general public.
The content and scope of this course on monkeypox have been tailored for outbreaks in African countries where the disease is endemic. The course material was last updated in 2020 and may not reflect most recent WHO guidance issued for the multi-country outbreak in 2022.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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Mpox is a zoonotic disease caused by a double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family. The disease presents with symptoms similar to smallpox but with a lesser severity. It was first discovered in 1958 when two outbreaks of a poxlike disease occurred in co...lonies of monkeys kept for research, hence the name ‘mpox. The first human case of mpox was recorded in 1970 in the Democratic Republic of the Congo (DRC), which has subsequently spread to other central and western African countries. There are two known clades of the virus: clade I and clade II. Clade I, which is most frequently reported from countries in Central Africa, tends to be more severe than clade II. Cameroon is the only country known to harbour both clades.
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Neonatal tetanus (NT), a severe newborn illness from the toxigenic strains of Clostridium tetani, persists in middle- and low-income countries due to non-sterile childbirth practices. Unlike smallpox and polio, tetanus cannot be eradicated: Clostridium tetani spores exist in the environment, and ani...mal reservoirs. However, elimination as a public health issue is achievable through widespread tetanus vaccination, clean deliveries, and proper umbilical cord care. The goal of eliminating maternal and neonatal tetanus (MNT) as a public health problem is considered met when all municipalities in a country have an annual incidence rate of NT of less than 1 case per 1000 live births. The Region of the Americas achieved the maternal and neonatal tetanus elimination (MNTE) target in 2017 when elimination was validated in the Republic of Haiti. Yet maintaining this progress requires continued efforts. High vaccination coverage, booster doses in countries lacking them, hygienic practices, and strong maternal and child health services are key. The Pan American Health Organization’s (PAHO) integrated maternal and neonatal immunization platform further strengthens this fight against early childhood diseases.
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Monkeypox is a viral zoonotic disease, caused by monkeypox virus, recognized as the most important orthopoxvirus infection after the eradication of smallpox.
This course offers public health officers and health workers in-depth information to understand the epidemiology, modes of transmission, clin...ical presentation, diagnostics, and treatment of monkeypox, as well as the strategies needed for effective prevention and outbreak investigation and response.
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The purpose of this document is to inform the public about biological and chemical hazards and thereby prepare the population for an immediate response in the event of an incident until public health support is provided.
The agents reported here are: Anthrax, Botulism, Haemorrhagic Fever,
...Smallpox, the Plague, Tularaemia, Chlorine, Cyanide, Lewisite, Mustard Gas,
Ricin, Sarin, Soman, Tabun and VX. This list is not exhaustive and no doubt
other dangerous types could be produced. They have been selected as they are the most often mentioned threats. This information has been prepared with the public in mind, and thus much of the medical terminology has been removed and replaced with every day language.
Also available in Arabic: http://www.who.int/csr/delibepidemics/biochem_threatsAR.pdf?ua=1
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The goal of the global outbreak response for monkeypox is to stop human-to-human transmission of monkeypox, with a priority focus on communities at high risk of exposure which may differ according to context, and to effectively use strong public health measures to prevent onward spread of the diseas...e. Judicious use of vaccines can support this response. This interim guidance, developed with the advice and support of the Strategic Advisory Group of Experts (SAGE) Working Group on smallpox and monkeypox vaccines, provides the first WHO recommendations on vaccines and immunization for monkeypox. Key points follow.
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Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated eff...icacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies.
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Interim Assessement Report
The EMA review was started by the Agency’s Committee for Medicinal Products for Human Use (CHMP) to support decision-making by health authorities. This first interim report includes information on seven experimental medicines intended for the treatment of people infecte...d with the Ebola virus:
BCX4430 (Biocryst);
Brincidofovir (Chimerix);
Favipiravir (Fujifilm Corporation/Toyama);
TKM-100802 (Tekmira);
AVI-7537 (Sarepta);
ZMapp (Leafbio Inc.);
Anti-Ebola F(ab’)2 (Fab’entech).
The amount of information available for the seven treatments is highly variable. For some compounds there is no data from use in human subjects available. A small number of treatments have been administered to patients in the current Ebola outbreak as compassionate use. Finally, there are also medicines included in this review that have already been studied in humans, albeit for the treatment of other viral diseases.
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The intent of these guidelines is to develop a holistic, coordinated, proactive and technology driven strategy for management of biological disasters through a culture of prevention, mitigation and preparedness to generate a prompt and effective response in the event of an emergency. Th...e document contains comprehensive guidelines for preparedness activities, biosafety and biosecurity measures, capacity development, specialised health care and laboratory facilities, strengthening of the existing legislative/
regulatory framework, mental health support, response, rehabilitation and recovery, etc. It specifically lays down the approach for implementation of the guidelines by the central ministries/departments, states, districts and other stakeholders, in a time bound manner.
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This publication is part of WHO 75th anniversary and aims to capture key successes in public health globally and in Namibia. It includes contributory messages from the Head of State, Prime Minister and the Minister of Health and Social Services.
Any individual that meets the suspected case definition of monkeypox should be offered testing in appropriately equipped laboratories by staff trained in the relevant technical and safety procedures. Confirmation of monkeypox virus infection is based on nucleic acid amplification testing (NAAT), usi...ng real-time or conventional polymerase chain reaction (PCR), for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing. The recommended specimen type for laboratory confirmation of monkeypox is skin lesion material, including swabs of lesion surface and/or exudate, roofs from more than one lesion, or lesion crusts.
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Where are the outbreaks? What is monkeypox? Recongnizing monkeypox and more. An update on the monkeypox outbreak including protection, diagnosis, treatment.
Cases of monkeypox (MPX) acquired in the EU have recently been reported in nine EU Member States (Austria, Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the Netherlands).
Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact ...with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse
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19 August 2022. A monkeypox case investigation form (CIF) has been designed as a tool for Member States and researchers to conduct in-depth epidemiological investigation of suspected, probable and confirmed cases of monkeypox. This form allows to collect data prospectively or retrospectively for bot...h cases and their contacts. The full form is meant to serve as a tool for in-country use and the data are not required to be reported to WHO.
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