#17,137
As I've written often in the past, the name `monkeypox’ is more than a little misleading.
While the virus was first detected (in 1958) in laboratory monkeys, further research has revealed its primary host likely to be rodents or possibly squirrels. Humans can contract it in the wild from an animal bite or direct contact with the infected animal’s blood, body fluids, or lesions.
But for the past 65 years, the name has stuck, both in the vernacular, and in scientific literature. As have the names of the two major clades (West Africa and Congo Basin), named after the regions where they were first identified.
In June, following the high profile international outbreak of the virus, a group of international scientists called for renaming the virus (and its clades) in a position paper called Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus.
Last August, in WHO: Expert Group Assigns New Names For Monkeypox Clades, we saw the WHO announce new designations (clade I and clade II) for the (formerly Congo Basin and West African) clades of the Monkeypox virus.
Today the WHO has announced a `preferred' replacement for the term `Monkeypox', to be phased in over the next 12 months; Mpox.
WHO recommends new name for monkeypox disease28 November 2022
News release
Geneva, Switzerland
Following a series of consultations with global experts, WHO will begin using a new preferred term “mpox” as a synonym for monkeypox. Both names will be used simultaneously for one year while “monkeypox” is phased out.
When the outbreak of monkeypox expanded earlier this year, racist and stigmatizing language online, in other settings and in some communities was observed and reported to WHO. In several meetings, public and private, a number of individuals and countries raised concerns and asked WHO to propose a way forward to change the name.
Assigning names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases (ICD) and the WHO Family of International Health Related Classifications through a consultative process which includes WHO Member States.
WHO, in accordance with the ICD update process, held consultations to gather views from a range of experts, as well as countries and the general public, who were invited to submit suggestions for new names. Based on these consultations, and further discussions with WHO’s Director-General Dr Tedros Adhanom Ghebreyesus, WHO recommends the following:
Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information.
- Adoption of the new synonym mpox in English for the disease.
- Mpox will become a preferred term, replacing monkeypox, after a transition period of one year. This serves to mitigate the concerns raised by experts about confusion caused by a name change in the midst of a global outbreak. It also gives time to complete the ICD update process and to update WHO publications.
- The synonym mpox will be included in the ICD-10 online in the coming days. It will be a part of the official 2023 release of ICD-11, which is the current global standard for health data, clinical documentation and statistical aggregation.
- The term “monkeypox” will remain a searchable term in ICD, to match historic information.
Usually, the ICD updating process can take up to several years. In this case, the process was accelerated, though following the standard steps.
Various advisory bodies were heard during the consultation process, including experts from the medical and scientific and classification and statistics advisory committees which constituted of representatives from government authorities of 45 different countries.
The issue of the use of the new name in different languages was extensively discussed. The preferred term mpox can be used in other languages. If additional naming issues arise, these will be addressed via the same mechanism. Translations are usually discussed in formal collaboration with relevant government authorities and the related scientific societies.
WHO will adopt the term mpox in its communications, and encourages others to follow these recommendations, to minimize any ongoing negative impact of the current name and from adoption of the new name.
While the WHO released a Best Practices for the Naming of New Human Infectious Diseases position paper in 2015, there are literally thousands of existing viruses and/or diseases with problematic names (think: Ebola, Rift Valley Fever, Nipah, West Nile Virus, MERS-CoV, etc.).
But renaming an existing virus isn't as easy as it might sound. First, you need a consensus from an international committee, and even once that can be agreed upon, there are going to be negative impacts.
To start, the continuity of scientific and medical literature (going back decades) would disrupted. While researchers today might be mindful enough to conduct two searches (new name & old name), over time some of this data could be `lost', or misplaced, or simply ignored.
Add in the revamping of medical and insurance billing codes (on an international scale), the awkwardness for the public (and the press) when a new name is adopted ("X: the virus formerly known as . . . "), and any changes are going to take time to take effect.
Despite the `Best practices' mentioned above - which discourages the practice - we continue to see new viruses (see J. Virus Erad: A Review Of The Langya Virus Outbreak in China, 2022) named after the place where they were discovered.
