What you should know about Mpox

Angela Onwuzoo

The Africa Centre for Disease Control and Prevention, on Tuesday, declared Mpox, formerly Monkeypox, a continental public health emergency in response to its growing spread and rise in fatalities in some countries on the continent.

The Director General of Africa CDC, Jean Kaseya, announced this during a “special press briefing” on crucial steps and implications of the disease to Africa’s health security.

Mpox is an infectious disease caused by a virus. Flu-like symptoms including fever, chills, and muscle aches are typically followed by a rash that starts as raised spots, which turn into blisters filled with fluid. These eventually form scabs.

According to the World Health Organisation, Mpox is caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus in the Poxviridae family, which also includes variola, cowpox, vaccinia, and other viruses. The virus has two genetic clades, known as clades I and II.

Why an Emergency Declaration?

There is an unprecedented spike in reported cases in Africa which have risen by 79 percent from 2022-2023 and by 160 percent from 2023-24. Since the beginning of 2022 and as of 28 July 2024, a total of 37,583 cases and 1,451 deaths (case fatality rate of 3.9 percent) of mpox have been reported from Nigeria and 14 other African countries.

In 2023, 14,957 cases and 739 deaths (CFR: 4.9 percent) were reported from seven countries, representing a 78.5 percent increase in the number of new cases compared to 2022.

The current outbreak on the continent has swept through several countries, particularly the Democratic Republic of Congo.
A new offshoot of clade I, clade Ib, has been detected in the east of the DRC and has been confirmed in Kenya, Rwanda and Uganda. Scientists believe this variant is playing a role in the spread.

Clade I has, in the past, typically spread by people eating infected bushmeat. Clade Ib is spreading person to person, often via sexual contact, but also through other physical and face-to-face contact, or via contaminated bedding or towels.

Other forms of the virus remain in circulation. The DRC is also recording cases of clade Ia, as is the Central African Republic. Clade II has been reported in Cameroon, Ivory Coast, Liberia, Nigeria and South Africa, according to the WHO.

Should you be worried?

Giving reasons for declaring mpox a public health emergency in Africa, Kaseya said, “With a heavy heart but with an unyielding commitment to our people, to our African citizens, we declare mpox as a public health emergency of continental security.

“Mpox has now crossed borders, affecting thousands across our continent, families have been torn apart, and the pain and suffering have touched every corner of our continent.”
Kaseya noted that the declaration is not merely a formality, it is a clarion call to action.
“It is a recognition that we can no longer afford to be reactive. We must be proactive and aggressive in our efforts to contain and eliminate this threat,” he added.

How is it spreading and who is infected?

The virus is crossing borders with infected people on the move. Mpox is also spreading through sexual networks. Sex workers originally made up a high proportion of those infected.

Are there vaccines?

There are two vaccines but issues with access. Africa CDC says it needs 10 million doses, but only 200,000 are available. A lack of treatments and diagnostics is hampering the response.

Plans for vaccination programmes remain under review but are likely to involve tracing and vaccinating contacts of cases and targeting groups such as people living with HIV, who appear to be at higher risk of severe disease.

The WHO has triggered an emergency use listing for mpox vaccines . WHO issued a call for an Expression of Interest for Emergency Use Listing for mpox vaccines. The EUL procedure serves as an emergency use authorisation process to expedite the availability of unlicensed medical products.

Currently, two vaccines are in use against mpox, both recommended by the WHO Strategic Advisory Group of Experts on Immunisation.

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