WHO declares global health emergency over monkeypox outbreak - Reuters

• Declaration is WHO's highest level of alert
• Tedros breaks deadlock on advisory committee
• Decision welcomed as way to stem disease's spread

July 23 (Reuters) - The rapidly spreading monkeypox outbreak represents a global health emergency, the World Health Organization's highest level of alert, WHO Director-General Tedros Adhanom Ghebreyesus said on Saturday.

The WHO label - a "public health emergency of international concern (PHEIC)" - is designed to trigger a coordinated international response and could unlock funding to collaborate on sharing vaccines and treatments.

Members of an expert committee that met on Thursday to discuss the potential recommendation were split on the decision, with nine members against and six in favour of the declaration, prompting Tedros himself to break the deadlock, he told reporters.

"Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners," Tedros told a media briefing in Geneva. read more

"Stigma and discrimination can be as dangerous as any virus," he added.

He said the risk of monkeypox - which spreads via close contact and tends to cause flu-like symptoms and pus-filled skin lesions - was moderate globally, except in the Europe, where the WHO has deemed the risk as high. read more

Previously, Tedros has typically endorsed expert committee recommendations, but the two sources told Reuters earlier on Saturday said he had likely decided to back the highest alert level due to concerns about escalating case rates and a short supply of vaccines and treatments.

So far this year, there have been more than 16,000 cases of monkeypox in more than 75 countries, and five deaths in Africa.

The viral disease has been spreading chiefly in men who have sex with men in the recent outbreak, outside Africa where it is endemic.

Health experts welcomed the WHO's decision to issue the PHEIC declaration, which until now had only been applied to the coronavirus pandemic and ongoing efforts to eradicate polio.

Test tubes labeled "Monkeypox virus positive and negative" are seen in this illustration taken May 23, 2022. REUTERS/Dado Ruvic/Illustration/File Photo

"The right result is clear – not declaring an emergency at this point would be a historic missed opportunity," said Lawrence Gostin, a professor at Georgetown Law in Washington, D.C., calling the decision politically brave.

The decision should help contain the spread of the viral disease, said Josie Golding, head of epidemics and epidemiology at the Wellcome Trust.

"We cannot afford to keep waiting for diseases to escalate before we intervene," she said.

JUNE MEETING

The WHO and national governments have been facing intense pressure from scientists and public health experts to take more action on monkeypox.

Cases of the viral disease have ballooned since the committee first met at the end of June, when there were only about 3,000 cases.

At the time, the expert group agreed to reconsider their position on the emergency declaration if the outbreak escalated.

One of the key issues driving a reassessment was whether cases would spread to other groups, particularly children or others who have been vulnerable to the virus in past outbreaks in endemic countries.

On Friday, the United States identified its first two monkeypox cases in children. read more

WHO officials said on Saturday they were exploring the possibility of the virus spreading via new modes of transmission.

Reporting by Jennifer Rigby and Natalie Grover in London and John Revill in Zurich Editing by Helen Popper

Our Standards: The Thomson Reuters Trust Principles.

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WHO chief: Monkeypox now a global emergency - USA TODAY

U.S. confirms first two cases of monkeypox in children — one case is in California - CBS News

Health officials have confirmed the first two U.S. cases of monkeypox in children, the Centers for Disease Control and Prevention announced Friday. 

Both cases are "likely the result of household transmission" and "had no contact with each other," the agency said in a statement. 

One is a toddler who lives in California and the other is in an infant who is not a resident of the U.S. and was "transiting through" the Washington, D.C. area when the test was done.

"We became aware of these cases just this week, and we've been working with the jurisdictions to understand more about these cases," the CDC's Jennifer McQuiston told reporters on Friday.

CDC Director Dr. Rochelle Walensky first disclosed news of the cases at a virtual event with The Washington Post on Friday, saying that both children "are doing well." 

Children, especially those under 8 years old, are among those the Centers for Disease Control and Prevention warns are at "especially increased risk" for severe monkeypox disease. 

Last week, CDC officials told reporters that at that point, they were only aware of monkeypox cases in adults. But the agency acknowledged that state and local health authorities had only relayed additional demographic information to them for less than half of all tallied cases.

The agency is also now aware of at least eight cases in people who identify as cisgender women, McQuiston said. Most cases so far have been among men who have sex with men. 

"There is no evidence to date that we're seeing this virus spread outside of those populations to any degree, and I think that the primary drivers for this infection in the U.S. remain in the gay, bisexual, and men who have sex with men communities right now," McQuiston added.

As of Friday, the CDC had tallied a total of 2,891 cases of monkeypox in the U.S. across 44 states, as well as the District of Columbia and Puerto Rico. 

While the virus has led to many adult patients enduring pain and sometimes severe complications, many of the cases have so far resolved after several weeks without intensive treatment or hospitalization.

But health authorities warn that monkeypox may pose greater dangers to young children.

In countries that have seen an endemic spread of monkeypox before 2022, the World Health Organization warns that young children have died at higher rates from the disease.

During the current outbreak, a handful of countries have also spotted cases of monkeypox in children under 18 years old. 

The CDC's European counterpart tallied at least five cases on Wednesday. Authorities in Spain's capital announced on Wednesday that they had detected a case in a 7-month-old baby who likely caught the virus from their parents. 

In the Netherlands, doctors reported they were unable to identify how a boy under 10 years old had caught the virus. No secondary cases were identified from the infection.

As is the case with adults, medicines like the antiviral tecovirimat or TPOXX are available for treating monkeypox cases in children and have been safely given to children in the past. However, the CDC says no clinical studies have specifically investigated use of the antiviral in children.

The agency said that both children are being treated with tecovirimat.

For vaccination, Food and Drug Administration has only formally approved the Jynneos monkeypox shots for use in adults. However, federal health officials have said the Biden administration has worked out arrangements to be able to offer doses for children in the current outbreak. 

In June, CDC officials said that they had offered doses of the Jynneos vaccine to at least one pediatric patient. This week, a hospital in New Jersey announced they had facilitated vaccination of a 3-year-old who had been exposed to a positive case. 

CDC scientists have estimated that monkeypox symptoms during the current outbreak take a little over a week on average to develop, following exposure to an infected person. 

During that incubation period, the CDC says taking the two-dose monkeypox vaccine can still reduce the severity of the disease or even prevent it from developing. 

"CDC recommends that the vaccine be given within 4 days from the date of exposure in order to prevent onset of the disease. If given between 4–14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease," the agency says in its guidance.

A spokesperson for the Food and Drug Administration declined to confirm how many requests the agency has granted for use of the vaccine in children. 

Bavarian Nordic plans to collect data based on the CDC's use of the vaccine, a company spokesperson confirmed.

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Alexander Tin

CBS News reporter covering public health and the pandemic.

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New York adult diagnosed with polio, first US case in nearly a decade - CNN

(CNN)A person from Rockland County, New York, has been diagnosed with polio, the first case identified in the United States in nearly a decade.

The unvaccinated young adult began experiencing weakness and paralysis about a month ago, county Health Commissioner Dr. Patricia Schnabel Ruppert said Thursday.

The case comes nearly a month after the UK Health Security Agency warned that it had detected poliovirus in its surveillance of London sewage samples, indicating that there had been some spread between closely linked individuals in North and East London, although no cases had been identified there.

Polio is an infection caused by the poliovirus. About 1 in 4 infected people have flu-like symptoms including sore throat, fever, tiredness, nausea, headache and stomach pain. As many as 1 in 200 will develop more serious symptoms that include tingling and numbness in the legs, an infection of the brain or spinal cord, and paralysis, according to the US Centers for the Disease control and Prevention.

There is no cure for polio. Treatment to address symptoms may include medication to relax muscles and heat and physical therapy to stimulate muscles. However, any paralysis caused by polio is permanent.

"This patient did present with weakness and paralysis," Schnabel Ruppert said.

This is the first polio case diagnosed in the United States since 2013, according to the New York Department of Health.

State and county health officials are advising health-care providers to stay vigilant for additional cases, and they are advising county residents to get vaccinated for polio.

"The risk to an unvaccinated community member from this event is still being determined," Ruppert Schnabel said. "We strongly advise anyone who's unvaccinated to get vaccinated."

Polio vaccine is part of the CDC's standard immunization schedule and is required for school attendance. People who are vaccinated are not expected to be at risk.

The New York case was identified as a revertant polio Sabin type 2 virus, indicating that it was derived from someone who received the oral polio vaccine, which contains a live but weakened form of the polio virus.

Officials say this suggests that the virus originated outside the US, where the oral vaccine is still administered, but they are investigating the origins of this particular case.

Health officials said Thursday that the person had not traveled outside the US before or after they were diagnosed.

Typically, people who catch polio can spread it to others for about two weeks. Officials said the individual is not expected to be contagious right now because they are past that window of time and have normal immune function. But others may have been exposed before the case was diagnosed.

The oral polio vaccine is no longer authorized for use in this country. In the US, only the inactivated polio vaccine has been given since 2000.

Health officials think the strain of the virus the individual contracted originated through shedding from the orgal vaccine. A person cannot get polio from the vaccine itself, but in recent years, cases of polio linked to shedding have arisen in communities that have low vaccination rates.

When this weakened strain of the virus circulates in under-immunized populations -- typically in areas with poor sanitary conditions -- the virus can acquire mutations and revert to a form that causes paralysis. These vaccine-derived viruses are different from wild polioviruses, which now circulate only in Pakistan and Afghanistan.

County health officials declined to give personal details about the case, but The New York Times reported that the patient is a man from the Orthodox Jewish community, citing unnamed local elected officials. Community newspaper New York Jewish Week also quoted multiple sources saying the same thing.

Rockland County is home to an ultra-Orthodox Jewish community in which vaccination rates have historically been very low. In 2018 and 2019, Rockland County was the epicenter of a major measles outbreak that continued for nearly a year and sickened 312 people. County health officials reported at the time that only 8% of cases had been vaccinated against measles, mumps and rubella before the outbreak began.

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"Based on what we know about this case, and polio in general, the Department of Health strongly recommends that unvaccinated individuals get vaccinated or boosted with the FDA-approved IPV polio vaccine as soon as possible," State Health Commissioner Mary T. Bassett said in a statement Thursday. "The polio vaccine is safe and effective, protecting against this potentially debilitating disease, and it has been part of the backbone of required, routine childhood immunizations recommended by health officials and public health agencies nationwide."

Polio cases were once common in the United States and around the world. During one of the most severe outbreaks in 1952, the virus infected 58,000 people in the US, paralyzed more than 21,000 and killed more than 3,100. However, vaccination campaigns cut cases dramatically. The last naturally occurring case of polio in the US was in 1979.

This story has been updated with additional details about the patient's case.

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First US case of polio in nearly a decade is an Orthodox Jewish man - The Times of Israel

New York Jewish Week via JTA — The first case of polio in the United States in a decade has been diagnosed in an Orthodox Jewish man in Rockland County, just north of New York City.

Local health officials announced the case Thursday and said they would begin a drive to increase vaccination against the potentially deadly virus. They said the victim was experiencing paralysis, a hallmark of the disease, and that he had not been vaccinated against it.

Multiple sources told the New York Jewish Week that the man is part of Rockland County’s substantial Jewish community. A local elected official said the same thing in a now-deleted statement condemning those who do not vaccinate, which drew fierce criticism on Twitter from many in the local Jewish community.

“He was released from the hospital,” one source told the Jewish Week on condition of anonymity. “He’s a young adult, in a wheelchair. He got married recently.”

Polio is a highly contagious disease that can cause paralysis and even death. Before an effective vaccine was developed in the early 1950s, tens of thousands of Americans were infected annually; some wound up with permanent disabilities and a handful were consigned to iron lungs, machines that would help them breathe mechanically after their own bodies were too weakened to do so on their own. A 1952 outbreak killed more than 3,000 people, mostly children.

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The new polio case comes amid fierce backlash against vaccination in some Orthodox communities fueled by the COVID-19 pandemic and following a measles outbreak in Rockland County in 2018 and 2019 that was centered in the area’s Haredi Orthodox population. The county barred unvaccinated children from entering public places during the outbreak.

Signs about measles and the measles vaccine are displayed at the Rockland County Health Department in Pomona, New York, March 27, 2019. (Seth Wenig/AP)

According to state data, 60% of Rockland County children have received all three doses of the polio vaccine by age 2, the recommended timeline for vaccination. Nationally, more than 92% of children are fully vaccinated by that age. Last year, Rockland County’s rate of completion of the childhood vaccination schedule, which protects against a range of diseases, was 42%, the lowest in the state. While the county has many residents who are not Orthodox Jews, its multiple Orthodox enclaves are the fastest-growing areas, in part because of their large number of young children.

On Thursday, Rockland County Executive Ed Day said the county is not “immune to vaccine hesitancy.”

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“It’s exactly what led to the measles crisis we dealt with, and why we are constantly doing what we can to be proactive about getting people vaccinated,” Day said.

Rockland County will offer free polio vaccinations in Pomona for any unvaccinated New Yorkers starting Friday.

State Sen. James Skoufis, a Democrat whose district includes part of Rockland County, released a statement on Twitter in a now-deleted tweet asking to “bring the full force of the law down on those who have skirted these requirements.”

He singled Ramapo Yeshivas as having “a history of non-compliance with the state’s vaccine laws.” Ramapo is one of the Five Towns of Rockland County, in which the source said there are over 120 Yeshivas.

“Additional enforcement is required in light of today’s news,” Skoufis said in his statement.

Skoufis’ statement drew criticism from within the Jewish community. Yossi Gestetner, a Rockland County resident whose Orthodox Jewish Public Affairs Council worked to combat negative publicity stemming from the measles outbreak in 2019, tweeted that Skoufis’ statement was “hateful and inflammatory.”

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This is a scene in the emergency polio ward at Haynes Memorial Hospital in Boston, Ma., on Aug. 16, 1955. The city’s polio epidemic hit a high of 480 cases. The critical patients are lined up close together in iron lung respirators so that a team of doctors and nurses can give fast emergency treatment as needed. (AP Photo)

“I missed your tweet calling out LGBTQ+ by name and as a community for Monkeypox,” Gestetner wrote, referring to the outbreak of a different virus that is underway. “So why treat visibly Jewish people this way? Every elected Dem should condemn you.”

Gestetner told the New York Jewish Week that he recognized that there is vaccine hesitancy within the Orthodox community, but rejected the notion that vaccine hesitancy “is just an Orthodox community issue.”

“People have real concerns about vaccines,” he said. “Even if they’re wrong, the government should go out there and show them the benefit of these vaccines rather than just yelling at people.”

Gestetner said he worried that directing attention to the Orthodox community could fuel antisemitism in the area, adding that comments like the one Skoufis made do not help.

After the backlash to his statement, Skoufis said on Twitter that he met with members of the Rockland County Jewish community to discuss the situation. “I truly appreciate the sensitivity on the ground and the need to make sure the language used like that in my statement from today better reflects that sensitivity,” Skoufis said on Twitter.

After the 2019 measles outbreak, public health campaigns resulted in more children being vaccinated against the virus, including within the Rockland County and Brooklyn Jewish communities that were hardest hit. But since then, the advent of COVID-19 vaccines have heightened tensions around vaccination in those communities and beyond, with inaccurate information circulating widely. Zev Zelenko, an Orthodox doctor who became a hero in some circles for promoting untested treatments and opposing vaccination, was based just outside of Rockland County.

This 2014 illustration made available by the US Centers for Disease Control and Prevention depicts a polio virus particle. (Sarah Poser, Meredith Boyter Newlove/CDC via AP)

Meanwhile, the COVID-19 pandemic has also caused childhood vaccinations to slow across the United States, as families have delayed or deprioritized routine health care.

“Childhood vaccine hesitancy is huge, and I think a lot of it may have worsened with the whole pandemic of misinformation,” Blimi Marcus, an Orthodox nurse who led a COVID-19 vaccine campaign in her community, told the New York Jewish Week in December.

The Rockland County polio vaccination site will be open Friday morning and Monday for a longer period at the Pomona Health Complex at 50 Sanitarium Road. Officials are urging anyone who is unvaccinated, including people who are pregnant, or who are concerned they might have been exposed to be vaccinated or boosted during the clinics.

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1st polio case reported in US in nearly a decade detected in New York state - ABC News

The first case of polio reported in the U.S. in nearly a decade was detected in New York state, health officials said Thursday.

The case is in a resident of Rockland County, the state health department said.

State health officials said sequencing determined that the newly detected case is an instance of vaccine-derived polio. The oral polio vaccine contains a weakened version of the polio virus that can be excreted in stool and transmitted.

That vaccine has not been administered in the U.S. since 2000, suggesting that the virus may have originated somewhere outside the U.S., health officials said.

The Rockland County polio patient is a young adult whose symptoms began a month ago, according to public health officials in Rockland County. The person is no longer contagious but has suffered some paralysis. It is unknown whether that will be permanent.

The infected person contracted polio through exposure to someone who was inoculated with the oral vaccine. The patient did not travel outside of the country, so the exposure was here, said health officials, who are now investigating whether there are any close contacts of the patient who are at risk. There are no other suspected cases at this time.

This 2014 illustration made available by the U.S. Centers for Disease Control and Prevention depicts a polio virus particle. On Thursday, July 21, 2022, New York health officials reported a polio case, the first in the U.S. in nearly a decade.

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Health officials urged those who are unvaccinated, and parents of unvaccinated children, to seek polio vaccination now.

"The polio vaccine is safe and effective, protecting against this potentially debilitating disease, and it has been part of the backbone of required, routine childhood immunizations recommended by health officials and public health agencies nationwide," State Health Commissioner Dr. Mary Bassett said in a statement.

Rockland County will host vaccine clinics on Friday and Monday, the health department said.

The last known case in the U.S. was recorded by the U.S. Centers for Disease Control and Prevention in 2013, which was also an instance of vaccine-derived polio. The last "wild" case of polio was detected in the U.S. in 1979.

The U.S. uses the inactivated polio vaccine, which cannot cause infection.

Being vaccinated against polio protects people against both vaccine-derived and "wild" polio.

Polio is a very contagious, potentially fatal, virus that can be spread even when an infected person has no symptoms.

Symptoms, which include fatigue, fever, headache, stiffness, muscle pain and vomiting, can take up to 30 days to appear. In rare cases, polio can cause paralysis or death.

"Many of you may be too young to remember polio, but when I was growing up, this disease struck fear in families, including my own," Rockland County Executive Ed Day said in a statement. "The fact that it is still around decades after the vaccine was created shows you just how relentless it is. Do the right thing for your child and the greater good of your community and have your child vaccinated now."

ABC News' Sony Salzman and Aaron Katersky contributed to this report.

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