The World Health Organization (WHO) has recently declared the ongoing mpox outbreak in Africa a global health emergency. This announcement underscores the gravity of the situation, as the current strain of the virus is considered more severe and more deadly than the one that emerged in 2022. The declaration comes amid rising concerns over the rapid spread of the virus across multiple African countries, leading to an unprecedented number of cases and fatalities.
According to the WHO, over 14,000 cases of mpox have been reported across Africa in 2024, along with 524 confirmed deaths. These figures have already surpassed those from the previous year, highlighting the increased virulence of the current outbreak. The situation is particularly dire in the Democratic Republic of the Congo (DRC), which accounts for more than 96% of all reported cases and deaths. This alarming concentration of cases in a single country has raised significant concerns among global health experts and has prompted urgent calls for international assistance.
Understanding Mpox: A Closer Look at the Virus
Mpox, also known as monkeypox, is a viral illness caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Although mpox is less deadly than smallpox, it can still cause significant health complications, particularly in vulnerable populations. The virus primarily spreads through close contact with an infected person, making it highly contagious in settings where people live or work in close quarters.
Transmission can occur through direct contact with bodily fluids, respiratory droplets, or skin lesions of an infected individual. Additionally, the virus can spread indirectly through contact with contaminated objects, such as clothing, bedding, or other surfaces that have been touched by someone with mpox. In some regions where the monkeypox virus is present among wild animals, transmission can also occur from animals to humans, particularly through bites, scratches, or handling of infected animals.
Symptoms and Progression of Mpox
Mpox typically manifests with a variety of symptoms that can vary in severity depending on the individual and their immune response. The illness often begins with a flu-like phase, characterized by fever, headache, muscle aches, back pain, and general fatigue. These symptoms may appear anywhere from 5 to 21 days after exposure to the virus, with most cases presenting symptoms within 7 to 14 days.
One of the most distinctive symptoms of mpox is the development of a rash that usually appears 1 to 3 days after the onset of fever. This rash often begins as flat, red spots on the skin that eventually become raised and filled with clear or yellowish fluid, resembling blisters. Over time, these lesions progress to pustules, which can be quite painful. The rash typically starts on the face and then spreads to other parts of the body, including the palms of the hands, soles of the feet, and genital areas. In severe cases, the rash can also affect the mucous membranes, leading to sores in the mouth, throat, anus, rectum, vagina, or even the eyes.
The rash associated with mpox can last for 2 to 4 weeks, during which the lesions will eventually scab over and heal. However, the number of lesions can vary widely, with some individuals experiencing only a few sores, while others may develop thousands of lesions across their bodies. In addition to the physical discomfort, the rash can leave significant scarring, particularly in cases where the lesions are extensive or become infected.
At-Risk Populations and Severe Mpox Cases
While mpox can affect anyone, certain groups are at a higher risk of developing severe forms of the disease. These groups include newborns, young children, pregnant women, and individuals with compromised immune systems, such as those living with advanced HIV/AIDS or other conditions that weaken the immune response.
Severe cases of mpox are characterized by more extensive and widespread lesions, which can lead to additional complications. For example, when lesions occur in sensitive areas such as the mouth, eyes, or genital regions, they can cause significant pain and increase the risk of secondary bacterial infections. These infections can further complicate the illness, potentially leading to life-threatening conditions such as sepsis, pneumonia, or encephalitis (inflammation of the brain).
In extreme cases, mpox can result in multi-organ failure, particularly if the virus or secondary infections spread to vital organs like the heart, lungs, or brain. Patients with severe mpox may require hospitalization, where they can receive supportive care, including pain management, hydration, and treatment with antiviral medications. However, access to such care varies widely across different regions, contributing to differences in outcomes and mortality rates.
Mortality Rates and Global Health Impact
The mortality rate of mpox can vary significantly depending on the region and the healthcare infrastructure in place. According to WHO data, the overall mortality rate for mpox ranges from 0.1% to 10%, with higher rates observed in regions with limited access to medical care or in populations with a high prevalence of immunocompromising conditions.
In the current outbreak, the higher mortality rate observed in the DRC and other affected African countries is likely due to a combination of factors, including the virulence of the circulating strain, limited access to healthcare, and the presence of underlying health conditions that increase vulnerability to severe disease. The WHO has emphasized the need for urgent international support to improve healthcare capacity in these regions and to ensure that affected populations have access to life-saving treatments and vaccines.
Vaccination and Prevention Efforts
Vaccination is a critical tool in the fight against mpox. Currently, there is a specific mpox vaccine available that provides protection after two doses. However, the WHO recommends that only individuals at high risk of contracting the virus receive the vaccine, due to limited global supplies. This includes healthcare workers, laboratory personnel, and individuals who have had close contact with confirmed cases.
In addition to the mpox-specific vaccine, the smallpox vaccine has also been shown to provide some level of protection against mpox, due to the genetic similarities between the two viruses. However, it remains unclear whether these vaccines will be effective against the new strain of mpox currently circulating in Africa. Researchers are closely monitoring the situation and conducting studies to determine the efficacy of these vaccines against the emerging variant.
One of the major challenges in controlling the current outbreak is the limited availability of vaccines in the most affected regions. According to estimates, Africa needs around 10 million doses of the mpox vaccine to adequately protect its population, but current supplies are far below this requirement. Public health experts, including those at the London School of Hygiene & Tropical Medicine, have called for urgent international cooperation to increase vaccine production and distribution to the hardest-hit areas.
Geographic Spread and Global Implications
The epicenter of the current mpox outbreak is in the Democratic Republic of the Congo, but the virus has now spread to at least 11 other African countries. This includes four nations—Kenya, Rwanda, Burundi, and Uganda—that had never previously reported mpox cases. The spread of the virus to these new regions is particularly concerning, as it indicates that the virus is expanding its geographic range and could potentially establish itself in new areas.
The global nature of the outbreak is further underscored by the detection of mpox in one person in Sweden, marking the virus’s presence outside of Africa. This highlights the potential for mpox to spread to other continents, particularly if international travel and trade resume normal patterns without adequate screening and preventive measures in place.
The current outbreak is being driven by a strain known as Clade I, which is more virulent than the Clade II strain responsible for the 2022 outbreak. Clade I has a higher likelihood of causing severe disease, particularly in individuals who are already at risk due to underlying health conditions or lack of access to medical care. The fact that this more dangerous strain is now circulating widely in Africa raises significant concerns about the potential for increased morbidity and mortality if the outbreak is not contained.
Global Response and Future Outlook
In response to the growing crisis, the WHO and other international health organizations are mobilizing resources to support affected countries. This includes the deployment of medical supplies, training for healthcare workers, and efforts to improve surveillance and diagnostic capabilities. However, the scale of the outbreak and the challenges posed by the new strain mean that a coordinated global response is essential to prevent further spread and to protect vulnerable populations.
Looking ahead, experts emphasize the importance of ongoing research to better understand the virus and its transmission dynamics. This includes studies on the effectiveness of existing vaccines against the new strain, as well as the development of new treatments and preventive measures. Additionally, there is a need for continued investment in healthcare infrastructure in affected regions to ensure that populations have access to the care they need during this and future outbreaks.
The current mpox outbreak serves as a stark reminder of the interconnectedness of global health and the importance of international cooperation in addressing emerging infectious diseases. As the world continues to grapple with the aftermath of the COVID-19 pandemic, the response to mpox will be a critical test of global health systems’ ability to respond to new and evolving threats.
The ongoing mpox outbreak in Africa, particularly in the Democratic Republic of the Congo, represents a significant global health emergency. With a more virulent strain of the virus spreading rapidly and causing high levels of morbidity and mortality, the need for a coordinated international response has never been more urgent. The WHO’s declaration of a global health emergency highlights the seriousness of the situation and the need for immediate action to contain the outbreak and protect vulnerable populations.
Efforts to control the spread of mpox must focus on expanding access to vaccines, improving healthcare infrastructure, and supporting ongoing research to develop more effective treatments and preventive measures. Only through a concerted global effort can the current outbreak be brought under control and future outbreaks be prevented.
