As monkeypox cases rise, European countries urged to take extra steps

Europe’s disease control body has urged countries to prepare contact tracing, vaccines, treatments and diagnostics as ways to combat an increasing number of monkeypox cases.

In the U.K. a further 36 cases have been identified, bringing the total number of monkeypox infections to 56, according to the U.K. Health Security Agency on Monday. In the EU, 67 cases have been identified since May 15 in nine countries: Austria, Belgium, France, Germany, Italy, the Netherlands, Portugal, Spain and Sweden.

While the numbers remain relatively low, the European Center for Disease Prevention and Control (ECDC) recommended on Monday that countries focus on quick identification, management, contact-tracing and reporting of new monkeypox cases.

Countries should update their contact-tracing mechanisms and diagnostic capacity for orthopoxviruses (which includes monkeypox), the ECDC said in a statement, and review the availability of smallpox vaccines, antivirals and personal protective equipment for health professionals.

While the virus, which causes a rash, fever and malaise, usually disappears after about three weeks, if can be serious in certain groups of people, including young children, pregnant women and those with weaker immune systems.

Stella Kyriakides, the European commissioner for health and food safety, said she was “concerned” about the increasing number of monkeypox cases in the EU and globally, adding that “while currently the likelihood of spread in the broader population is low, the situation is evolving.”

Meanwhile, Europe’s infectious disease heavyweights are joining forces to ensure the region is as prepared as it can be in case of rapidly rising numbers of cases. The Commission is in talks with EU countries, alongside the Health Emergency Response and Preparedness Authority (HERA), the ECDC and the European Medicines Agency to ensure countries can effectively respond to any outbreaks. And the EU Health Security Committee will discuss monkeypox at a meeting Tuesday.

Vaccine talks

Among the key concerns are vaccines and treatments.

As part of HERA’s mandate, the EU’s newest authority “is on stand-by to work on procurement” of medical countermeasures, DG SANTE spokesperson Stefan De Keersmaecker said in an emailed statement.

That includes tackling challenges relating to the availability of and distribution of antivirals and vaccines, and to increase stockpiling capacity to avoid shortages and bottlenecks in deployment, he said.

Bavarian Nordic, the only manufacturer of a monkeypox vaccine available in the EU, told POLITICO that it has received calls from “many, many countries” wishing to purchase its Imvanex shot. The shot is approved in the U.S. and Canada to protect against monkeypox and smallpox, but so far only authorized for smallpox in the EU.

“We’re talking to a large number of countries that are putting in procurement requests to us as the problem is just spreading and increasing day by day,” the firm’s Rolf Sass Sørensen told POLITICO.

He said the company was in talks with HERA, the World Health Organization “and every other regulatory agency on the planet.”

“Data exists” on the “prevention of monkeypox in animals,” a spokesperson for the European Medicines Agency said in an emailed statement, adding that data also shows that “smallpox vaccines can also prevent monkeypox in humans.”

In the U.K., 1,000 doses of Imvanex have already been administered. Public health authorities are immunizing high-risk contacts of people who have been infected and the country has a 3,500 doses left.

Just one drug is also licensed to treat monkeypox in the EU, the EMA said. The medicine, Tecovirimat from SIGA, can treat smallpox, monkeypox and cowpox — three infections caused by viruses belonging to the orthopoxviruses family. It can also treat complications following vaccination against smallpox.

The majority of cases in the EU and U.K. have so far been identified among men who have sex with men.

“Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact a sexual health service if they have any symptoms,” said Susan Hopkins, chief medical adviser at the UKHSA.

Keep away from pets

The ECDC recommends that close contacts of monkeypox cases should self-monitor for the development of symptoms for 21 days after the last exposure. The U.K. takes a more stringent approach, advising people to isolate for three weeks.

Meanwhile, the ECDC has a warning about pets.

“If human-to-animal transmission occurs, and the virus spreads in an animal population, there is a risk that the disease could become endemic in Europe,” the ECDC said in its statement.

The infectious disease authority urged both veterinary and public health authorities to collaborate to carefully manage pets exposed to the virus, to prevent transmissions into wildlife.

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