For the second time in two years, the World Health Organization (WHO) has declared mpox (previously known as monkeypox) a global public health emergency. This declaration comes after an alarming outbreak in the Democratic Republic of Congo (DRC) that has now spread to several neighboring countries in Africa. The WHO’s decision underscores the serious threat posed by this rapidly spreading viral infection and the urgent need for coordinated global action.
What Prompted the Declaration?
On Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus convened an emergency committee meeting to assess whether the current outbreak of mpox qualifies as a “public health emergency of international concern” (PHEIC). A PHEIC is WHO’s highest level of alert and is intended to prompt global collaboration, funding, and research efforts to contain and control the spread of a disease.
“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” said Tedros.
Mpox, though typically mild, can be fatal in some cases. The virus usually causes flu-like symptoms along with pus-filled lesions on the body. The DRC outbreak initially involved a known endemic strain, clade I, but a more transmissible variant, clade Ib, has emerged, prompting the new emergency. This variant is believed to spread more easily through close contact, including sexual contact, and has now reached countries like Burundi, Kenya, Rwanda, and Uganda.
The Growing Impact in Africa
The outbreak in DRC has escalated with more than 14,000 cases and over 500 deaths reported across Africa this year, surpassing last year’s figures. The spread of mpox, particularly among children, is causing significant concern. In response, WHO has released $1.5 million in contingency funds and is preparing to seek an additional $15 million to combat the outbreak.
Africa’s top public health body, the Africa Centers for Disease Control and Prevention (Africa CDC), also declared mpox a public health emergency earlier this week, citing the rapid spread of the virus. Mpox has now been detected in at least 13 African countries, with a 160% increase in cases compared to the same period last year.
Understanding Mpox: Transmission and Symptoms
Mpox is a viral infection that primarily affects humans and some animals. It belongs to the Orthopoxvirus genus, the same group that includes smallpox and other pox-like viruses. Although mpox was initially discovered in monkeys in 1958, the virus also affects rodents and humans.
Transmission occurs through both animal-to-human and human-to-human contact. Animal-to-human transmission typically happens through bites, scratches, or direct contact with the body fluids of an infected animal. Human-to-human transmission can occur through:
- Direct contact with skin lesions, body fluids, or respiratory droplets from an infected person.
- Prolonged face-to-face contact.
- Touching contaminated objects like bedding or clothing.
Once infected, individuals may experience flu-like symptoms, including fever, headache, and muscle aches, followed by the appearance of a distinctive rash. The rash usually develops into pus-filled lesions that eventually scab over and heal. The virus can be fatal in rare cases, particularly in individuals with weakened immune systems.
Symptoms usually appear within 3 to 21 days of exposure and can last for two to four weeks. Importantly, mpox can be transmitted before symptoms fully develop, making early detection and isolation critical for preventing further spread.
Why Has WHO Declared Mpox a Global Emergency Again?
The decision to declare mpox a global public health emergency was driven by the detection of a new clade and the first-time reporting of cases in countries like Kenya and Rwanda. The WHO is concerned that the outbreak may spread beyond Africa, creating a wider global health crisis.
This is not the first time WHO has raised the alarm over mpox. In July 2022, the organization declared a global health emergency when mpox cases surged, primarily among men who have sex with men. Although that outbreak was brought under control, the reemergence of the virus in different regions signals a need for sustained vigilance.
Current Challenges and the Need for Vaccines
One of the key challenges in managing the current outbreak is the lack of available vaccines and treatments in Africa. While some vaccines, like JYNNEOS, have been approved for emergency use in severe cases, these are not widely available in the regions most affected. In the DRC, where the outbreak is concentrated, more than 60% of cases involve individuals under the age of 18, highlighting the need for targeted interventions.
WHO and other health agencies are working to secure vaccine supplies and study the most effective ways to distribute them. However, limited resources and competing global health priorities have hindered efforts.
The Road Ahead: Containing Mpox
The reclassification of mpox as a global emergency aims to mobilize resources and accelerate international cooperation. According to Amita Gupta, director of the Division of Infectious Diseases at the Johns Hopkins School of Medicine, “There is a real attempt right now to mobilize resources, and that is why WHO called for the public health emergency now.”
The situation remains fluid, with health experts calling for improved surveillance, rapid testing, and access to treatment in affected regions. As the global community grapples with this renewed threat, the focus will be on preventing further spread and ensuring that countries have the tools they need to combat the virus effectively.
In conclusion, while mpox may not have the same global profile as other health crises, its resurgence in Africa and potential to spread internationally are reminders that the world cannot afford to be complacent. Public health emergencies require swift and sustained responses, and the fight against mpox is far from over.
