The World Health Organization said Sunday that 780 laboratory-confirmed monkeypox cases had been reported to it from 27 non-endemic countries, while maintaining that the global risk level was moderate.
The WHO said the 780 figure, for cases from May 13 to Thursday, was probably an underestimate due to limited epidemiological and laboratory information.
“It is highly likely that other countries will identify cases and there will be further spread of the virus,” the UN health agency added.
Few hospitalisations have been reported, apart from patients being isolated.
The WHO listed the non-endemic countries reporting the most cases as Britain (207), Spain (156), Portugal (138), Canada (58) and Germany (57).
Besides Europe and North America, cases have also been reported — in single figures — in Argentina, Australia, Morocco and the United Arab Emirates.
One case of monkeypox in a non-endemic country is considered an outbreak.
“Some countries are reporting that new generations of cases are no longer appearing only among known contacts of previously confirmed cases, suggesting that chains of transmission are being missed through undetected circulation of the virus,” the WHO said.
“Although the current risk to human health and for the general public remains low, the public health risk could become high if this virus exploits the opportunity to establish itself in non-endemic countries as a widespread human pathogen,” it said in a disease outbreak update.
“WHO assesses the risk at the global level as moderate considering this is the first time that many monkeypox cases and clusters are reported concurrently in non-endemic and endemic countries.”
– Atypical cases –
Most reported cases so far have been presented through sexual health or other health services and have mainly involved men who have sex with men, said the WHO.
The organisation said many cases were not presenting with the classical clinical picture for monkeypox: some have described having pustules appear before symptoms such as fever, and having lesions at different stages of development — both of which are atypical.
The WHO said there had been no deaths associated with outbreaks in non-endemic countries, but cases and deaths continue to be reported from endemic areas.
The WHO listed the endemic states as Cameroon, the Central African Republic, Congo-Brazzaville, the Democratic Republic of the Congo, Liberia, Nigeria, Sierra Leone, Gabon and Ivory Coast, plus Ghana where it has been identified in animals only.
From the first seven of those countries, 66 deaths were reported in the first five months of 2022.
Last week the WHO convened virtually more than 500 experts and over 2,000 participants to discuss monkeypox knowledge gaps and research priorities.
Experts stressed the need for clinical studies of vaccines and treatments to better understand their effectiveness, and called for faster research into the disease epidemiology and transmission.
Prime Minister Boris Johnson pledged on Tuesday to deliver an “infrastructure revolution” to help Britain build its way out of the economic devastation of the coronavirus outbreak.
But his optimistic message, thin on detail and reminiscent of last year’s election pledges, was overshadowed by the first local lockdown since an easing of measures was announced, because of a spike in cases in the city of Leicester.
Shops which only reopened two weeks ago after being shut for more than three months were forced to close again, and travel was restricted to the city in the English East Midlands.
Johnson, however, tried to harness the can-do spirit that US president Franklin D. Roosevelt adopted when he introduced a “New Deal” for tackling the Great Depression 90 years ago.
“This is a programme for jobs, jobs, jobs because it’s by building, building, building… that we will get the jobs this nation needs,” he said after touring a construction site in Dudley, 40 miles (64 kilometres) away in the West Midlands.
“It sounds like a New Deal, and all I can say is, if that is so then that is how it is meant to sound and to be because that is what the times demand.”
He promised £1 billion ($1.2 billion) for school repairs and a further £4 billion for “shovel-ready” projects from road maintenance to public transport in what he said was a new “infrastructure revolution” that will also build new homes.
– ‘Neglected and unloved’ –
Johnson’s message was thin on detail, particularly on jobs, and in part repackaged broad-brush promises made by his Conservative party before December’s general election.
He pledged again to spread the wealth more fairly from London to economically struggling regions that traditionally supported the opposition Labour party.
“Too many parts of this country have felt left behind, neglected, unloved,” he said.
That pledge helped Johnson secure a record 80-seat parliamentary majority that enabled him in January to take Britain out of the European Union after repeated delays.
But Britain is now dealing with Europe’s deadliest virus outbreak and the worst economic contraction among the Group of Seven (G7) leading industrialised states.
Johnson’s once soaring approval ratings slipped into negative territory in a YouGov poll this month.
And opposition leaders said the £5 billion announced on Tuesday was simply bringing forward some of the money promised in a spending plan his government had already unveiled for the coming five years.
“The government’s refusal to genuinely emulate Roosevelt’s boldness is a missed opportunity,” the Labour-supporting New Statesman magazine wrote.
The Financial Times said Roosevelt’s New Deal “spawned mega-projects such as the Hoover Dam” but Johnson’s list of priorities included repairing a bridge near Birmingham.
– Local lockdown –
Johnson’s rambunctious style and oratory flourishes have appealed to Britons tired of ceaseless battles over Brexit that dragged on for nearly four years.
The 56-year-old former journalist remains popular in his party and has commanding control of Britain’s political agenda.
But he has faced criticism for Britain having the world’s third-highest virus death toll in the outbreak — now officially at 43,575 — and one of Europe’s longest lockdowns.
Labour leader Keir Starmer accused Johnson on Monday of falling “asleep at the wheel” — and the Leicester lockdown will be a further test of his strategy to fight the disease.
It will mean the city’s pubs and restaurants will not fully reopen along with those across the rest on England from this weekend.
Johnson had expected the reopening, along with swathes of the tourism and cultural sectors, to help kick-start the country’s stalled economy.
Revised official data released on Tuesday indicated the country has suffered its biggest quarterly contraction for more than 40 years, as the pandemic slashed activity.
Gross domestic product shrank 2.2 percent in the first quarter compared to the three previous months, with second quarter data likely to be even worse.
Recent data showed UK economic activity crashed by a record 20.4 percent in April, and there are widespread predictions of a deep, long-lasting recession.
A raft of EU nations reopened their borders to fellow Europeans on Monday after months of coronavirus curbs, but China was battling a new outbreak that has stoked fears of a second wave.
As caseloads have declined in recent weeks across many parts of Europe, governments have been keen to ease painful lockdowns that have saved lives but devastated economies and wearied confined populations.
Belgium, France, Germany, Greece and Ukraine were among those lifting border restrictions on Monday, while shops and outdoor attractions in England were set to welcome their first customers since March and in Paris cafes and restaurants were allowed to fully reopen.
“We’re desperate about tourists, we need them and we want them. If we don’t have the people, how will we survive,” says Michalis Drosos, who works in a souvenir shop in Fira, capital of the Greek island of Santorini.
However, the pandemic is gathering pace in Latin America, and Iran and India have reported worrying increases in deaths and infections — adding to concern over challenges the world will face in the long fight against COVID-19.
China, where the virus emerged late last year, was the first country to implement extreme restrictions on movement early this year, forcing local transmission down to near-zero as the crisis hammered the rest of the world.
Britain has shuttered its embassy in North Korea and all its diplomats have left the country, its ambassador said Thursday as Pyongyang maintains strict entry controls to try to prevent a coronavirus outbreak.
The North has closed its borders and insists it has not had a single case of the virus that emerged in neighbouring China late last year and has since swept the world.
The closure was a temporary move and came because Pyongyang’s “restrictions on entry to the country have made it impossible to rotate our staff and sustain the operation of the Embassy”, a Foreign Office spokesperson said.
Ambassador Colin Crooks tweeted: “The #BritishEmbassy in #Pyongyang closed temporarily on 27 May 2020 and all diplomatic staff have left the #DPRK for the time being.”
The Swedish embassy — which remains open — replied that they would miss him and his team “and hope they can return soon”.
The specialist news site NK News said the British diplomats crossed the border into China overland on Wednesday.
Britain intends to maintain diplomatic relations with the North “and will seek to re-establish our presence in Pyongyang as soon as it is possible to do so”, the Foreign Office said.
Early in the outbreak, Pyongyang imposed tight quarantine restrictions on all resident foreigners, including a virtual lockdown in their own premises that Russian ambassador Alexander Matsegora described as “morally crushing”.
Those rules were later eased and dozens of diplomats and other foreigners were allowed to leave the country in March, when several missions in Pyongyang closed, among them the German embassy and France’s representative office — Paris does not maintain full diplomatic relations with the North.
Hundreds of foreigners remain in the country.
Analysts say that the North is unlikely to have avoided infections, and that its ramshackle health system could struggle to cope with a major outbreak.
Japan’s prime minister on Thursday lifted a state of emergency imposed due to the coronavirus for the majority of the country but kept it in place for top cities Tokyo and Osaka.
After fears the virus could explode in Japan, new infections have come down sharply, enabling the government to end the measure in 39 out of 47 prefectures before it was due to expire on May 31.
But with new cases still emerging daily in Tokyo, Osaka and the northern island of Hokkaido, Shinzo Abe told reporters in a televised news conference that the state of emergency would be kept in place for those regions.
“If possible, before May 31, we would like to lift the state of emergency for the other regions as well,” he said.
“It’s going to be a long road ahead,” Abe warned, asking residents to continue to refrain from going out and visiting other regions.
He also urged Japan’s 126 million people to remain alert to prevent a possible fresh outbreak.
“If each of us fails to exercise full vigilance, the future in two weeks time is unpredictable. A second declaration of a state of emergency is possible,” he warned.
– ‘Cluster-focused approach’ –
Japan’s state of emergency falls far short of the toughest measures seen in parts of Europe and the United States.
It allows local governors to urge people to stay at home and call on businesses to remain shut.
But officials cannot compel citizens to comply and there are no punishments for those who fail to do so.
Schools in much of the country closed down even before the emergency was declared on April 7 in Tokyo and six other regions, before being expanded nationwide.
Japan’s virus outbreak remains small compared with those seen in parts of Europe and the United States, with a little over 16,000 confirmed infections recorded and 687 deaths.
New cases have dropped recently, with 55 fresh infections confirmed Wednesday nationwide, and just 10 in Tokyo.
Japan recorded its first coronavirus infection in mid-January and came under early pressure with a mass outbreak on the Diamond Princess cruise ship docked off the city of Yokohama.
Despite so far avoiding the devastating tolls seen in places such as Italy and New York, there have been persistent fears that Japan’s healthcare system could be quickly overwhelmed by a sudden spike in infections.
Japan has also come under fire for a relatively low level of testing.
However, Abe stressed that Japan’s strategy of keeping track of clusters had worked in the regions where the state of emergency was being lifted.
“As for the 39 prefectures, we were able to contain (the spread of infections) to the level at which it can be prevented with a thorough cluster-focused approach,” Abe told reporters.
Borno State has recorded its first Lassa fever death, in this year’s outbreak.
The Commissioner For Health, Dr Salisu Kwaya-Bura confirmed the death to journalists at a news conference on Thursday.
According to Kwaya-Bura, three other suspected cases are still under investigation and can only be confirmed as Lassa Fever when the results come back.
The cases were detected at the University of Maiduguri Teaching Hospital on Thursday, which led to a temporary closure of the Accident and Emergency Unit of the hospital as part of measures to manage the situation.
Reacting to the development, the government has advised people of the state not to panic but imbibe hygienic and preventive practices that would deny carrier rodents a breeding ground and consequently, curtail further spread of the virus.
The World Health Organization (W.H.O) said Friday that the Ebola outbreak in the Democratic Republic of Congo does not qualify as an international threat, despite the spread of the virus to neighbouring Uganda carried by an infected family.
The closely-watched decision followed advice from WHO’s emergency committee, which only meets to review the world’s most severe outbreaks.
The head of the UN health agency Tedros Adhanom Ghebreyesus, who is in DRC reviewing the Ebola response, said he accepted the committee’s advice.
“Although the outbreak does not at this time pose a global health threat, I want to emphasise that for the affected families and communities, this outbreak is very much an emergency,” Tedros told reporters.
He also appealed for more funds to combat the ongoing Ebola flare-up, which has recorded more than 2,000 cases, including over 1,400 deaths, since it emerged in eastern DRC in August.
Friday’s emergency committee meeting was prompted by confirmation this week of Ebola deaths in a western Uganda region that borders DRC.
The W.H.O panel has used the label “public health emergency of international concern” only four times previously.
Those included the H1N1, or swine flu, pandemic of 2009, the spread of poliovirus in 2014, the Ebola epidemic that devastated parts of West Africa from 2014 to 2016 and the surge of the Zika virus in 2016.
This is the third time the WHO panel has considered — but held off — making the emergency call for this DRC outbreak, which has been concentrated in the restive provinces of Ituri and North Kivu.
The head of the committee, Preben Aavitsland, told reporters in Geneva that current Ebola crisis was “an extraordinary event, with risk of international spread, (but) the ongoing response would not be enhanced” by an emergency declaration.
Uganda Cases Confirmed
The Uganda cases stem from a Congolese woman, married to a Ugandan, who travelled with her mother, three children and their nanny to DRC to care for her ill father, who later died of Ebola.
WHO said 12 members of the family who attended the burial in Congo were placed in isolation in the DRC, but six “escaped and crossed over to Uganda” on June 9.
The next day, a five-year-old boy was admitted to hospital in Bwera, a border town, vomiting blood before he died. Tests confirmed he had Ebola and the family was placed in an isolation ward.
His three-year-old brother was also confirmed to have Ebola, as was their grandmother, who died late Wednesday.
Speaking from western Uganda’s Kasese district, a senior Red Cross official told AFP that “the biggest challenge” was ensuring robust monitoring along the porous border with DRC.
“People are continuing to come into the country and not passing through the areas where screening is taking place because screening has been instituted along certain points of entry but not all the points,” said Josephine Okwera, the director of health and social services for the Ugandan Red Cross.
Health officials had initially hoped that they could contain the outbreak with help from a new vaccine, which has now been given to more than 130,000 people in DRC.
But chronic violence and militia activity in the affected eastern DRC provinces, as well as hostility to medical teams among some in the region have hampered the response.
WHO has also accused political leaders in Ituri and North Kivu of manipulating the Ebola issue to turn people against health workers.
Ebola spreads among humans through close contact with the blood, body fluids, secretions or organs of an infected person.
The current outbreak is the worst on record after an epidemic that struck mainly in Liberia, Guinea and Sierra Leone between 2014-2016, leaving more than 11,300 people dead.