WHO Declares Mpox a Global Health Emergency. What to Know About the New Strain

WHO Declares Mpox a Global Health Emergency. What to Know About the New Strain …C0NTINUE READING HERE >>>

Key Takeaways
The World Health Organization declared mpox to be a global health threat for the second time in three years.A surge of mpox cases in the Democratic Republic of the Congo and a growing number of African countries raised concern about the potential for a larger outbreak.A new, deadlier viral strain is responsible for many of those cases. So far, there are no known cases of that viral strain in the U.S.

On Wednesday, the World Health Organization (WHO) declared mpox, formerly known as monkeypox, as a “public health emergency of international concern.” A day after the WHO’s announcement, Sweden detected one case of the new mpox strain, the first known infection of the strain outside of Africa.

The WHO made a similar declaration in 2022. Since then, nearly 100,000 people worldwide—mostly men who have sex with men (MSM)—have had confirmed mpox and more than 200 people have died of the disease.

A deadlier strain of the mpox virus has since emerged. So far this year, the Democratic Republic of the Congo has reported more than 15,600 mpox cases and 537 deaths. The disease has spread through 13 countries in Africa, including a few that had never reported mpox cases before. WHO Director-General Tedros Adhanom Ghebreyesus said the outbreak has the potential to spread to more countries in Africa and possibly beyond the continent.

“The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries are very worrying,” Tedros said in a statement. “It’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”

In the current outbreak, women and children under the age of 15 are also at high risk for infection.

No cases of the new strain have been detected in the United States or elsewhere outside of the African continent. According to the Department of Health and Human Services, the risk to the U.S. general public from the strain is “very low.”

Nevertheless, the Centers for Disease Control and Prevention (CDC) told clinicians and the public to be on alert for signs of mpox.

“Although mpox is a global threat in terms of its ability to spread and cause a significant global outbreak like we saw in 2022, it had fallen out of the news headlines,” said Boghuma Titanji, MD, MSc, PhD, an assistant professor of medicine at Emory University. “I’m hoping that this declaration would certainly focus the global attention on the importance of containing the outbreak while it’s still geographically limited, so that we don’t see further extension to other parts of the world.”

What Is Mpox?

Mpox was first discovered in monkeys, which led to its original name, “monkeypox.” Scientists now think the virus originated in rodents. In 2022, WHO renamed the disease due to complaints that the former name stigmatizes patients and perpetuates racist tropes.

Mpox is a viral infection that is caused by an orthopoxvirus, the same family that causes smallpox.

It can spread from infected animals and between humans through close contact, such as touching, kissing, and sex. You can also get mpox by touching contaminated materials like sheets, clothing, and needles. There’s increasing evidence that the virus could be airborne, though the CDC doesn’t currently recognize that as a transmission route.

An mpox infection may first feel like getting the flu. People often experience fever, headaches, muscle aches, swollen lymph nodes, and fatigue. After a few days, a rash or lesions appear. Those lesions tend to progress from flat, colorless lesions to fluid-filled lesions to scabs that fall off during the healing process.

Mpox was detected in humans in 1970 in the DRC. It’s now considered endemic to countries in central and west Africa.

In the summer of 2022, mpox spread rapidly through countries that hadn’t seen it before, including the U.S. In that outbreak, the disease was transmitted mostly through sexual contact. The WHO ended the global health emergency in May 2023, and there was a decline in cases worldwide after that.

A Potentially More Dangerous Viral Strain

The new mpox strain is called clade 1. Historically, the mortality rate for people infected with clade 1 is between 5% and 10%. That’s deadlier than the 1% to 3% mortality rate for clade 2, which caused most infections in the 2022 outbreak.

However, death rates tend to be lower in the U.S., where health care is more accessible than in the rural parts of African countries where mpox is most common. During the 2022 outbreak, for instance, the death rate was 0.01% in the U.S. Titanji said that if clade 1 made its way to the U.S., it would cause fewer deaths than it does in the DRC and its neighboring countries. 

Like clade 2, clade 1 appears to spread through close contact and especially through sexual transmission. Some reports show that many people who got sick with the new strain in the DRC are sex workers and women. The CDC says there’s no confirmed evidence of widespread transmission of clade 1 between heterosexual people in the DRC and that the risk to that group in the U.S. is low.

Still, genetic sequencing shows signs that after years of moving from person to person, the virus is evolving to better infect humans.

“Is it something about the virus changing that has made it more easily transmissible through sexual means, or is it just a consequence of a virus exploiting social factors to more efficiently transmit? If we don’t have a good understanding of these questions, then it makes it harder to have a robust strategy to respond to it,” Titanji said.

The purpose of the WHO’s public health emergency declaration is to increase resources to distribute vaccines and monitor cases for a better understanding of how the virus is spreading.

More than 100 lab-confirmed cases of clade 1 have been reported in four countries neighboring DRC that have not previously reported pox. The WHO says the number of cases is probably higher because many of them haven’t been tested.

How to Prevent and Treat Mpox

The mpox vaccine available in the U.S. is called Jynneos. It’s a two-dose series, with the second shot given four weeks after the first.

The CDC recommends the vaccine to men who have sex with other men, transgender, non-binary, or gender-diver people. You should also get the shot if you have, or may have, been exposed to someone with mpox or if you’ve had sex at a commercial venue like a sex club or bathhouse.

About one in four people who are eligible for an mpox vaccine have received their full dose, according to the CDC’s last update in January 2023. Two shots are required to be protected from the disease.

“These vaccines confer cross-immunity to other poxviruses and are anticipated to be effective even against the clade 1 virus, so it will be important for people who meet criteria to go and get vaccinated,” Titanji said.

There’s no treatment approved for treating mpox, specifically. For most people, the symptoms will go away on their own after a few weeks. People who have severe infections or who are at high risk for complications of the disease may get an off-label prescription for Tpoxx (tecovirimat), a smallpox antiviral that may be helpful for treating mpox.

What This Means For You

The CDC recommends getting vaccinated if you’re at high risk for being exposed to mpox. Talk to a health provider if you recently traveled to the DRC, if you have symptoms of mpox, or if you’ve been exposed to someone with the disease.

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