On Tuesday, the African Centers for Disease Control and Prevention declared a public health emergency due to the alarming surge in cases of mpox (formerly referred to as monkeypox). In 2024, there have been 17,500 mpox cases and 460 deaths in Africa, more than were recorded all of last year. The severity of the outbreak has public health officials discussing whether a global public health emergency is needed.
What is Mpox?
Mpox is a disease caused by monkeypox virus, which was first discovered in 1958 when an outbreak of a pox-like illness occurred in monkeys used for research. The first human case was reported in 1970 in the Democratic Republic of Congo and the disease is now considered endemic in several central and west-African countries.
There are two known clades (i.e., types) of monkeypox virus. Clade I is endemic to Central Africa and infection may be associated with more severe disease with a mortality rate up to 10%. A variant of this clade, known as Clade 1.b is causing the current outbreak in Africa. Clade II is endemic to West Africa and typically results in less severe illness with less than 0.1% of individuals dying from the infection. In 2022, a worldwide outbreak of clade II monkeypox virus resulted in ~99,500 confirmed cases and over 200 deaths.
Infection with monkeypox virus can cause a range of clinical manifestations, from asymptomatic infection to a flu-like illness (i.e., fever, body aches, headache), swollen lymph nodes, and the development of fluid-filled pustules or lesions. The virus is spread through contact with infected animals or through direct contact with infected lesions or contaminated material (e.g., bedding or clothing).
Why is The Latest Outbreak in Africa a Concern?
The unprecedented rise in mpox cases has led the Director-General of the World Health Organization to convene an Emergency Committee meeting, scheduled for Wednesday, August 14th, to discuss the situation and determine whether the outbreak constitutes a public health emergency of international concern (PHEIC).
This is due to several factors. First, the number of mpox cases in Africa this year has already surpassed the total cases recorded in 2023. Second, the virus has now spread from the Democratic Republic of Congo to surrounding countries, including Burundi, Kenya, Rwanda and Uganda. Third, cases are largely due to clade I of the virus—specifically the variant clade I.b—which can be associated with more severe disease. Also, clade I.b appears to be more transmissible, with spread occurring through more routine contact, especially among young children.
Given the extent of global travel, public health officials are concerned that a more transmissible form of the virus could enter and spread in nations outside of Africa.
What Can Be Done to Prevent a Global Outbreak?
Fortunately, the current strains of monkeypox virus do not appear to be spread through the respiratory route. To date, cases have resulted from direct contact with infected lesions—especially through sexual exposure—or through prolonged close contact with an infected individual. Individuals should avoid direct contact with anyone who has skin lesions, and new sexual partners should wear protection.
Doctors should be aware of the ongoing mpox outbreak, and consider testing individuals for mpox if they present with a flu-like illness and skin lesions, especially if they have recent travel to Central or Western Africa. Finally, an mpox vaccine is available, and rapid distribution is needed in African nations impacted by the ongoing outbreak to reduce the rate of further spread. Other nations worldwide should also be planning for how to increase testing for mpox and the availability of the mpox vaccine to at-risk individuals.
Read the full article here
