The World Health Organisation has declared the most recent outbreak of mpox in Africa as a "public health emergency of international concern," which puts it in the same category used for the Ebola outbreaks between 2014, Covid-19, and the 2022 European mpox surge.
As several African countries are experiencing more infectious disease cases, mpox has begun crossing national borders, causing fears that it could develop into a global outbreak.
So far, there have been just 250 cases of mpox in Ireland since the first recorded incident in May 2022. The first case of the disease recorded this year came in February 2024, with four more people being recorded as having mpox in Ireland since then, but is it a real risk for the people of Ireland, and what do we know about it?
What is mpox?
Mpox, formerly known as monkeypox, is an infectious disease caused by a virus which causes symptoms such as fever, chills, and muscle aches. Typically, a rash follows these flu-like symptoms, appearing as raised spots, turning into blisters filled with fluid and eventually scabs.
There are generally two types of mpox, known as "clades," which are split into Clade I and II. Clade I was once identified as the Congo Basin Clade, and Clade II as the West African Clade.
Both variants of the infectious disease can be fatal, although Clade I has a historically higher death rate. Still, according to the World Health Organization, cases identified as part of the 2022 global outbreak are caused mainly by Clade II.
WHO Emergency declaration - what does it mean?
WHO’s emergency declaration aims to motivate nations and donor organizations to take action. Medical experts have urged that the declaration accelerate access to testing, vaccines, and therapeutic drugs in the affected areas and launch campaigns to lessen the stigma associated with the virus.
The highest alert level from the WHO is a "public health emergency of international concern," or PHEIC. It is intended to mobilize international cooperation and funding to combat an outbreak and is announced when diseases spread in novel or unusual ways.
However, the worldwide response to previous declarations has been mixed, with experts claiming that the outbreak in Africa is being largely ignored as cases surge.
Where are the infections surging?
According to a recent Africa CDC briefing, 34 of the 54 countries making up the continent have reported infections or are considered "high-risk" so far.
At present, the Democratic Republic of the Congo (DRC) is experiencing a severe outbreak, with over 14,000 cases reported since the start of 2024. Additionally, 524 people have died from mpox since the turn of the year, with numbers for January to August 2024 already matching the whole of 2023.
Additionally, infections are being reported in the DRC’s neighbours Burundi, Kenya, Rwanda, and Uganda, where cases had not previously been reported.
Why are mpox cases rising now?
Recently, a new variant of mpox Clade I, Clade IB, was discovered in the east of the Democratic Republic of the Congo and confirmed in Kenya, Rwanda, and Uganda. Scientists investigating the new offshoot believe that it is contributing to the spread of mpox in Africa.
In the past, eating contaminated bushmeat was the primary way that Clade I spread. Clade Ib is transmitted from person to person, primarily through sexual content but also by other forms of direct physical contact, contaminated linens or towels, and other means.
Other forms of the virus remain in circulation, with the DRC and the Central African Republic also recording cases of Clade Ia. According to the World Health Organisation, Clade II has been reported in Cameroon, Ivory Coast, Liberia, Nigeria, and South Africa so far.
Dr. Jean Kaseya, the director of the Africa CDC, noted that high levels of insecurity in the area and humans’ increasing proximity to the natural world due to the climate crisis are contributing factors to the increase.
How is it spreading, and why are children more extremely affected
The virus is spreading as infected people continue to move around and cross country borders, carrying mpox into new areas and regions that might not have suffered from this particular plight of disease in the past.
Kenyan Authorities have since diagnosed mpox in a Kenyan Lorry driver who had travelled across Rwanda, Tanzania, and Uganda. Additionally, mpox is spreading quickly through sexual networks, with sex workers initially making up a high proportion of those infected with the disease.
The 2022 global outbreak saw gay and bisexual men account for the majority of cases as mpox was being spread predominantly through close or intimate contact. Despite similar patterns emerging across Africa, children under 15 years old now make up more than 70% of mpox cases and 85% of mpox deaths in the Congo.
According to experts, this could be a result of differences in immune systems, with high malnourishment rates making children in these countries more vulnerable to infection. While older members of these communities may be vaccinated against smallpox, which offers partial protection, younger generations have not received any protective vaccines for mpox.
The director of Save the Children’s operations in Congo, Greg Ramm, told the Irish Times that the organisation was especially concerned about the spread of mpox in the densely populated refugee camps in the east, where 345,000 children were "crammed into tents in unsanitary conditions."
Are there vaccines for mpox?
There are vaccines, but there are access problems. According to the Africa CDC, only 200,000 doses are available despite the need for 10 million. A shortage of diagnoses and therapies is hampering the response.
In response to the African mpox outbreak, the Health Emergency Preparedness and Response Authority (HERA) of the European Commission will acquire and distribute 175,420 MVA-BN vaccines, the only mpox vaccine approved by the FDA and EMA. Bavarian Nordic, a pharmaceutical company, will contribute 40,000 doses to HERA. The Africa CDC will distribute the vaccinations per local needs.
Plans for official vaccination programmes are currently under review. Still, they will likely involve tracing and vaccinating contacts of those diagnosed with the disease, as well as groups living with other conditions, such as HIV, who will be at higher risk of developing the disease.
Mpox outbreak 2022
In 2022, the mpox outbreak spread globally from Europe, mainly infecting communities of men who engage in sexual intercourse with men. The World Health Organisation declared a public health emergency in July 2022, with mass-contact tracing efforts and vaccination programmes deployed immediately.
In May 2023, the Guardian service confirmed that the emergency status was lifted after over 90,000 people had been affected by the infectious disease.
*This article was originally published on Extra.ie.
Comments