A deadly new strain of the Mpox virus, known as Clade 1B, has emerged in Central Africa, causing concern as it spreads beyond the continent. This year’s major outbreak began in the Democratic Republic of Congo, where it has claimed at least 450 lives, before spreading to other parts of Central and East Africa. The virus has now reached countries outside Africa, with Sweden and Pakistan reporting their first cases of this highly infectious strain, previously known as Monkeypox.
The World Health Organization (WHO) has declared the ongoing Mpox outbreak in Africa a global health emergency, the highest level of alarm under international health law. Before this declaration, the Africa Centres for Disease Control and Prevention had already issued a public health emergency for the continent. The last time Mpox was declared a global health emergency was in 2022, when a different strain, Clade II, which is endemic to West Africa, caused an outbreak. The WHO’s decision to declare the current outbreak a global emergency came after the virus spread to several other African countries, raising fears of a potential global crisis.
The Origin and History of Mpox
The Mpox virus was first discovered in 1958 in Denmark, in monkeys kept for research, which led to its original name, Monkeypox. The first human case of Mpox was reported in 1970 in a nine-month-old boy in the Democratic Republic of the Congo. As the virus continues to spread, experts are increasingly concerned about its potential to become as deadly as COVID-19.
What is Mpox Virus? Understanding Its Symptoms
Mpox is a zoonotic disease caused by the Mpox virus, with initial symptoms resembling those of the flu, such as fever, chills, and body aches. A few days after these flu-like symptoms appear, a distinctive rash begins to develop, typically starting on the face and spreading across the body, including the palms and soles. The rash evolves through several stages—macules, papules, vesicles, pustules—over a period of 2-4 weeks. Mpox is divided into two main clades: Clade I and Clade II, with Clade 1B currently responsible for the ongoing outbreak.
How Does Mpox Spread?
Animal to Human Transmission: Mpox can be transmitted from animals to humans, particularly through contact with infected monkeys, squirrels, rats, and other non-human primates. Transmission occurs through bites, scratches, or contact with bodily fluids, and is more common among people who hunt or handle animals in regions where Mpox is endemic. To reduce the risk of zoonotic transmission, it is crucial to use protective gear and avoid contact with potentially infected animals.
Human to Human Transmission: The current outbreak is primarily driven by human-to-human transmission. The virus spreads through respiratory droplets, direct contact with bodily fluids, or contact with contaminated objects such as bedding or clothing. Although the role of sexual transmission is not fully understood, close physical contact, including during sexual activity, can facilitate the spread of the virus. Pregnant women can also pass the virus to their fetuses.
Transmission in Healthcare Settings: Healthcare workers are at particular risk due to their close contact with infected patients. The virus can spread through respiratory droplets during prolonged face-to-face interactions, or through contact with vesicular or pustular skin lesions.
Clades of Mpox
- Clade I: Predominantly found in Central Africa, this clade is associated with more severe disease, including high fever, extensive rash, and systemic complications. The mortality rate can be as high as 10% in unvaccinated populations. Mpox Clade 1b Variant outbreaks are often linked to direct contact with infected wildlife.
- Clade II: Mainly observed in West Africa, Clade II is generally less severe, with milder symptoms and a lower mortality rate of around 1-3%. However, it still poses a significant risk to vulnerable populations. Clade II outbreaks are often associated with urban settings and international spread, frequently linked to travel and close human contact.
Preventing Mpox Infection
Dr. Urman Dhruv, MD (Internal Medicine) at HCG Hospitals, Ahmedabad, suggests the following measures to prevent Mpox infection:
- Vaccination: The JYNNEOS vaccine, although not currently available in India, is recommended for preventing Mpox. It is important to receive both doses, spaced four weeks apart, for optimal protection.
- Avoiding Wild Animals: In areas where Mpox is endemic, avoid contact with wild animals and ensure that animal products are thoroughly cooked before consumption.
- Human-to-Human Transmission: To prevent transmission between humans, avoid close contact with individuals showing symptoms of Mpox. Practice good hand hygiene and wear protective clothing or masks when caring for infected persons.
- Sanitization: Regularly sanitize potentially contaminated environments and objects to prevent the spread of the virus.
- Hand Hygiene: Wash your hands frequently with soap and water, or use an alcohol-based hand sanitizer, especially before eating, touching your face, or after using the bathroom.
The Bigger Picture
Dr. Tanu Singhal, a Consultant in Paediatrics and Infectious Diseases at Kokilaben Dhirubhai Ambani Hospital, Mumbai, emphasizes that the resurgence of Mpox is partly due to declining immunity from the cessation of smallpox vaccination, which offers partial protection against Mpox. Factors such as deforestation, encroachment into animal habitats, and risky sexual behavior also contribute to the spread of the virus.
In conclusion, preventing the spread of Mpox requires a multifaceted approach that includes vaccination, good hygiene practices, and avoiding contact with both infected individuals and animals. Public awareness and adherence to preventive measures are crucial in managing and controlling the outbreak, particularly as the virus continues to spread beyond its traditional regions.
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