Why that is a concern for other countries

Due to the alarming increase in the number of cases of MPox (formerly called monkeypox), the African Centers for Disease Control and Prevention declared the disease a public health emergency on Tuesday. There have already been 17,500 cases of MPOX and 460 deaths in Africa 2024more than all of last year. The severity of the outbreak has public health officials questioning the need for a global public health emergency.

What is Mpox?

Mpox is a disease caused by monkeypox virus, which was first discovered in 1958 when an outbreak of a pox-like disease occurred in monkeys used for research. The first human case was reported in 1970 in the Democratic Republic of Congo, and the disease is now considered endemic in several Central and West African countries.

There are two known clades (types) of monkeypox virus. Clade I is endemic to Central Africa and infection can be associated with more severe disease, with a mortality rate of up to 10%. A variant of this clade, known as clade Ib, is causing the current outbreak in Africa. Clade II is endemic to West Africa and typically results in less severe disease, with less than 0.1% of individuals dying from the infection. In 2022, a global outbreak of clade II monkeypox virus resulted in approximately 99,500 confirmed cases and more than 200 deaths.

Infection with monkeypox virus can cause a range of clinical signs, from asymptomatic infection to a flu-like illness (i.e. fever, body aches, headache), swollen lymph nodes and the development of fluid-filled pustules or lesions. The virus is spread by contact with infected animals or by direct contact with infected lesions or contaminated material, such as bedding or clothing.

Why is Africa’s latest outbreak worrying?

The unprecedented rise in MPOX cases has prompted the Director-General of the World Health Organization to convene an emergency committee meeting, scheduled for Wednesday, August 14, to discuss the situation and determine whether the outbreak constitutes a health emergency of public health is of international importance.

This is due to several factors. First, the number of MPOX cases in Africa this year has already surpassed the total number of cases in 2023. Second, the virus has now spread from the Democratic Republic of Congo to surrounding countries, including Burundi, Kenya, Rwanda and Uganda. Third, the cases are largely due to clade I of the virus – particularly the variant clade Ib – which can be associated with more severe disease. Furthermore, clade Ib appears to be more transmissible, with spread occurring through more routine contact, especially among young children.

Given the volume of global travel, public health officials are concerned that a more transmissible form of the virus could enter and spread in countries outside Africa.

What can be done to prevent a global outbreak?

Fortunately, current variants of monkeypox virus do not appear to be spread through the respiratory tract. To date, cases have resulted from direct contact with infected lesions – mainly through sexual exposure – or from prolonged close contact with an infected individual. Individuals should avoid direct contact with anyone who has skin lesions, and new sexual partners should wear protection.

Clinicians should be aware of the ongoing MPox outbreak and consider testing individuals for MPox if they present with influenza-like illness or skin lesions, especially if they have recently traveled to Central or West Africa. Finally an mpox vaccine is available, and rapid distribution is needed in African countries affected by the ongoing outbreak to reduce the rate of further spread. Other countries around the world should also plan to expand MPox testing and availability of the MPox vaccine to at-risk individuals.