It is possible to eliminate the monkeypox outbreak in Europe, World Health Organization officials said Tuesday, highlighting evidence that the number of cases is slowing in a handful of countries. (REUTERS)

In many European countries, including France, Germany, Portugal, Spain and Great Britain, there are encouraging signs of a continued week-on-week decline in the number of cases, as well as a slowdown in some parts of the United States, despite the scarcity of vaccine supplies.

“We believe we can eliminate the ongoing human-to-human transmission of monkeypox in the (European) region,” said Hans Kluge, WHO Regional Director for Europe. “To move towards elimination… we urgently need to step up our efforts.”

Bavarian Nordic’s monkeypox vaccine rollout has been impacted by a limited stock of the injection, which is also approved to prevent smallpox, although regulators are taking steps to expand existing stocks.

US, European and UK regulators have backed a change in how the vaccine is administered by injecting a smaller amount of the injection intradermally, increasing the doses that can be used from one vial fivefold.

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In addition to the tight supply of vaccines, given the time it takes for the vaccine to be up and running, the significant factors behind the delay appear to be detection, leading patients to self-isolate earlier, and behavioral changes, Catherine Smallwood WHO/Europe senior emergency officer and monkeypox incident manager said in a news conference.

“We have pretty good anecdotal evidence that people — especially men who have sex with men who are in certain risk groups — are much more informed about the disease.”

Since early May, more than 47,600 confirmed cases have been reported in 90 countries where monkeypox is not endemic. The WHO has declared the outbreak a global health emergency.

COVID, POLICY

Meanwhile, cases of COVID-19 and other respiratory viruses are also expected to increase this fall and winter, as is typically the case in the colder months, WHO officials said.

For example, the preventive measures that kept seasonal flu at bay in 2021 and 2020 are no longer in effect — so it may not be a typical flu season this year, Smallwood said.

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Separately, polio, a deadly disease that used to paralyze tens of thousands of children a year, is spreading for the first time in decades in London, New York and Jerusalem, prompting catch-up vaccination campaigns.

The cases appear to be related to so-called vaccine-derived polio, which rarely results from the use of an oral polio vaccine containing an attenuated live virus.

After children are vaccinated, they excrete the virus in their feces for several weeks. In insufficiently vaccinated communities, this can lead to a spread of the disease, which can mutate to a harmful version of the virus.

While countries like Britain and the United States no longer use this live vaccine, others do — mainly to stop outbreaks — allowing polio to spread worldwide.

The evidence suggests that the polio virus detected in all three sites appears to be genetically linked, said WHO/Europe’s vaccination expert, Siddhartha Datta.

But what remains to be explored is whether there are any links around the cases, he said.

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