What we know about the new Mpox outbreak

The World Health Organization this week declared a state of emergency over a spreading MPOX outbreak in Africa and the European Centre for Disease Prevention and Control (ECDC), an EU agency, said on Friday that it was “highly likely” that more cases would be imported into Europe.

The Africa Centers for Disease Control and Prevention (Africa CDC) has declared a Public Health Emergency of Continental Security (PHECS) for the first time due to the deadly disease.

It is the second time the WHO has issued its public health emergency warning since the epidemic first spread worldwide in 2022.

The virus has now spread from its epicenter in the Democratic Republic of Congo to other African countries and was detected for the first time in Sweden and Pakistan this week.

What is mpox?

The disease, formerly known as monkeypox, was first identified in humans in the Democratic Republic of Congo in 1970.

There are two subtypes of the virus: clade 1 and clade 2.

The more deadly clade 1 has been endemic to the Congo Basin in Central Africa for decades.

The less severe clade 2 has become endemic in parts of West Africa.

Mpox can be transmitted from person to person through sexual or close physical contact. Symptoms include fever, muscle aches, and large, boil-like skin lesions.

The virus gained international notoriety in May 2022 when a less deadly strain called Clade 2b spread around the world, primarily affecting gay and bisexual men.

Between January 2022 and June 2024, 208 deaths and more than 99,000 MPOX cases were recorded in 116 countries, according to the WHO.

What’s new?

The recent increase involved the more deadly clade 1 – and its new mutated variant.

The new strain, designated clade 1b, was first discovered among sex workers in the Democratic Republic of Congo in September 2023.

Sweden reported the first case of the variant outside Africa this week and the EU health agency urged countries to improve their preparedness. Pakistan reported the first case in Asia.

“It is not surprising that this case came to Europe through travel between continents,” said Brian Ferguson, associate professor of immunology at the University of Cambridge.

He added that case numbers in Europe and elsewhere were likely to skyrocket because “there are currently no mechanisms in place to stop imported cases of MPOX.”

“Rapid international cooperation” is needed to contain the epidemic, said Francois Balloux of the Genetics Institute at University College London. He added that there is “no evidence of transmission in Europe at this stage.”

Who is affected?

Clade 1 mpox is “known to cause more severe disease in young children, pregnant women and immunocompromised people,” said Jonas Albarnaz, who specializes in smallpox viruses at the UK’s Pirbright Institute.

Clade 1b is caused by sexual transmission and primarily infects young adults, Albarnaz said.

There are also reports of spread through non-sexual contact between people, for example among children playing together at school.

According to the WHO, Clade 1b causes death in about 3.6 percent of cases, but infants and children are at greater risk.

Where is it affected?

According to WHO figures, more MPOX cases were reported in the first half of this year than in the whole of 2023.

The majority of recent cases have occurred in the Democratic Republic of Congo, where 548 people have died so far this year, the government said.

Last month, previously unaffected countries such as Burundi, Kenya, Rwanda and Uganda reported outbreaks, the Africa CDC said. However, none of the countries reported deaths, the WHO said.

In Nigeria, 39 cases of a milder form of Mpox have been reported this year, health officials said on Friday.

Sweden and Pakistan reported the first MPOX cases outside Africa this week, and the WHO warns that more cases of the new variant are likely to emerge in Europe.

Is there a vaccine?

During the global spread of Mpox in 2022, vaccines were deployed in Europe and North America, helping to contain the outbreak.

However, in the African countries most affected by MPOX, vaccines are not widely available.

The U.S. Department of Health and Human Services said Wednesday it would donate 50,000 doses of an Mpox vaccine to the Democratic Republic of Congo.

On Tuesday, Jean Kaseya, head of the Africa CDC, announced an agreement with the European Union and Danish drugmaker Bavarian Nordic to distribute 200,000 doses across the continent.

Although this would not be enough, Africa could secure another 10 million vaccines, Kaseya said at a press conference.

Bavarian Nordic announced on Friday that it is seeking European approval for the use of its Mpox vaccine in children aged 12 to 17.

© 2024 AFP