‘M’ replaces monkey in monkeypox disease

Geneva: Following a series of consultations with global experts, the World Health Organization (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. 

The global experts convened by WHO agreed on new names for monkeypox virus variants, as part of ongoing efforts to align the names of the monkeypox disease, virus and variants – or clades – with current best practices. The experts agreed to name the clades using Roman numerals.

The monkeypox virus was named upon its first discovery in 1958 before current best practices in naming diseases and viruses were adopted. Similarly for the name of the disease it causes. Major variants were identified by the geographic regions where they were known to circulate.

Human monkeypox was given its name in 1970 (after the virus that causes the disease was discovered in captive monkeys in 1958), before the publication of WHO best practices in naming diseases, published in 2015. According to these best practices, new disease names should be given with the aim to minimize the unnecessary negative impact of names on trade, travel, tourism or animal welfare, and avoid causing offence to any cultural, social, national, regional, professional or ethnic groups.  

The current best practice is that newly-identified viruses, related diseases, and virus variants should be given names with the aim to avoid causing offence to any cultural, social, national, regional, professional, or ethnic groups and minimize any negative impact on trade, travel, tourism or animal welfare.

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 stated today that in accordance with the ICD update process, it 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 recommended the following:

• 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 the 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.

Considerations for the recommendations included rationale, scientific appropriateness, the extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific 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 were 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 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 the adoption of the new name. 

Naming the disease

Assigning new names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health-Related Classifications (WHO-FIC) through a consultative process which includes WHO Member States. ICD is part of the WHO Family of International Health-Related Classifications (WHO-FIC).

Naming of viruses

The naming of viruses is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV). Prior to the 2022 global monkeypox outbreak, there was already a process underway to reconsider the naming of all orthopoxvirus species, including the monkeypox virus. This will continue under ICTV leadership.

Naming monkeypox virus variants or clades

In August, a group of global experts convened by WHO agreed on new names for monkeypox virus variants, as part of ongoing efforts to align the names of the monkeypox disease, virus and variants – or clades – with current best practices. The consensus was reached to refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II). Additionally, it was agreed that Clade II consists of two subclades, IIa and IIb.

– global bihari bureau