Mpox returns as a global health emergency, says WHO; What we know about the deadly new outbreak
The virus, which has become a public health emergency, is crossing borders, and there are concerns that it could reach other continents.
A laboratory nurse collects a sample from a child suspected of having mpox near Goma, in the province of North Kivu, in the Democratic Republic of Congo - Photo Reproduction / Arlette Bashizi / Reuters
The World Health Organization (WHO) announced this Wednesday (14) that the Mpox, formerly known as monkeypox, was again classified as a Public Health Emergency of International Importance (ESPII), i.e. an Emergency Global Health. The organization's highest alert level was declared for the "monkeypox" outbreak in July 2022. It was not until May 2023 that the organization decided to downgrade its status due to the global decrease in the number of cases, as was the case with Covid-19.
Now, the concern is about the rapid spread of mpox - a new variant - that is spreading across the African continent, especially in the Democratic Republic of Congo (DRC). This year alone, the country has recorded almost 14,000 cases, including 450 deaths, according to the latest report from the African Center for Disease Control and Prevention (Africa CDC). The deadly virus is also crossing international borders, raising concerns of a potential large global outbreak.
The Return of the Emergency
Although the disease was initially considered under control, the recent outbreak has raised new concerns for public health officials. The WHO described the decision as a "wake-up call" for countries to step up their monitoring and control measures. Outside Africa, the outbreak still has a low level of transmission, as reported by the WHO. Tedros Adhanom, the organization's director-general, declared this Wednesday that the WHO is committed to coordinating the global response in the coming days and weeks. The organization will work closely with affected countries, using its local presence to prevent transmission, treat those infected and save lives.
What is Mpox?
Mpox, formerly known as monkeypox, is a viral infection caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. The symptoms are flu-like and include fever, lymphadenopathy, a condition in which lymph nodes become abnormal in size, consistency or number, usually swelling and rashes which start as raised spots, which turn into fluid-filled blisters. These eventually form scabs.
There are basically two distinct types, known as "clades". Clade I, previously called clade from the Congo Basin, and clade II, known as the West African clade. Both can be fatal, although clade I has historically had a higher mortality rate. Transmission occurs mainly through direct contact with bodily fluids or injuries from infected people, and can also be transmitted through contact with contaminated materials.
Context of the Outbreak
Since the virus was first identified in 1958, the disease has been relatively rare and confined to specific areas of Central and West Africa. However, since the beginning of 2022, the Mpox has begun to spread beyond its endemic areas, affecting countries on other continents and raising global concerns. According to a CDC Africa briefing, 34 countries in Africa are reporting infections or are considered “high risk.”
The Democratic Republic of the Congo (DRC) is experiencing a serious outbreak, with more than 14,000 cases and 511 deaths since the start of 2024. While outbreaks in the DRC are not uncommon, this year's numbers already equal the total for all of 2023 and include cases in previously unaffected provinces. Additionally, infections are being reported in Burundi, Kenya, Rwanda and Uganda, countries neighboring the DRC where cases had previously not been recorded.
Why are we seeing a rise in cases now?
A new subgroup of clade I, called clade Ib, was identified in eastern Democratic Republic of the Congo and confirmed in Kenya, Rwanda and Uganda. Scientists believe this variant is contributing to the spread of the disease. In the past, clade I used to spread mainly through the consumption of infected bushmeat. However, clade Ib is spreading from person to person, mainly through sexual contact, but also through other types of physical contact, such as shared use of contaminated bedding or towels. Dr. Rosamund Lewis, World Health Organization (WHO) leader for mpox, stated: "We don't know if this variant is more transmissible, but it is spreading efficiently.
Global Response
The WHO has called on countries to step up their efforts to detect and control the spread of the virus. Mpox. This includes increasing surveillance, promoting public awareness campaigns, and ensuring access to vaccines and treatments for at-risk populations. The organization also highlighted the importance of international cooperation in responding to the outbreak.
Currently, the Ministry of Health assesses that the risk for Brazil is low. The WHO recommends two vaccines against the disease, but none of them are being administered in the country. Experts recommend vaccination in cases of contact with infected people to prevent outbreaks, such as the one that occurred in the DRC. A mass vaccination campaign is unlikely unless there is a major global health emergency. These measures are seen as essential to protect the most vulnerable groups.
