2023-06-23-世界卫生组织-Multi-country_outbreak_of_mpox,_External_situation_report_25_–_24_June_2023_15页_1mb

报告摘要

Summary of the Multi-country Outbreak of Mpox (Monkeypox)

Core Content

As of 19 June 2023, the global multi-country outbreak of monkeypox (mpox) has reported 87,972 laboratory-confirmed cases and 147 deaths across 112 countries in all six WHO regions. The global risk assessment remains moderate, with the majority of cases concentrated in the Region of the Americas, European Region, and Western Pacific Region.

Key Findings

New Cases and Trends: Since the last report on 10 June 2023, 114 new cases and 1 death have been reported. The weekly decline in new cases was 42% in week 24 compared to week 23. The Western Pacific Region reported the highest number of new cases in the past three weeks (74 cases, 31%), followed by the Americas (67 cases, 28%) and the African Region (41 cases, 17%).
Geographic Distribution: The United States of America (30,267 cases), Brazil (10,950), Spain (7,559), France (4,146), and Colombia (4,090) account for 83.9% of all global cases.
Demographics: 96.2% of confirmed and probable cases are men, with a median age of 34 years. 84.1% of cases self-identify as gay, bisexual, or other men who have sex with men (MSM), indicating ongoing transmission primarily within this group.
Transmission Routes: The most common mode of transmission is skin and mucosal contact during sexual encounters (82.0% of reported events). Party settings with sexual contact are the most frequently reported exposure setting (66.3%).
Symptoms: The most common symptom is rash (90.0%), followed by fever (55.2%) and genital rash (47.6%). Symptomatology remains consistent over time.

Mpox in Pregnancy

Limited Data: There is limited data on mpox during pregnancy, but adverse outcomes such as pregnancy loss, stillbirth, preterm birth, and neonatal infection have been reported.
Transmission Risk: It is unknown whether pregnant individuals are more susceptible to severe disease, but transmission from mother to child during pregnancy or at birth is possible. Breastfeeding is not definitively associated with transmission risk, and WHO recommends that mothers with mpox should continue breastfeeding if possible, with measures to reduce transmission (e.g., covering lesions).
Pregnancy Outcomes: From 1 January 2022 to 11 June 2023, 58 pregnant or recently pregnant cases were reported globally. Most cases were in Brazil and the USA, with no deaths reported among pregnant individuals. 13 cases were hospitalized, but none required ICU or died. Sexual contact was the most common transmission route.

WHO Recommendations

Clinical Management: Pregnant individuals with mpox should receive person-centred, respectful, and skilled care. They should abstain from sexual activity until all symptoms have resolved, and use condoms for 12 weeks post-recovery.
Prevention: Non-replicating vaccines (MVA-BN) are recommended for pregnant individuals receiving pre- or post-exposure vaccination.
Public Health Measures: Close contact avoidance is advised for pregnant individuals. General infection prevention and control measures should be followed when handling infants.

Risk Communication and Guidelines

WHO has issued interim guidance on clinical management, infection prevention, and risk communication.
Public health advice includes recommendations for congregate settings, sexual health, and stigma reduction.
Surveillance and Data Management: WHO provides case investigation forms, minimum datasets, and clinical data platforms to support global mpox surveillance.

Strategic Planning and Response

WHO has developed a Strategic Preparedness, Readiness, and Response Plan (SPRP) and issued emergency appeals to support global response efforts.
International Health Regulations (IHR) Emergency Committees have been convened multiple times to assess the outbreak and provide recommendations.

Additional Resources

WHO Interim Technical Guidance includes vaccination protocols, risk communication, and data management tools.
EPI-WIN Updates provide regular situation reports, transmission updates, and advice for health workers.
Laboratory and Diagnostics: WHO provides guidance on testing and genomic epidemiology for mpox.

Conclusion

The mpox outbreak remains a moderate global risk, with the majority of cases and deaths occurring in the Americas and Europe, and sexual contact as the primary transmission route. Pregnant individuals and newborns are at risk of infection, but breastfeeding is encouraged when feasible. WHO recommends close monitoring, respectful care, and prevention measures for affected individuals. Risk communication and community engagement are emphasized to reduce stigma and ensure effective public health response.