Monkeypox is starting to spill into high-risk groups including children, the World Health Organization has warned.
So far, the bulk of some 4,800 cases reported worldwide – including more than 1,000 in the UK – have been detected among men who have sex with men.
But at a press conference on Wednesday, Dr Tedros Adhanom Ghebreyesus, head of the UN health agency, said the scale of the outbreak meant monkeypox was starting to spill into more vulnerable groups.
“I’m concerned about sustained transmission because it would suggest that the virus is establishing itself and it could move into high risk groups – including children, the immunocompromised and pregnant women,” Dr Tedros told a media briefing. “We’re starting to see this with several children already infected right now.”
The WHO added that it was investigating reports of infections in children under 18 in Spain and France, while two cases have been found in the UK since May.
But the warning, which comes amid mounting concerns that the virus is gaining a permanent foothold outside of endemic countries, follows a decision not to call the outbreak a public health emergency of international concern (PHEIC) – the WHO’s highest alert.
On Saturday, a panel stopped short of declaring that monkeypox a global health emergency. Dr Tedros said on Wednesday that three of the 14 members felt a PHEIC should have been announced, but the overall consensus was that the criteria had not been met.
However he stressed that he would “reconvene them quickly” if the situation further evolves.
The decision has sparked significant criticism. Prof Michael Worobey, head of ecology and evolutionary biology at the University of Arizona, told Science Magazine that it does not reflect the threat posed by the virus.
“The window may already have closed on stopping the establishment of a new sexually transmitted disease worldwide, but a PHEIC has not even been declared,” he said.
But Dr Tedros insisted that the decision does not mean monkeypox is not a threat, nor that it isn't being taken seriously.
He said that the WHO is working on a mechanism to distribute vaccines more equitably, after countries including Britain and the United States suggested they were willing to share their stockpiled smallpox vaccines, which also protect against monkeypox.
The WHO chief also urged governments to increase testing and surveillance, and actively engage with the LGBTQ commmunity ahead of large gatherings, such as Pride festivals.
On Tuesday Dr Sophia Makki, an Incident director at UKHSA, warned that the agency expects to see cases “continue to rise further in the coming days and weeks” in Britain, where 1,076 cases have now been detected.
London is the epicentre, with 79 per cent of cases where residential information is known, while the average age is 36.
“If you are attending large events over the summer or having sex with new partners, be alert to any monkeypox symptoms so you can get tested rapidly and help avoid passing the infection on,” Dr Makki said.
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