From Africa to Sweden and now Pakistan, how mpox is spreading across the globe – Firstpost

Mpox, a viral infection that spreads through close contact, has been declared a global health emergency for the second time in two years.

The World Health Organization (WHO) on Wednesday issued its highest level of alert for the viral disease, noting that more than 14,000 cases and 524 deaths in Africa this year have already exceeded last year’s figures.

The announcement comes a day after the Centers for Disease Control and Prevention (CDC) in Africa declared mpox a public health emergency.

Here’s all we know about the virus.

What is mpox?

Mpox is a viral infection that primarily affects humans and animals. It belongs to the same family of viruses as smallpox, called “Orthopoxvirus genus.”

Like smallpox, which is now eradicated, mpox is caused by the same poxvirus as cowpox and vaccinia, as per Al Jazeera.

Mpox usually results in a pox-like illness that causes skin blisters or raised lumps. The lumps can gradually crust over and heal, and they are frequently filled with pus or fluid.

Originally named monkeypox, the virus was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in captive research monkeys in Denmark, as per The Associated Press.

In 1970, the first reported human case was a nine-month-old boy in the Democratic Republic of the Congo.

Until recently, most human cases were seen in people in central and west Africa who had close contact with infected animals.

Given that the illness can also infect rodents and human beings, the WHO suggested changing the name in 2022 to “mpox” to lessen stigma and associations with monkeys.

How is it transmitted?

Humans contract the mpox virus when they come into close contact with an infected animal or person.

Animal bites, scratches, or direct contact with an infected animal’s blood, bodily fluids, or wounds are the most common ways that animals can spread an infection to humans. The respiratory system, mucous membranes, such as those in the mouth, nose, and eyes, and broken skin are the passages that bring the virus into the body, according to Al Jazeera.

Transmission from one person to another can occur via:

• Direct contact with skin lesions, body fluids, or respiratory droplets of an infected person.

• Prolonged face-to-face contact with an infected person.

• Touching contaminated objects, such as bedding or clothing that have been in contact with the infectious material, although this is a rare mode of transmission.

What are its symptoms?

Fever, headaches, aches in the muscles, and an unusual rash that can emerge on the face, hands, feet, and other parts of the body are just some of the symptoms. Before the rash heals, it eventually develops pustules and scabs.

As the immune system tries to combat the virus, lymph nodes — bean-shaped glands — may also swell up, often behind the neck, on the sides, and beneath each arm.

Usually mild, it is fatal in rare cases.

The infection can linger anywhere from two to four weeks overall. However, its symptoms may appear three to 21 days after being exposed to the virus. The virus can spread from one person to another for one to four days before symptoms appear, as per the report.

Is there a vaccine against it?

No vaccines are yet available, although efforts are underway to change that and work out who best to target.

The report says treating mpox is being researched with the antiviral medication tecovirimat (TPOXX), which was first developed for smallpox.

JYNNEOS (also known as Imvamune or Imvanex), a smallpox vaccine, has been licensed by the US Food and Drug Administration (FDA) for use in cases of severe mpox in individuals 18 years of age and older.

Vaccines and behaviour change helped stop the spread when a different strain of  mpox  spread globally, primarily among men who have sex with men, and WHO declared an emergency in 2022, as per Reuters.

The CDC advises vaccination and isolation after coming into contact with an individual who has mpox.

Why has it been declared a global emergency?

A new mpox variant was discovered, and cases were recorded for the first time in numerous countries, including Kenya and Rwanda, prompting the WHO to designate mpox a public health emergency of international concern (PHEIC), warning the disease’s potential to spill across international borders.

PHEIC status is WHO’s highest level of alert and aims to accelerate research, funding and international public health measures and cooperation to contain a disease.

“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” said WHO Director-General Tedros Adhanom Ghebreyesus, as per Reuters.

Two years ago, WHO declared  mpox  was an emergency when a form of the disease began to spread globally, largely among men who have sex with men. The virus was reported in more than 70 countries across the world.

That outbreak was brought under control after behaviour change and safe sex practices, plus vaccines, helped people at risk protect themselves in many countries.  Once cases declined, the WHO lifted the emergency status in May 2023.

Tedros said on Wednesday that WHO had released $1.5 million in contingency funds and plans to release more in the coming days. WHO’s response plan would require an initial $15 million, and the agency plans to appeal to donors for funding, as per the report.

Also read: Can a deadly new mpox strain in Africa ignite another global outbreak?

How bad is the situation in Africa?

Mpox has been a public health problem in parts of Africa for decades. The first ever human case was in Congo in 1970, and it has had outbreaks ever since, as per the news agency.

The current outbreak, Congo’s worst ever, has seen 27,000 cases and more than 1,100 deaths since January 2023, largely among children.

Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries.

Compared with the same period last year, the agency said cases are up 160 per cent and deaths have increased by 19 per cent.

What’s behind the current outbreak?

The
outbreak in Congo began with the spread of an endemic strain, known as clade I. But a new variant, clade Ib, appears to spread more easily through routine close contact, including sexual contact.

It has spread from the Congo to neighbouring countries, including Burundi, Kenya, Rwanda and Uganda, triggering action from the WHO.

Clade Ib appears to spread more easily through routine close contact, including sexual contact. Clade I mpox tends to cause a higher number of severe infections and have a higher mortality rate than clade II mpox, according to US health officials.

This is especially concerning for vulnerable groups like children in displacement camps in parts of the Congo, who are now moved from the eastern Congo to Rwanda, Uganda, Burundi and Kenya.

What about other countries?

Global health officials on Thursday confirmed an infection with a new strain of the mpox virus in Sweden and linked it to a growing outbreak in Africa, the first sign of its spread outside the continent.

Swedish health officials said at a press conference that the person was infected while in Africa with the clade Ib type of mpox involved in the recent outbreak. The person is receiving treatment.

“The emergence of a case on the European continent could spur rapid international spread of mpox,” said Lawrence Gostin, a public health expert and professor at Georgetown Law in Washington.

“A case in Sweden most likely means dozens of undetected cases in Europe.”

Pakistan has detected three patients with the mpox virus, the health department in northern Khyber Pakhtunkhwa province said on Friday.

The viral infection was detected in the patients on their arrival from the United Arab Emirates, the department said.

China will monitor people and goods entering the country for mpox for the next six months, a statement from its customs administration said on Friday.

“Personnel from countries with monkeypox outbreaks who have been in contact with monkeypox cases or display symptoms … should take the initiative to declare themselves to Customs,” it said. Vehicles, containers and goods from areas with mpox cases should be sanitised, the statement added.

China’s National Health Commission last year announced mpox would be managed as a Category B infectious disease, enabling officials to take emergency measures such as restricting gatherings, suspending work and school or sealing off areas when there is an outbreak of a disease.

According to Focus Taiwan CAN English News, Taiwan’s Centers for Disease Control (CDC) raised its travel alert for Congo and six other African countries on Thursday after the WHO’s alert.

CDC Deputy Director-General Lo Yi-chun reportedly said that the CDC decided to raise Travel Health starting Thursday due to “the high transmission rate and mortality rate” of the new strain that has already spread in the country and neighbouring countries.

With inputs from agencies