The World Health Organization (WHO) recently declared the Mpox virus a “public health emergency,” signaling the severity and urgency of the situation. This declaration comes after reports of the virus spreading beyond Africa, where it has been predominantly active. A newer, more aggressive strain known as Clade 1 has been at the forefront of this epidemic. Since 2022, Clade 1 has been causing significant outbreaks across various African nations, with the Democratic Republic of Congo (DRC) experiencing the most severe impacts.
As of June this year, the DRC has reported tens of thousands of infections, marking the largest outbreak of Mpox ever recorded in the country’s history. The DRC government recognized the gravity of the situation and declared an epidemic in December 2022. This declaration was not made lightly, as the virus continues to spread rapidly within the region.
The Africa Centers for Disease Control and Prevention (Africa CDC) reported last week that the Mpox virus is now present in at least 13 African countries. This alarming spread highlights the virus’s ability to cross borders and affect a growing number of populations. When compared to the same period last year, the data is stark: cases have increased by 160%, and the number of deaths has risen by 19%. These figures underscore the urgent need for a coordinated response to contain and manage the outbreak.
The Spread of Mpox Beyond Africa
In recent developments, the Mpox virus has been detected in countries outside of Africa, raising concerns about its potential global spread. On Friday, Pakistan’s Ministry of National Health Services confirmed the country’s first case of Mpox. The infected individual had recently returned from Saudi Arabia, prompting health officials to investigate the source of the infection. While the exact strain of the virus is still being determined, the situation has triggered a swift response from health authorities.
Similarly, in Sweden, health officials confirmed their first case of Mpox on Thursday. The patient, who had traveled to Africa, was diagnosed with the Clade 1 strain. This strain is particularly concerning due to its higher rate of severe infections and its ability to spread more easily through close contact, including sexual contact. The patient is currently receiving treatment, and Swedish health authorities are closely monitoring the situation to prevent further transmission.
In response to these new cases, the European Center for Disease Prevention and Control (ECDC) has raised its risk alert level from “low” to “moderate.” This change reflects the growing concern that the virus could spread more widely in Europe. The ECDC has urged countries to maintain high levels of vigilance, particularly among travelers returning from regions where the virus is active. The situation is being monitored closely, and public health measures are being implemented to contain the spread.
Understanding the Mpox Virus and Its Impact on the Human Body
Mpox, also known as Monkeypox, is a viral disease that primarily affects humans and animals. It belongs to the same family of viruses as smallpox, but it typically causes milder symptoms. Despite this, the virus can still lead to severe illness and even death in some cases. The symptoms of Mpox often start with fever, chills, and body aches, which can be mistaken for other illnesses. However, the disease soon progresses to more noticeable symptoms, such as skin lesions that can be painful and disfiguring.
The virus enters the human body through broken skin, respiratory droplets, or mucous membranes such as the eyes, nose, or mouth. Once inside the body, it spreads through the bloodstream, leading to the development of flu-like symptoms and skin lesions. These lesions, which are filled with pus, can appear on various parts of the body and can take weeks to heal.
Dr. Michael Marks, a scientist at the London School of Hygiene and Tropical Medicine, has provided insights into the virus’s behavior. According to Dr. Marks, there is no evidence that Mpox has long-term effects on the immune system. “We don’t think that Mpox has direct effects on the immune system,” he explained. This means that while the virus triggers an immune response during infection, it does not appear to cause lasting damage to the body’s immune defenses. Symptoms typically last for two to four weeks, after which most patients recover fully.
Dr. Ngashi Ngongo, Chief of Staff at Africa CDC, has echoed these sentiments, stating that the virus is not known to cause long-term health issues. He emphasized that Mpox is a disease that runs its course over a few weeks. “It’s a disease. Whether you get the severe form – which can lead to death – or you just recover within two to four weeks, everything goes back to normal,” he said. This information is reassuring for many, but it does not diminish the importance of addressing the current outbreak with seriousness and urgency.
How Does the Virus Spread?
The Mpox virus is primarily spread through close contact with an infected person or animal. Human-to-human transmission can occur in several ways, making the virus highly contagious in certain environments. The most common method of transmission is through direct contact with the skin lesions of an infected person. These lesions contain a high concentration of the virus, making them a significant source of infection.
In addition to skin contact, the virus can also be transmitted through respiratory droplets when people are in close proximity to each other. Talking, coughing, or sneezing near an infected person increases the risk of transmission. This form of spread is similar to how other respiratory viruses, such as the flu or COVID-19, are transmitted.
Contaminated objects, such as bedding, clothing, or towels, can also serve as a medium for the virus to spread. If someone comes into contact with these items and then touches their face, especially their eyes, nose, or mouth, the virus can enter their body. This type of indirect transmission is particularly concerning in settings where hygiene practices may be lacking or where people share common spaces and items.
Dr. Marks highlighted that while respiratory transmission is possible, the most significant risk comes from skin-to-skin contact. He noted that the virus can remain detectable on skin lesions for up to three weeks, which is much longer than it remains in the respiratory system. “Most people clear the virus from their throat within seven to 10 days, but it can persist on the skin for much longer,” he explained. This means that individuals with visible lesions can remain infectious for weeks, even after their respiratory symptoms have subsided.
Human-to-animal transmission is another route through which the virus can spread. This usually occurs when a person comes into contact with an infected animal, either through bites, scratches, or handling the animal’s wounds. Given that Mpox can affect a wide range of animal species, including rodents and primates, there is a risk of zoonotic transmission, where the virus jumps from animals to humans. This is particularly concerning in regions where humans and wildlife live in close proximity.
Recognizing the Symptoms of Mpox
The symptoms of Mpox can vary widely in severity, ranging from mild to life-threatening. The disease typically begins with flu-like symptoms, such as fever, muscle aches, and fatigue. These early symptoms can be easily overlooked or mistaken for other common illnesses, which can delay diagnosis and increase the risk of spreading the virus to others.
As the disease progresses, patients develop a rash that evolves into pus-filled lesions. These lesions can appear anywhere on the body but are most commonly found on the face, hands, and feet. The number of lesions can vary significantly from person to person. Some individuals may only develop a few lesions, while others may experience hundreds of them spread across their body.
Dr. Marks provided additional insights into the symptomatology of Mpox. He noted that while most people experience a “relatively mild illness,” with only a few lesions, there are cases where the disease is much more severe. “Some people become much more unwell and they may develop a more severe illness with hundreds of lesions all over the body,” he said. These severe cases are more likely to result in complications and may require intensive medical care.
Who Is Most at Risk for Severe Mpox Symptoms?
While Mpox can affect anyone, certain groups are at higher risk of developing severe symptoms. Dr. Marks explained that individuals with untreated HIV or those with weakened immune systems are particularly vulnerable. This is because their bodies are less capable of fighting off the virus, leading to more severe disease outcomes.
Children are another group at higher risk for severe Mpox. Dr. Marks suggested that children are more likely to contract the virus for several reasons. “A lot of the transmission is in densely populated areas with many children, and children are probably more prone to running around and coming into direct skin-to-skin contact with others – so that then causes transmission,” he said. In environments where children are in close quarters, such as schools or playgrounds, the risk of spreading the virus is significantly increased.
Dr. Ngongo added that children’s immune systems are still developing, which makes them more susceptible to severe illness. He emphasized the importance of protecting vulnerable populations, such as children and those with compromised immune systems, through public health measures and vaccination.
Current Treatment Options and Vaccination Availability
At present, there is no specific treatment for Mpox. However, antiviral drugs are being tested to determine their effectiveness against the virus. Treatment is generally supportive, focusing on relieving symptoms and preventing complications. This may include managing fever, providing pain relief, and treating secondary bacterial infections that can occur in severe cases.
Vaccination is a critical tool in preventing the spread of Mpox. The vaccine used in the 2022 Mpox outbreak in many Western countries has proven effective in reducing the risk of infection. However, access to this vaccine is severely limited in African countries, where the epidemic is most intense. Dr. Marks emphasized the importance of making the vaccine available to those most at risk, particularly in the DRC and surrounding countries.
“There is, however, vaccination, which is effective at reducing risk. The priority needs to be getting an adequate
supply of vaccine to those populations most at risk in DRC and surrounding countries,” Dr. Marks said. He also pointed out that vaccinating individuals at risk would not only protect them from infection but also help control the broader epidemic by reducing the overall number of cases.
Dr. Ngongo provided further context on the challenges of vaccine distribution in Africa. He explained that while Africa CDC has managed to secure 280,000 doses of the vaccine through donations, this is far from sufficient. Since the vaccine requires two doses for full protection, the current supply can only cover 140,000 people. Given the scale of the outbreak, this is a small fraction of what is needed.
“There is no vaccine in Africa. Whatever is left of that vaccine is stockpiled in the West as part of their own emergency preparedness. But we have an ongoing emergency here,” Dr. Ngongo said, highlighting the disparity in vaccine access between wealthy and poorer nations. He called for greater international cooperation and support to ensure that African countries have the resources they need to combat the virus effectively.
Preventative Measures: How to Protect Yourself from Mpox
Preventing the spread of Mpox requires a combination of personal hygiene practices, public health measures, and vaccination. Dr. Ngongo advised that people should “go back to the basics of personal hygiene,” emphasizing the importance of regular handwashing, avoiding contact with sick individuals, and seeking medical attention if symptoms develop.
In regions where the Mpox vaccine is available, getting vaccinated is one of the most effective ways to protect yourself. The vaccine not only reduces the risk of infection but also helps to control the spread of the virus within communities.
Dr. Marks and Dr. Ngongo both stressed the importance of public awareness and education in preventing the spread of Mpox. Understanding how the virus is transmitted, recognizing the symptoms, and knowing when to seek medical help are all critical components of an effective public health response.
Could the Mpox Virus Spread Further?
The potential for the Mpox virus to spread further is a significant concern for public health officials. While countries with robust healthcare systems and resources may be able to contain new outbreaks quickly, the situation in central Africa remains precarious.
Dr. Marks noted that the “major risk” is in central Africa, where the epidemic is ongoing and spreading. He warned that while cases may be exported to other regions, as seen in Sweden and Pakistan, the primary focus should be on controlling the outbreak in Africa. “There are likely to be small numbers of cases exported further afield, as [in] the Swedish case, but the major risk and the focus for action needs to be on central Africa,” he said.
The experience of the COVID-19 pandemic has shown the importance of acting swiftly to contain outbreaks before they spread globally. Dr. Ngongo urged the international community to learn from these lessons and take immediate action to prevent Mpox from becoming a more widespread public health crisis. “We need to act now,” he said, emphasizing the urgency of the situation.
The spread of the Mpox virus beyond Africa is a concerning development that requires a coordinated global response. While the virus has been detected in countries like Pakistan and Sweden, the primary focus must remain on central Africa, where the epidemic is most severe.
Public health measures, including vaccination, good hygiene practices, and public awareness, are critical to preventing the further spread of the virus. Ensuring that vaccines are available to those most at risk, particularly in African countries, is essential to controlling the epidemic and preventing further deaths.
The Mpox virus presents a significant challenge, but with swift and coordinated action, it is possible to contain the outbreak and prevent it from becoming a global crisis. As the world continues to monitor the situation, it is crucial that resources are allocated where they are most needed and that public health strategies are implemented effectively to protect populations at risk.
