The World Health Organization has declared a global health emergency over another outbreak of mpox, the second in three years, which has spread to more than a dozen African countries. Mpox is the modified name for Monkeypox.
WHO Director-General Dr Tedros Adhanom Ghebreyesus made the declaration, August 14, based on the advice of the International Health Regulation Emergency Committee of independent experts, who reviewed data presented by experts from WHO and affected countries including the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa. Mpox upsurge in the affected countries is now considered to be a Public Health Emergency of International Concern PHEIC, with potential to spread further across countries in Africa and possibly outside the continent.
In declaring the PHEIC, Dr Tedros said, “The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”
Mpox has been reported in the DRC for more than a decade, and the number of cases reported each year has increased steadily over that period. Last year, reported cases increased significantly, and already the number of cases reported so far this year has exceeded last year’s total, with more than 15,600 cases and 537 deaths.
Committee Chair Professor Dimie Ogoina said, “The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself.”
This PHEIC determination is the second in two years relating to mpox. Caused by an Orthopoxvirus, mpox was first detected in humans in 1970, in the DRC. The disease is considered endemic to countries in the Central and West Africa.
In the past month, over 100 laboratory-confirmed cases have been reported in four countries neighboring the DRC that have not reported mpox before: Burundi, Kenya, Rwanda, and Uganda.
WHO Intervention
Vaccines & Emergency Use Listing:
The two vaccines currently in use for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization and are also approved by WHO-listed national regulatory authorities, as well as by individual countries including Nigeria and the DRC.
The Director-General has triggered the process for Emergency Use Listing for mpox vaccines, which will accelerate vaccine access for lower-income countries which have not yet issued their own national regulatory approval. Emergency Use Listing also enables partners including Gavi and UNICEF to procure vaccines for distribution.
WHO is working with countries and vaccine manufacturers on potential vaccine donations, and coordinating with partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics, and other tools.
Funding:
WHO anticipates an immediate funding requirement of an initial US$ 15 million to support surveillance, preparedness, and response activities. A needs assessment is being undertaken across the three levels of the Organization.
To allow for an immediate scale-up, WHO has released US$ 1.45 million from the WHO Contingency Fund for Emergencies and may need to release more in the coming days. The Organization appeals to donors to fund the full extent of the needs of the mpox response.
What’s Mpox?
Mpox is an illness caused by the monkeypox virus. This virus is part of the same family as the virus that causes smallpox. People with mpox often get a rash, along with other symptoms. The rash will go through several stages, including scabs, before healing.
It is a zoonotic viral infection that can spread between animals and people mainly through close contact, and occasionally from the environment to people via things and surfaces that have been touched by a person with mpox. In settings where the monkeypox virus is present among some wild animals, it can also be transmitted from infected animals to people who have contact with them and from humans to pet animals:
Person to Person
Animals to humans
Humans to Animal
Prevalence
Ninety-six percent of the mpox deaths reported in June, 2024 were in Congo. But the disease has now been identified in 13 countries, including for the first time in the East African nations of Burundi, Kenya, Rwanda, and Uganda.
According to WHO reports, the spread of monkeypox is from Africa to the rest of the world. Since 1970, human cases of monkeypox have been reported in 11 African countries: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Cote d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone and South Sudan. In 1996–97, an outbreak was reported in the Democratic Republic of Congo. Since 2017, Nigeria has experienced a large outbreak, with over 500 suspected cases and over 200 confirmed cases and a case fatality ratio of approximately 3%.
Monkeypox has become a disease of global public health importance as it not only affects countries in west and central Africa, but the rest of the world. In 2003, according to WHO, the first monkeypox outbreak outside of Africa was in the United States of America and was linked to contact with infected pet dogs from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. Monkeypox has also been reported in travellers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021 and May 2022, to Singapore in May 2019, and to the United States of America in July and November 2021.
Signs and symptoms
Fever, intense headache, swelling of the lymph nodes, back pain, muscle aches, and intense asthenia (lack of energy). There is also the skin eruption that usually begins within 1–3 days of the appearance of fever. The monkeypox rash tends to be more concentrated on the face, palms of hands, and soles of the feet.
Also affected are oral mucous membranes, genitalia, and conjunctivae, as well as the cornea. The rash evolves sequentially from lesions with a flat base to slightly raised firm lesions, lesions filled with clear fluid, lesions filled with yellowish fluid, and crusts which dry up and fall off. The number of lesions varies from a few to several thousand. In severe cases, lesions can coalesce until large sections of skin slough off.
Prevention
While the WHO is gearing efforts to get the vaccines across the globe, there are personal hygiene that can minimize the spread of the mpox virus.
-Avoid eating not well-cooked meat
-Regular hand washing
-Health workers must implement standard precautionary control mechanism
-Avoid unprotected contact with wild animals, especially those that are sick or dead, including their meat, blood, and other parts.
Source: Dare Agbeluyi, Chief Publisher, with WHO Reports.
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