The World Health Organization (WHO) has declared the recent mpox outbreak, previously known as monkeypox, as a global health emergency. This recognition arises from the alarming increase of cases primarily occurring across Africa, particularly concentrated in the Democratic Republic of the Congo (DRC).
The DRC is experiencing unprecedented infection numbers, reporting over 27,000 suspected mpox cases since the beginning of 2023. This surge has resulted in more than 14,000 confirmed cases and 524 deaths across African nations this year alone, far exceeding last year's statistics.
A notable difference between the current outbreak and the one seen in 2022 is the virus's impact demographic. The 2022 outbreak predominantly affected men who have sex with men, whereas current cases are increasingly reported among families and children.
Daniel Pastula, MD, MHS, who focuses on neuroinfectious diseases at the CU School of Medicine, emphasizes this shift, stating, "What we’re seeing now is families and children with mpox, as well as reports of transmission occurring through sharing items like blankets or utensils. It’s not just about sexual transmission anymore.”
Currently, the most severe variant identified is clade I, which carries with it a mortality rate of around 3%, significantly higher than the less than 1% for clade II associated with the 2022 outbreak. Pastula also notes how the symptoms of mpox have remained classic, beginning with fever and rash, unlike many patients during the last outbreak who exhibited milder or different symptoms.
Public health officials are consolidations efforts to stem this outbreak with various measures, including the distribution of vaccines. Vaccines like JYNNEOS, effective against all strains of mpox, are currently being deployed to vulnerable locations, particularly within the DRC and its neighboring countries.
Direct Relief, for example, is engaged on the front lines by preparing the delivery of 50,000 doses of the ACAM2000 vaccine, along with syringes and other necessary components for administration. This effort is being coordinated with local health authorities to reach affected populations effectively.
Given the disturbing trend of increasing mpox infections, WHO has also activated the Emergency Use Listing process for vaccines to expedite access to preventive measures in poorer nations. This would allow countries without their own regulatory approval to obtain the necessary vaccines quickly.
The healthcare infrastructure is facing significant challenges with the current mpox outbreak, as evidenced by the reports indicating children under 18 account for about 70% of cases and 85% of deaths within the DRC. Their vulnerability stems from factors like low immunity and high rates of malnutrition.
Conditions are even more dire for groups facing social instability, such as displaced individuals living in overcrowded refugee camps, where sanitation is often inadequate. With the outbreak worsening, public health systems across the region are at risk of becoming overwhelmed.
Meanwhile, the U.S. remains vigilant, currently without any travel-imported mpox cases reported. It’s important for healthcare providers and public health officials to stay informed and prepared to respond should the virus spread beyond its current geographical hotspots.
Health officials have reiterated their guidance, stressing vaccination and awareness for those at higher risk, particularly individuals with close contacts or multiple sexual partners. Efforts to increase the vaccine's availability, such as enabling certified pharmacists to administer it, have begun to roll out across various states.
New York serves as one such example, with state health officials urging residents to vaccinate as the more virulent clade I variant becomes increasingly prevalent. There’s been concern over the vaccine uptake, with only 45% of recommended individuals taking the necessary precautions.
The WHO has continued to highlight the global threat posed by mpox, noting it has spread from Africa to several other nations, including reports of new variants entering regions where mpox had not previously been present. These developments have increased the urgency for comprehensive vaccination and public health strategies worldwide.
Finally, as discussions surrounding the pandemic's potential for resurgence gain traction, health authorities remain committed to monitoring the situation closely. They are adjusting strategies based on the disease's transmission patterns and responding dynamically to the changing epidemiological circumstances as they arise.
The swift actions of various health organizations and governments will be pivotal as they continue working to hamper the contagious nature of mpox and protect at-risk populations.
