2022-10-04-世界卫生组织-Multi-country_outbreak_of_monkeypox,_External_situation_report_7_-_5_October_2022_13页_517kb

Summary of the Multi-country Outbreak of Monkeypox (External Situation Report 7, 5 October 2022)

Core Content

The document provides an epidemiological update and risk assessment on the ongoing multi-country outbreak of monkeypox as of 3 October 2022. It outlines the global situation, key findings, WHO's strategic response, and recommendations for managing the outbreak.

Key Statistics

• Total confirmed cases: 68,900
• Total deaths: 25
• Countries affected: 106
• Global risk level: Moderate
• Regional risk levels:
  • European Region and Region of the Americas: High
  • African Region, Eastern Mediterranean Region, Southeast Asia Region: Moderate
  • Western Pacific Region: Low-Moderate

Main Points

Epidemiological Trends

• The number of monkeypox cases reported in the European and Americas regions declined during the week of 26 September to 2 October 2022, contributing to an overall downward trend since August 2022.
• Since the last report on 21 September 2022, 7,147 new cases (11.6% increase in total cases) and three new deaths have been reported.
• The global number of weekly new cases dropped by 16.8% in week 39 (26 September - 2 October) compared to week 38 (19 - 25 September).
• The Region of the Americas reported the highest proportion of cases (85.6%) and highest number of deaths (52% of total deaths), with Nigeria having the largest proportional increase in cases (44.4%).
• 39 countries have not reported new cases for over 21 days, which is the maximum incubation period of the disease.

Demographics and Transmission

• 97.5% of cases with available data are men, with a median age of 35 years.
• 89.9% of cases with reported sexual orientation are gay, bisexual, and other men who have sex with men.
• 87.1% of all reported transmission events involve skin and mucosal contact during sexual activities.
• 48.8% of cases reported their likely exposure in party settings with sexual contacts.
• 49.2% of cases with known HIV status are HIV-positive.
• The most common symptoms are rash (83.4%), fever (57.8%), systemic rash (49.6%), and genital lesions (45.4%).

Death Reporting

• 25 deaths have been reported globally, with a crude case fatality rate of 0.04%.
• Nine of the 25 deaths have detailed case-based information, with 88% being male and 100% identifying as gay, bisexual, or other men who have sex with men.
• Five of the nine deceased were HIV-positive, and seven were hospitalized, with four in intensive care units.
• WHO emphasizes the use of standardized definitions for monkeypox deaths to ensure accurate reporting.

WHO Strategic Response

• On 5 October 2022, WHO launched the Monkeypox Strategic Preparedness, Readiness and Response Plan to stop human-to-human transmission, minimize animal-human transmission, and protect vulnerable groups.
• WHO continues to monitor the outbreak, support international coordination, and provide clinical and public health incident response.
• The risk-based approach is recommended for managing gatherings, with three key steps: risk evaluation, risk mitigation, and risk communication.

Key Recommendations

• Gatherings: Health authorities should collaborate with event organizers to manage risks through public health and social measures (PHSM), especially in settings involving skin-to-skin contact.
• Surveillance and Reporting: Member States are encouraged to adopt and apply the WHO monkeypox death definition and use the case reporting form (CRF) for detailed data collection.
• Vaccination and Prevention: WHO provides interim guidance on vaccination and clinical management, emphasizing the importance of infection prevention and control measures.
• Infodemic Management: WHO's EPI-WIN monitors digital conversations and provides updates and webinars to address misinformation, stigma, and public concerns.
• One Health Approach: WHO highlights the importance of animal-to-human and human-to-animal transmission and advises preventing close contact with animals to reduce spillback and new animal reservoirs.

Additional Resources

• WHO Interim Guidance: Includes technical briefs on surveillance, vaccination, clinical management, risk communication, and handling of gatherings.
• EPI-WIN Updates: Focus on transmission, stigma, and mass gatherings.
• Training Modules: Open WHO offers online training on monkeypox introduction, epidemiology, preparedness, and response.
• Data Management Tools: WHO provides data reporting forms, clinical platforms, and data management systems like Go.Data for managing outbreak data.

Conclusion

The multi-country monkeypox outbreak continues to be a significant public health concern, with the majority of cases and deaths concentrated in the Region of the Americas and African Region. WHO emphasizes the need for standardized reporting, risk-based decision-making, and coordinated international efforts to manage the outbreak effectively and prevent further spread.