The World Health Organization (WHO) announced that it will continue to classify mpox (monkeypox) as a Public Health Emergency of International Concern (PHEIC) due to a continuous rise in cases, particularly in West Africa and the Democratic Republic of the Congo (DRC). The decision followed the fourth meeting of the WHO's International Health Regulations (IHR) Emergency Committee, during which the committee noted the ongoing increase in cases and operational challenges in responding to the outbreak.

WHO Director-General Tedros Adhanom Ghebreyesus announced the continuation of the emergency status after being advised by the emergency committee, citing the increase in cases and the probability of undetected infections. "The rising levels of monkeypox still meet the criteria for a public health emergency of international concern as stipulated in the International Health Regulations," said Dr. Tedros.

The IHR Emergency Committee recognized progress in response capacity in certain countries but informed the Director-General that the mpox event continues to constitute a PHEIC due to the ongoing increase in cases, including recently in West Africa, and the likely continuation of undetected transmission in some countries beyond the African continent. The committee noted a recent surge in mpox cases in West Africa and expressed concern over persistent operational difficulties in surveillance and testing.

Since the beginning of 2024, over 37,000 confirmed mpox cases and 125 deaths have been reported to the WHO by 25 countries. The DRC accounts for over 8,000 confirmed cases and 22 deaths, representing 60% of global cases and 40% of deaths. Uganda has reported nearly 5,000 cases and 28 deaths, Burundi close to a thousand cases with no deaths, and Sierra Leone has seen a continuous increase with more than 2,600 cases, including over 600 new infections in the most recent week.

The WHO highlighted persistent operational challenges in responding to the mpox outbreak, including a lack of funding, which makes it difficult to prioritize interventions and necessitates ongoing international support. "We need strategic and targeted vaccination. And we need all partners and donors to support the global strategic plan for mpox preparedness and response by providing the $147 million needed," requested Dr. Tedros.

The current alert by the WHO for mpox responds to the rapid expansion in Africa of a new variant, clade Ib, which is spreading through sexual transmission and is different from the one that caused another outbreak in 2022. Mpox has two subtypes, clade 1 and clade 2. The virus, long endemic in Central Africa, crossed borders in May 2022 when clade 2 spread worldwide, affecting mainly men who have sex with men.

"Since the previous meeting of the committee in February, seven other countries have reported outbreaks for the first time: Albania, Ethiopia, Malawi, North Macedonia, South Sudan, Tanzania, and Togo," noted Dr. Tedros. This spread underscores the committee's concern about the likely continuation of undetected transmission in some countries beyond the African continent.

Mpox, caused by a virus of the same family as smallpox, primarily manifests as a high fever and the appearance of skin lesions such as pustules and causes severe flu-like symptoms. In addition to confirmed cases, the DRC continues to report between 2,000 and 3,000 suspected cases each week, particularly in areas difficult to access due to conflict.

As the outbreak continues, the WHO and international health authorities are urging nations to remain vigilant. The potential for undetected transmission and the challenges posed by limited resources highlight the importance of a coordinated global response to prevent further spread of the virus.

Produced with the assistance of a news-analysis system.