An electron microscopic (EM) image shows mature, oval-shaped monkeypox virus particles as well as crescents and spherical particles of immature virions, obtained from a clinical human skin sample associated with the 2003 prairie dog outbreak in this undated image obtained by Reuters on May 18, 2022. [Photo/Agencies]

Rules for diagnosis, treatment issued as global counts of disease on the rise

China released its first diagnosis and treatment guideline for monkeypox on June 15, making it clear that the virus can spread through close contact and droplets, but most patients can recover without special treatment.

The guideline was published by the National Health Commission as global counts of the contagious disease rise and World Health Organization experts are weighing up whether to declare the outbreak of a public health emergency of international concern – its highest warning level.

According to the guideline, the monkeypox virus is mainly transmitted through close contact with an infected person and can be spread by respiratory droplets or contact with contaminated materials. It can also pass between mother and baby during pregnancy or delivery.

The disease is often self-limiting, but severe cases can occur in young children or people with weak immune systems. The case fatality rate of the West Africa strain is 3 percent, whereas for the Congo Basin variant, it can be as high as 10 percent.

The incubation period of monkeypox ranges from five to 21 days. Suspected and confirmed cases should be admitted into isolation wards, but no treatment targeting the disease directly is available currently, the guideline said.

"Local health authorities should organize training on monkeypox, and improve abilities to detect, report, isolate and treat cases promptly," the commission said.

Monkeypox is most commonly found in Central and West Africa, but a number of nonendemic countries in Europe and in North and South America have reported infections since May.

The WHO said during a news briefing on Tuesday that it had received reports of 1,600 confirmed and 1,500 suspected monkeypox cases this year from 39 countries. Thirty-two countries among them are newly affected by the virus and the strain detected there is the West Africa variant – the less deadly one.

"The global outbreak of monkeypox is clearly unusual and concerning," said WHO Director-General Tedros Adhanom Ghebreyesus. "For that reason, I have decided to convene the emergency committee next week…to assess whether this outbreak represents a public health emergency of international concern."

An emergency designation indicates that a public health risk has the potential to spread around the globe. Currently, it is now being applied to polio and COVID-19, according to the WHO.

Rosamund Lewis, a monkeypox expert at the WHO, said the organization is building a mechanism aimed at deploying smallpox vaccines – a disease closely related to monkeypox – to countries in need.

The WHO currently does not recommend mass vaccinations.

China has reported no monkeypox cases so far, but domestic researchers have begun ramping up testing capacity.

Xu Wenbo, head of the Chinese Center for Disease Control and Prevention's National Institute for Viral Disease Control and Prevention, said during a news conference last week that the institute has developed a PCR testing technology targeting monkeypox and has examined its sensitivity and specificity against the West Africa strain.

"China is capable of identifying imported monkeypox cases in a timely manner," he said.