However, despite the recovery all around, experts have kept warning about an impending pandemic, possibly deadlier, asking policymakers and governments to exercise all caution.
And here it is – although not a pandemic yet: the outbreak of a new clade of mpox. The World Health Organization (WHO) has flagged it as a “public health emergency of international concern” no less.
“The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives,” WHO Director-General Dr Tedros Adhanom Ghebreyesus has declared.
Dr Tedros’s declaration came on the advice of an IHR Emergency Committee of independent experts who reviewed data presented by experts from WHO and affected countries.
The Committee informed Dr Tedros that it considers the upsurge of mpox to be a PHEIC (public health emergency of international concern), with potential to spread further across countries in Africa and possibly outside the continent.
What is mpox?
mpox, formerly called monkeypox, is a rare disease similar to smallpox caused by a virus.
According to my.clevelandclinic.org, mpox is found mostly in areas of Africa but it has been seen in other regions of the world also. “It causes flu-like symptoms such as fever and chills, and a rash that can take weeks to clear. There’s no proven treatment for mpox, but it usually goes away on its own,” according to my.clevelandclinic.org.
It spreads through close contact with someone who’s infected, and one can also get it from an infected animal.
“There are two known types (clades) of mpox virus — one that originated in Central Africa (Clade I) and one that originated in West Africa (Clade II). The current world outbreak (2022 to 2023) is caused by Clade IIb, a subtype of the less severe West African clade.”
[Nucleus Medical Media: mpox explained]
Meanwhile, commenting on the situation, WHO Regional Director for Africa Dr Matshidiso Moeti said, “Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to help reinforce measures to curb mpox. With the growing spread of the virus, we’re scaling up further through coordinated international action to support countries bring the outbreaks to an end.”
Committee Chair Professor Dimie Ogoina said, “The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself.”
Caused by an Orthopoxvirus, mpox was first detected in humans in 1970, in the DRC, and is considered endemic to countries in central and west Africa.
In July 2022, the multi-country outbreak of mpox was declared a PHEIC as it spread rapidly via sexual contact across a range of countries where the virus had not been seen before. That PHEIC was declared over in May 2023 after there had been a sustained decline in global cases.
Mpox has been reported in the DRC for more than a decade, and the number of cases reported each year has increased steadily over that period. Last year, reported cases increased significantly, and already the number of cases reported so far this year has exceeded last year’s total, with more than 15,600 cases and 537 deaths.
The emergence last year and rapid spread of a new virus strain in DRC, clade 1b, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring the DRC is especially concerning, and one of the main reasons for the declaration of the PHEIC.
In the past month, more than 100 laboratory-confirmed cases of clade 1b have been reported in four countries neighbouring the DRC that have not reported mpox before: Burundi, Kenya, Rwanda and Uganda. Experts believe the true number of cases to be higher as a large proportion of clinically compatible cases have not been tested.
Several outbreaks of different clades of mpox have occurred in different countries, with different modes of transmission and different levels of risk.
The two vaccines currently in use for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization and are also approved by WHO-listed national regulatory authorities and individual countries including Nigeria and the DRC.
Last week, the WHO Director-General triggered the process for Emergency Use Listing for mpox vaccines, which will accelerate vaccine access for lower-income countries which have not yet issued their national regulatory approval.
Emergency Use Listing also enables partners including Gavi and UNICEF to procure vaccines for distribution.
The WHO is working with countries and vaccine manufacturers on potential vaccine donations and coordinating with partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics and other tools.
The WHO anticipates an immediate funding requirement of an initial US$ 15 million to support surveillance, preparedness and response activities. A needs assessment is being undertaken across the three levels of the Organization.
To allow for an immediate scale-up, the WHO has released US$ 1.45 million from the WHO Contingency Fund for Emergencies and may need to release more in the coming days.
The WHO has appealed to donors to fund the full extent of the needs of the mpox response.
With inputs from who.int/Picture: Media report, Shutterstock
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