Amid the rise in Mpox cases, Africa’s vaccination drive is becoming more urgent

The first doses of an Mpox vaccine called Jynneos arrived this week in the Democratic Republic of Congo. Authorities expect more than 250,000 doses to be delivered to the DRC in the coming days. Given the current surge in cases, it is critical that sufficient vaccine supplies are shipped to the DRC and other African countries and administered to at-risk populations as quickly as possible.

There were just that last week alone 5,466 suspected new cases of Mpox (formerly known as monkeypox) in Africa, mainly in the Democratic Republic of Congo, according to Dutch news site NOS. This is evident from figures from CDC Africa 26 more people died from MPox last week.

It is estimated that at least 25,000 people have been infected with Mpox since the beginning of this year, although in light of very limited access to diagnostic tests across Africa, only a relatively small proportion have been confirmed. Since January, 643 people have died from the virus.

The World Health Organization declared last month that the rapid spread of Mpox in African countries constitutes a global public health emergency. This is the second time in three years that the WHO has declared an Mpox epidemic as a global emergency. This previously happened in the summer of 2022, when an outbreak broke out almost 100,000 people in 116 countries and killed about 200 people.

The WHO designation of a “public health emergency of international concern” is intended to prompt Member States to prepare for the emergence of the virus and to share vaccines, treatments and other important resources, especially with poorer countries.

The vaccine currently being shipped to the DRC, Jynneos, was licensed by the Food and Drug Administration in 2019 for adults 18 years and older who are at high risk of exposure to Mpox. In an interview with STAT newsthe creator of the product, Bavarian Nordic, said it can increase production by another eight million doses by 2025.

In particular, the vaccine can prevent Mpox and reduce the severity of the infection if it does occur. The U.S. Centers for Disease Control and Prevention recommends that people who have been exposed to Mpox or are at risk of exposure to the virus get vaccinated.

The FDA gave the green light two weeks ago to another Mpox vaccine, ACAM2000. It is a direct descendant of the world’s first vaccine invented by Edward Jenner more than two centuries ago.* First formally approved by the FDA for the prevention of smallpox in 2007, the US has a strategic stockpile of more than 100 million doses of ACAM2000. The vaccine has more side effects and contraindications than Jynneos. In particular, it is not recommended for people with compromised immune systems, such as HIV patients, pregnant women and people with autoimmune diseases.

It is unclear whether the federal government will deliver any doses of its large stockpile of ACAM2000 to African countries in need. On the other hand, the manufacturer of the product, Emergent BioSolutions, has say it is donating 50,000 doses to Africa.

It appears that the current strain of Mpox, clade Ib, is more virulent than the strain circulating in 2022, clade II, with possibly a higher mortality rate.

While the 2022 outbreak was mainly among gay and bisexual men, Mpox in Africa is now being spread not only through sexbut also through close personal contact in certain parts of the DRC, especially with children.

What is known about the transmission is mainly Mpox spreads through direct contact with bodily fluids or sores from a person or animal that has the disease. It is also thought that Mpox can spread through direct contact with material, such as clothing and bedding, that has touched bodily fluids or sores. In addition, Mpox can be infected through the consumption of bushmeat (meat from hunted wild animals in Africa).

The infection can cause fever, respiratory symptoms, muscle pain, and swollen lymph nodes, as well as a rash on the hands, feet, chest, mouth, or genitals. Reasons for hospitalization include the need for treatment of severe pain, as well as pharyngitis limiting oral intake, encephalitis (inflammation of the brain), eye lesions, acute kidney injury and myocarditis (inflammation of the heart).

So far the total mortality rate of the current clade Ib outbreak appears to be around 5%, but some regions have reported this rates above 10%. In comparison, the mortality rate during the 2022 Mpox outbreak, mainly caused by clade II, was only 0.18%.

Sweden confirmed its first case of a more virulent variant of Mpox in August. This was the first time this specific virus strain had been detected outside Africa. About the same time, Thailand confirmed a case of the clade Ib variant. Both individuals with confirmed cases had traveled to a part of Africa where there is a major epidemic of the disease.

In response to the potential threat of the global spread of the virus, the US CDC to have health care providers called and the public must be vigilant.

For now, the epidemic of the clade Ib variant of Mpox remains largely confined to the African continent. Nevertheless, amid a steadily growing outbreak, it is urgent that the vaccination campaign in Africa succeeds in containing the public health emergency there, but also reducing the risk of it spreading globally.