Declaring Monkeypox Global Health Emergency A Premature Move: Indian Expert

By OB Bureau On Jul 25, 2022

4th monkeypox case India — Pic courtesy Reuters

New Delhi: A day after the World Health Organisation (WHO) declared the monkeypox outbreak as a public health emergency, an Indian expert said that it is premature.

The disease poses low severity with a rare threat of increased spread worldwide, said Raman R Gangakhedkar, former head scientist of epidemiology and communicable diseases at the Indian Council of Medical Research.

“This is a self-limiting disease. If people get infected, they may get lesions but chances of fatality are extremely rare. From my viewpoint, declaring monkeypox a public health emergency is a premature move. I don’t think the conditions are strong enough for declaring this disease a public health emergency,” Gangakhedkar told Moneycontrol on Monday.

Gangakhedkar said the declaration of a disease as an emergency can’t be done just on the basis of detection in different parts of the world. It requires an overall assessment of transmission and mortality threat. The disease’s symptoms are similar to smallpox but less severe.

“Monkeypox has now been detected in Europe and the US and several other countries, but if you see other conditions like mortality, the spread potential and the infected pool of the population, all these remain very, very low,” he told Moneycontrol.

On the majority of infections in the current outbreak in men who have sex with men, especially those who have multiple partners, Gangakhedkar said associating monkeypox with any particular sexuality or gender identity would be incorrect. Notably, he was a key figure working on HIV prevention and control strategies in India

“We must be careful about linking monkeypox with a particular sexuality because then it may lead to stigmatisation. This disease can’t be termed as a disease for any particular sexuality or a gender identity, as further studies are needed. Also, how this disease transmits in a couple setting is still unknown,” he said. “Any form of association of monkeypox to a sexuality will increase the chances of people not coming forward fearing disclosure of their sexual identity,” he told the publication.

The challenges ahead

According to the epidemiologist, the challenges of tracing the disease in India are because of the incubation period. The incubation period, the interval from infection to the onset of symptoms of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days, according to WHO.

“The blisters which you see in the monkeypox images of a patient actually appear very late and that is why it’s a challenge to detect cases early. A patient can continue to transmit the infection unless the symptoms aggravate,” Gangakhedkar told Moneycontrol.

The former ICMR head of epidemiology said the elderly are likely to be less prone to monkeypox because they will be protected if they’ve taken the smallpox vaccine.

Gangakhedkar also said gene analysis has shown that the monkeypox virus has mutated since the previous outbreak, but their implications for disease severity or transmissibility are still unclear and need more study.