New Delhi:

The World Health Organization (WHO) said today that droplets were a “minor” route of transmission for mpox compared to physical contact, adding that more research is required to understand how the virus spreads.

The UN health agency declared mpox a public health emergency of international concern on August 14 amid a surge of cases across the Democratic Republic of Congo (DRC) and its neighbouring countries.

Mainly, two distinct clades of the virus, Ia and Ib, are causing significant concern in the DRC. A third variant, Clade II, originated in Nigeria and has been responsible for the global outbreak that began in 2022.

What is Mpox?

The mpox virus is an orthopoxvirus that causes mpox (monkeypox), a disease with symptoms similar to smallpox, although less severe, according to the WHO website. 

What are the symptoms of Mpox?

1. Fever
2. Extensive characteristic rash 
3. Swollen lymph nodes
4. Headache
5. Back pain and muscle ache
6. Lack of energy

The incubation period of mpox can range from 5 to 21 days. The febrile stage of illness (when fever persists) usually lasts 1 to 3 days, according to WHO. This is followed by the skin eruption stage, which can last for 2 to 4 weeks.

How does Mpox spread?

WHO has said that mpox spreads between people mainly through close physical contact with someone who has the virus. “Close contact includes skin-to-skin (such as touching or sex) and mouth-to-mouth, or mouth-to-skin contact (such as kissing),” it said.

However, WHO spokeswoman Margaret Harris said today that if a person with the virus had lesions, “if you’re talking closely to someone, breathing on them, physically close, face-to-face, there is a possibility” of viral spread, “but this is a minor source”.

“When you’re talking to somebody, you’re spitting out droplets,” but “it’s not a very major form of transmission — and it’s not a… through-the-air, long-distance sort of transmission,” she added.

The WHO recommends the use of facemasks for those with mpox, their close contacts and health workers treating them.

Does mpox have a vaccine?

Yes, there are vaccines recommended by WHO for use against mpox. However, only people who are at risk should get the vaccine. WHO has not recommended mass vaccination against mpox.

How has India prepared for a possible mpox outbreak?

India currently has no active mpox cases. The government had ordered the authorities in airports, ports and borders with Bangladesh and Pakistan to remain alert about incoming international passengers who show mpox symptoms.

The All India Institute for Medical Sciences (AIIMS) had issued protocols for handling suspected mpox cases in India. Various government hospitals were directed to set up isolation rooms for suspected and confirmed cases of mpox.

The institute has recommended setting up a screening process in the triage area wherein, upon arrival, patients with fever, rash, or a history of contact with confirmed mpox cases should be flagged for immediate assessment.

According to an assessment, the risk of a large outbreak with sustained transmission is low, officials had said.
 

(With inputs from AFP)

Photo taken for illustration purpose onluy.
| Photo Credit: Reuters

A World Health Organization official stressed on Tuesday that mpox, regardless of whether it is the new or old strain, is not the new COVID, as authorities know how to control its spread.

“We can and must tackle mpox together,” said Hans Kluge, WHO regional director for Europe, in a media briefing.

“So will we choose to put the systems in place to control and eliminate mpox globally? Or we will enter another cycle of panic and neglect? How we respond now and in the years to come will prove a critical test for Europe and the world,” he added.

Mpox, a viral infection that causes pus-filled lesions and flu-like symptoms, is usually mild but can kill.

Kluge said that the focus on the new clade 1 strain gives Europe a chance to refocus on the less severe clade 2 variety, including better public health advice and surveillance.

About 100 new cases of the clade 2 mpox strain are now being reported in the European region every month, added Kluge.

A health worker speaks to women about mpox prevention at a clinic in Munigi, eastern Congo.
| Photo Credit: AP

Congo will receive the first vaccine doses to address its mpox outbreak next week from the United States, the country’s health minister said Monday, days after the World Health Organization declared mpox outbreaks in Africa a global emergency.

Mpox cases have been confirmed among children and adults in more than a dozen African countries, and a new form of the virus is spreading. Few vaccine doses are available on the continent.

Congo has the vast majority of the mpox cases and currently needs 3 million vaccine doses. The U.S. and Japan have offered to donate vaccines, Health Minister Roger Kamba told journalists. He did not say how many doses would be sent or when the ones from Japan would arrive.

The WHO has reported over 17,000 mpox cases and over 500 deaths worldwide this year. More than 96% of all cases and deaths have been in Congo, whose health system has long struggled to contain disease outbreaks over the country’s vast area and poor infrastructure. Children under 15 account for more than 70% of the cases and 85% of deaths in Congo.

Scientists are also concerned by a new version of mpox in Congo that might be more easily transmitted. Last week, Sweden reported its first case of the new version. Officials said the risk to the general public was considered “very low” and that they expected sporadic imported cases to continue.

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form causes milder symptoms and lesions on the genitals. That makes it harder to detect, meaning people might sicken others without knowing they’re infected. Mpox is not airborne and typically requires close, skin-to-skin contact to spread.

The WHO has said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks were linked to the epidemic in Congo.

DR Congo:

An mpox outbreak in the Democratic Republic of Congo has killed 548 people since the start of the year, with all provinces affected by the virus, the health minister said on Thursday in a statement.

The World Health Organization (WHO) on Wednesday declared the mpox surge in Africa a global public health emergency, worried by the rise in cases in DRC and the spread to nearby countries.

“According to the latest epidemiological report, our country has recorded 15,664 potential cases and 548 deaths since the beginning of the year,” Health Minister Samuel-Roger Kamba said in a separate video message seen by AFP on Thursday.

The DRC is made up of 26 provinces and has a population of around 100 million.

The most affected provinces are South Kivu, North Kivu, Tshopo, Equateur, North Ubangi, Tshuapa, Mongala and Sankuru, Kamba said.

The UN health agency’s decision came the day after the African Union’s health watchdog declared its own public health emergency over the growing outbreak.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Dr. Tresor Wakilongo, verifies the evolution of skin lesions on the ear of Innocent, suffering from mpox — an infectious disease caused by the monkeypox virus that sparks off a painful rash, enlarged lymph nodes and fever; at the treatment centre in Munigi, following mpox cases in Nyiragongo territory near Goma, North Kivu province, Democratic Republic of the Congo July 19, 2024.
| Photo Credit: Reuters

The World Health Organization has declared the mpox outbreaks in Congo and elsewhere in Africa a global emergency, with cases confirmed among children and adults in more than a dozen countries and a new form of the virus spreading. Few vaccine doses are available on the continent.

Earlier this week, the Africa Centers for Disease Control and Prevention announced that the mpox outbreaks were a public health emergency, with more than 500 deaths, and called for international help to stop the virus’ spread.

Explained | Global mpox infections: Symptoms, treatment, and status of outbreak

“This is something that should concern us all … The potential for further spread beyond Africa and beyond is very worrying,” said WHO director-general Tedros Adhanom Ghebreyesus.

The Africa CDC previously said that mpox, also known as monkeypox, has been detected in 13 countries this year, and that more than 96% of all cases and deaths are in Congo. Cases are up 160% and deaths are up 19% compared with the same period last year. So far, there have been more than 14,000 cases and 524 people have died.

“We are now in a situation where (mpox) poses a risk to many more neighbors in and around central Africa,” said Salim Abdool Karim, a South African infectious diseases expert who chairs the Africa CDC emergency group. He noted that the new version of mpox spreading from Congo appears to have a death rate of about 3-4%.

During the global 2022 mpox outbreak that affected more than 70 countries, fewer than 1% of people died.

Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, said declaring the mpox outbreaks in Africa an emergency is warranted if that might lead to more support to contain them.

“It’s a failure of the global community that things had to get this bad to release the resources needed,” he said.

Officials at the Africa CDC said nearly 70% of cases in Congo are in children younger than 15, who also accounted for 85% of deaths.

Jacques Alonda, an epidemiologist working in Congo with international charities, said he and other experts were particularly worried about the spread of mpox in camps for refugees in the country’s conflict-ridden east.

“The worst case I’ve seen is that of a six-week-old baby who was just two weeks old when he contracted mpox,” Mr. Alonda said, adding the baby has been in their care for a month. “He got infected because hospital overcrowding meant he and his mother were forced to share a room with someone else who had the virus, which was undiagnosed.”

Save the Children said Congo’s health system already had been “collapsing” under the strain of malnutrition, measles and cholera.

WHO Director-General Tedros Adhanom Ghebreyesus said officials were facing several outbreaks of mpox outbreaks in various countries with “different modes of transmission and different levels of risk.”

The U.N. health agency said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks are linked to the one in Congo. In the Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread worldwide in 2022.

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form causes milder symptoms and lesions on the genitals. That makes it harder to spot, meaning people might also sicken others without knowing they’re infected.

In 2022, WHO declared mpox to be a global emergency after it spread to more than 70 countries that had not previously reported mpox, mostly affecting gay and bisexual men. Before that outbreak, the disease had mostly been seen in sporadic outbreaks in central and West Africa when people came into close contact with infected wild animals.

Western countries mostly shut down the spread of mpox with the help of vaccines and treatments, but very few of those have been available in Africa.

Marks of the London School of Hygiene and Tropical Medicine said that in the absence of mpox vaccines licensed in the West, officials could consider inoculating people against smallpox, a related disease. “We need a large supply of vaccine so that we can vaccinate populations most at risk,” he said, adding that would mean sex workers, children and adults living in outbreak regions.

Congolese authorities said they have asked for 4 million doses of mpox vaccine, Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee, told AP. Mr. Osako said those would mostly be used for children under 18.

“The United States and Japan are the two countries that positioned themselves to give vaccines to our country,” Mr. Osako said.

Although WHO’s emergency declaration is meant to spur donor agencies and countries into action, the global response to previous emergency designations has been mixed.

Dr. Boghuma Titanji, an infectious diseases expert at Emory University, said the last WHO emergency declaration for mpox “did very little to move the needle” on getting things like diagnostic tests, medicines and vaccines to Africa.

“The world has a real opportunity here to act in a decisive manner and not repeat past mistakes, (but) that will take more than an (emergency) declaration,” Dr. Titanji said.

File picture of a doctor examining the ear of a patient suffering from Mpox – an infectious disease caused by the monkeypox virus in the North Kivu province of the Democratic Republic of the Congo
| Photo Credit: Reuters

Vaccines to help curb an escalating mpox outbreak in Democratic Republic of Congo and neighbouring countries may still not reach the central African country for months even as the World Health Organization considers following Africa’s top public health agency in declaring the outbreak an emergency.

On Tuesday, Africa Centres for Disease Control and Prevention declared a public health emergency of continental concern for the first time ever, and on Wednesday, a WHO-led panel meets to decide if it represents a global threat.

ALSO READ: Global mpox infections: Symptoms, treatment, and status of outbreak | Explained

But while experts hoped the meetings would galvanise action worldwide, many obstacles remain, including limited vaccine supply, funding and competing disease outbreaks.

“It is important to declare an emergency because the disease is spreading,” said Jean-Jacques Muyembe-Tamfum, head of Congo’s Institut National pour la Recherche Biomedicale (INRB). He said he hoped any declaration would help provide more funding for surveillance as well as supporting access to vaccines in Congo.

But he acknowledged the road ahead was not easy in a huge country where health facilities and humanitarian funds are already stretched by conflict and outbreaks of diseases like measles and cholera.

“If the big declarations remain just words, it won’t make any material difference,” said Emmanuel Nakoune, an mpox expert at the Institut Pasteur de Bangui in Central African Republic.

Africa CDC said last week it had been granted $10.4 million in emergency funding from the Africa Union for its mpox response, and its director general Jean Kaseya said on Tuesday there was a clear plan to secure 3 million doses of vaccine this year, without elaborating further.

However, sources involved in planning a vaccination roll-out in Congo said only 65,000 doses were likely to be available in the short-term, and campaigns were unlikely to begin before October at the earliest.

There have been more than 15,000 suspected cases of mpox in Africa this year and 461 deaths, mainly among children in Congo, according to Africa CDC. The viral infection is usually mild but can kill, and causes flu-like symptoms and pus-filled lesions.

A new offshoot of the virus has caused outbreaks in refugee camps in the east of Congo this year, and spread to Uganda, Burundi, Rwanda and Kenya for the first time.

Ivory Coast and South Africa are also experiencing outbreaks linked to a different strain of the virus, which spread globally in 2022, largely among men who have sex with men. This outbreak prompted WHO to declare a global emergency before ending it 10 months later.

Then, two vaccines were used – Bavarian Nordic’s Jynneos, and LC16, made by KM Biologics. Outside clinical trials, neither has ever been available in Congo or across Africa, where the disease has been endemic for decades. Only LC16 is approved for use in children.

Congo’s regulators approved the use of the vaccines domestically in June, but the government is yet to officially request any from either the manufacturers or governments like the United States looking to make donations through the global vaccine group, Gavi.