Two mpox virus particles, colored pink, on the surface of an infected cell (blue/teal). Image: NIAID/NIH
On August 14, 2024, the World Health Organization (WHO) officially declared mpox, previously known as monkeypox, a public health emergency of international concern. The decision came after an alarming increase in cases, especially in African countries like the Democratic Republic of the Congo (DRC). The announcement has left many wondering what steps will be taken next to control the spread of this virus. The WHO’s declaration underscores the urgent need for coordinated efforts to stop the virus from spreading further across the globe.
Mpox is not a new virus. It has been present in Africa for decades, but its recent outbreaks have raised concerns due to its increasing transmissibility and severity. The latest strain, Clade I, circulating in the DRC, is more virulent than the strain responsible for the 2022 global outbreak, which was known as Clade II. This has made the situation particularly worrisome for health officials. What makes it even more concerning is that cases of mpox have now been reported outside Africa, including in parts of Europe, prompting fears of a larger outbreak.
Daniel Kuritzkes, an infectious disease expert at Harvard Medical School, explained that the rise in cases in Africa is not just a regional problem but a global concern. The world is interconnected through travel and migration, making it easier for diseases like mpox to spread beyond borders. He emphasized that the spread of mpox should not be ignored, even if it primarily affects distant regions. This is a humanitarian issue, and controlling the spread is essential for global health security.
In recent years, there has been a shift in how mpox spreads. Traditionally, it was transmitted through direct contact with infected individuals or animals. However, newer cases have shown that sexual transmission, particularly among men who have sex with men, is becoming more common. This is a new development for Clade I, the more severe strain of the virus. The virus is still primarily spread through close contact, but contaminated materials like bedding can also transmit it. Although airborne transmission is rare, it cannot be entirely ruled out.
The good news is that there are vaccines available that can help prevent mpox. The smallpox vaccine has been shown to be effective against mpox as well. However, it is still too early to know for certain how effective it will be against the currently circulating strains. There is a strong correlation between the decline in smallpox immunity and the rise of mpox cases. Many people born after smallpox vaccination was stopped are now at greater risk of contracting mpox.
Health officials are also concerned about the possibility of the virus mutating. While poxviruses like mpox are less likely to mutate compared to RNA viruses like HIV or COVID-19, the high rates of transmission increase the likelihood of new variants emerging. These variants could potentially evade the immunity developed through vaccination or previous exposure to the virus. This is why monitoring the situation closely is so important.
As of now, the Centers for Disease Control and Prevention (CDC) recommends vaccination for people who are at a higher risk of contracting mpox. This includes men who have sex with men and individuals who engage in high-risk sexual behaviors. Partners of these individuals should also consider getting vaccinated. The aim is to prevent the virus from spreading further within these communities.
For those who are already infected or have been exposed to the virus, there are treatment options available. Tecovirimat is a drug that has been used to treat smallpox and is currently being used to treat mpox as well. However, it is still considered an investigational drug, and its use is limited to clinical trials. These trials are ongoing in collaboration with the CDC and other research institutions, and treatment is available at select hospitals in the U.S.
The international community now faces the challenge of preventing the virus from spreading beyond Africa and into other regions. Vaccination campaigns in the DRC and other affected countries are critical to reducing the number of mpox-related illnesses and deaths. Ensuring that these countries have access to sufficient vaccine supplies and resources is a priority. Global cooperation is key to preventing the virus from spreading further and causing more harm.
As the world continues to grapple with the ongoing mpox outbreak, it is clear that swift action is necessary. The declaration of a public health emergency of international concern is a wake-up call for governments and health organizations around the world. The lessons learned from previous outbreaks, like the 2022 mpox surge and the COVID-19 pandemic, should inform the current response. With the right measures in place, it is possible to control the spread of the virus and prevent a larger global health crisis.
The next few weeks will be critical in determining how the mpox outbreak evolves. Countries will need to ramp up testing, contact tracing, and vaccination efforts to slow down the virus’s transmission. As more information about the virus and its behavior becomes available, health officials will be better equipped to tackle the outbreak and protect vulnerable populations.
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