This week, the World Health Organization (WHO) declared the rapidly escalating mpox outbreak in Africa a public health emergency. In parallel, the European Centre for Disease Prevention and Control (ECDC), an EU agency, warned on Friday that more imported cases into Europe were “highly likely.”
The Africa Centres for Disease Control and Prevention (Africa CDC) also declared its first-ever Public Health Emergency of Continental Security (PHECS) for the disease, which has become increasingly deadly.
This marks the second time the WHO has issued such a warning since mpox (formerly known as monkeypox) began spreading globally in 2022. The virus, which initially emerged in the Democratic Republic of Congo (DRC), has now spread to other African nations and, for the first time, has been detected in Sweden and Pakistan.
What is Mpox?
Mpox, first identified in humans in 1970 in the DRC, exists in two subtypes: clade 1 and clade 2. Clade 1, the more lethal strain, has been endemic in Central Africa’s Congo Basin for decades. Clade 2, which is less severe, is common in West Africa.
Mpox spreads between humans through close physical or sexual contact. Symptoms include fever, muscle aches, and large skin lesions. The disease gained global attention in May 2022 when clade 2b, a milder strain, spread globally, predominantly affecting gay and bisexual men.
Between January 2022 and June 2024, WHO recorded over 99,000 cases and 208 deaths across 116 countries.
The Latest Development
The current surge is driven by clade 1, particularly a new mutated strain called clade 1b, which was first identified among sex workers in the DRC in September 2023.
This week, Sweden reported the first case of clade 1b outside Africa, prompting the EU’s health authorities to urge nations to ramp up preparedness. Pakistan also reported the first case in Asia.
According to Brian Ferguson, an Associate Professor of Immunology at the University of Cambridge, the appearance of the virus in Europe is not unexpected, given the international travel between continents. He noted that cases in Europe could increase as no effective measures are in place to prevent imported cases.
Francois Balloux from the University College London Genetics Institute emphasized that “rapid international cooperation” would be essential in containing the epidemic, although there is “no evidence of transmission in Europe yet.”
Who is at Risk?
Clade 1 mpox is particularly dangerous for young children, pregnant women, and individuals with weakened immune systems, according to Jonas Albarnaz, a pox virus expert at the Pirbright Institute in the UK. Clade 1b, which is primarily spread through sexual contact, typically infects young adults but can also spread through non-sexual contact, such as among children playing together.
The WHO reports that clade 1b has a fatality rate of around 3.6%, with infants and children at higher risk of death.
Areas Affected
Mpox cases in the first half of 2024 have already exceeded the total for all of 2023, according to the WHO. Most cases have been reported in the DRC, where 548 deaths have been recorded so far this year.
Other African nations, including Burundi, Kenya, Rwanda, and Uganda, have recently reported outbreaks, although no deaths have been reported in these countries. In Nigeria, health officials confirmed 39 cases of a milder strain of mpox.
As of this week, Sweden and Pakistan have confirmed their first cases of mpox outside of Africa. The WHO has warned that more cases of the new clade 1b strain are expected in Europe.
Vaccine Availability
During the 2022 global outbreak, vaccines were deployed in Europe and North America, which helped control the spread. However, vaccines have not been widely available in Africa, where the outbreak has been most severe.
On Wednesday, the US Department of Health announced plans to donate 50,000 doses of the mpox vaccine to the DRC. Africa CDC head Jean Kaseya also revealed an agreement with the European Union and Danish pharmaceutical company Bavarian Nordic to distribute 200,000 doses across the continent. Despite this, Kaseya said that Africa will need another 10 million doses to adequately combat the outbreak.
Bavarian Nordic announced on Friday that it is seeking European approval to extend the use of its mpox vaccine to children aged 12 to 17.
