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Mpox (Clade IB) in Africa Declared a Public Health Emergency of International Concern
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Mpox, formerly known as monkeypox, has resurfaced as a significant global health threat. On August 14, 2024, the World Health Organization (WHO) declared Mpox, specifically Clade IB, a Public Health Emergency of International Concern (PHEIC). This declaration highlights the growing threat posed by this virus, especially in Africa, and its potential global implications.
Background: What is Mpox?
Mpox is caused by the monkeypox virus, which belongs to the orthopoxvirus family. This family includes the variola virus, which causes smallpox. There are two primary clades of the Mpox virus: Clade I and Clade II. Clade I, also known as Clade IB, is endemic to Central Africa, particularly the Democratic Republic of the Congo (DRC), and is more virulent and deadly. On the other hand, Clade II is found in West Africa and is less severe, with a much lower case fatality rate.
In 2022, Clade IIb of Mpox spread globally, primarily affecting men who have sex with men (MSM) through close, often sexual contact. The survival rate for Clade IIb was remarkably high at 99.9%, and the outbreak was relatively contained. However, the situation with Clade IB is different and far more concerning.
The Current Situation: Clade IB's (monkeypox) Rise in Africa
Clade IB is currently spreading in Central Africa, particularly in the DRC and neighboring countries like Burundi, Kenya, Rwanda, and Uganda. Unlike Clade IIb, which primarily spreads through sexual contact, Clade IB is more infectious and has begun spreading through other forms of close contact. This includes contact with contaminated clothing and bedding, and even healthcare workers caring for infected patients have contracted the virus.
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As of August 2024, approximately 177,000 people have been infected in Africa, with about 500 reported deaths, suggesting a case fatality rate of nearly 3%. This marks a significant increase of 160% in infections compared to the previous year. Alarmingly, 70% of those affected are children, who are particularly vulnerable due to their lack of immunity, as smallpox vaccination, which offers cross-protection against Mpox, has been discontinued for decades.
Global Implications: Monkeypox Spread Beyond Africa
The recent detection of a Clade IB case in Sweden underscores the global threat posed by this virus. The individual had recently traveled to Africa, highlighting the risk of international spread. The WHO's declaration of a PHEIC is a call to action for countries worldwide to allocate resources, streamline processes, and coordinate efforts to prevent a larger global outbreak.
The Role of Vaccination in Containing the Outbreak
To combat the spread of Mpox, vaccination is crucial. The African CDC has called for 10 million vaccine doses and $4 billion in funding to manage the outbreak. However, only a fraction of this—$12 million and 50,000 vaccine doses—has been pledged so far. The United States recently contributed an additional $10 million and began shipping vaccines to the affected region.
Two vaccines are currently available: ACAM2000 and JYNNEOS (also known as MVA-BN). Both vaccines were originally developed for smallpox but have shown effectiveness against Mpox due to the genetic similarities between the viruses.
ACAM2000 is a live, replicating virus vaccine that requires multiple punctures in the skin to administer. It has been stockpiled by the U.S. due to concerns about bioterrorism involving smallpox. However, ACAM2000 has significant side effects, making it less desirable for widespread use.
JYNNEOS, on the other hand, is a live, non-replicating virus vaccine. It is administered in two doses, 28 days apart. Originally given subcutaneously, the vaccine can now be administered intradermally, allowing one-fifth of the dose to be used while maintaining efficacy. This change has effectively multiplied the available doses by five, which is crucial given the current demand.
A recent study published in the New England Journal of Medicine examined the efficacy of the JYNNEOS vaccine in the U.S. during the 2022 Mpox outbreak. The study found that a single dose provided around 36% protection, while two doses increased efficacy to approximately 66%. While these figures are not ideal, they underscore the importance of vaccination in reducing the severity and spread of the virus. However, it is crucial to note that even with vaccination, the risk of infection remains, and individuals should continue to take precautions, especially in high-risk settings.
Transmission and Prevention: How Mpox Spreads
Mpox is primarily spread through close contact with an infected person or animal. The virus can be transmitted through respiratory droplets, direct contact with lesions, or contact with contaminated objects such as bedding and clothing. The incubation period ranges from 3 to 17 days, with symptoms typically appearing after a few days of fever.
In the current Clade IB outbreak, transmission is not limited to sexual contact. While 88% of hospitalized patients had a history of transactional sex, cases have also been reported among healthcare workers who contracted the virus through non-sexual contact with infected patients. This broader mode of transmission makes Clade IB more challenging to contain compared to the Clade IIb outbreak in 2022.
To reduce the risk of transmission, individuals should avoid close contact with infected persons, refrain from handling contaminated materials, and take precautions in environments where the virus is prevalent. For healthcare workers, proper protective equipment and protocols are essential to prevent the spread of the virus in healthcare settings.
The Need for Global Cooperation and Resources
The WHO's declaration of Mpox Clade IB as a PHEIC is a critical step in mobilizing international resources and attention to combat this emerging threat. However, the current funding and vaccine supply are insufficient to address the scale of the outbreak. The global community must act swiftly to provide the necessary support to Africa to prevent the situation from escalating into a global crisis.
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The African CDC's request for 10 million vaccine doses and $4 billion in funding highlights the scale of the challenge. Without adequate resources, the outbreak could spiral out of control, leading to more deaths and further spread beyond Africa's borders. The international community must recognize that this is not just Africa's problem but a global health issue that requires a coordinated and well-funded response.
Conclusion: A Call to Action
The resurgence of Mpox, particularly Clade IB, is a stark reminder of the ongoing threat posed by infectious diseases. The WHO's declaration of a PHEIC serves as a wake-up call for governments, health organizations, and the global community to take immediate action. Vaccination, public awareness, and resource allocation are critical components in the fight against this virus.
As the world continues to grapple with the aftermath of the COVID-19 pandemic, the Mpox outbreak is a reminder that vigilance and preparedness are essential. By working together, the global community can prevent this outbreak from becoming a full-blown crisis and protect vulnerable populations worldwide.
In the coming months, it will be crucial to monitor the situation closely, ensure that vaccines and resources reach those in need, and continue research into the virus's transmission and prevention. Only through a concerted and well-coordinated effort can we hope to contain the spread of Mpox and prevent further loss of life
In 2022 North Texas reports its first case of monkeypox in Dallas County, concerns are rising about this rare virus. However, health officials are urging the public not to panic. This recent case brings the total number of monkeypox cases in the U.S. to 34, according to the Centers for Disease Control and Prevention (CDC). Here's what you need to know about this development.
The First Case in Dallas County In 2022
The first confirmed case in Dallas County involves a man who tested positive for monkeypox on a recent Monday. The individual had traveled from Mexico to Dallas, and health officials are now working to identify and notify passengers who were on the same flight. They are also reaching out to anyone who had close contact with the patient to monitor for potential symptoms.
Despite the confirmation of this case, health officials have emphasized that the patient does not pose a risk to others at this time. Local health authorities are in ongoing discussions with doctors and healthcare providers in the area to ensure everyone is informed and vigilant for any further cases.
Monkeypox Emergency Declared in San Diego County
San Diego County has declared a public health emergency In 2022 due to the rapid spread of monkeypox, joining New York, Illinois, and California in this urgent response. The county currently reports 27 confirmed cases and 19 suspected ones, potentially bringing the total to 46.
The emergency declaration aims to increase resources, including vaccines and healthcare personnel like pharmacists and EMTs, to combat the outbreak effectively. Despite one hospitalization, no deaths have occurred in the county.
Monkeypox primarily spreads through close skin-to-skin contact, leading to lesions and flu-like symptoms. The outbreak has disproportionately affected the LGBTQ community, but officials emphasize that the virus is not exclusive to any group, urging against stigmatization.
Vaccination efforts are underway, with around 4,000 doses received and 2,500 administered. More vaccines are expected as demand rises. Although monkeypox is less contagious and severe than COVID-19, public health officials stress the importance of staying informed and vigilant to prevent further spread.
FAQS'
Do Doctors Get The Mpox Vaccine In 2024
Yes, as of 2024, healthcare workers, including doctors, may receive the mpox (formerly known as monkeypox) vaccine, especially if they are at high risk of exposure. This includes those working directly with patients who have been diagnosed with mpox or those involved in laboratory settings where the virus might be present.
Vaccination for healthcare workers is part of a broader public health strategy to prevent the spread of mpox, particularly in environments where exposure risk is higher. Guidelines may vary depending on the region and the current state of the outbreak, but generally, those in healthcare settings are prioritized for vaccination if they are likely to encounter the virus in their work.
Yes, the mpox (formerly known as monkeypox) vaccination will be available in 2024. It is recommended for individuals at higher risk of exposure, including:
- Healthcare Workers: Especially those who are directly involved in caring for mpox patients or handling laboratory specimens that may contain the virus.
- Close Contacts of Infected Individuals: Those who have been in close contact with someone diagnosed with mpox may be eligible for the vaccine as part of a post-exposure prophylaxis strategy.
- High-Risk Populations: This includes individuals in communities that have been disproportionately affected by the virus, such as men who have sex with men (MSM), or those with multiple sexual partners.
- Laboratory Personnel: Individuals working in labs that handle orthopoxviruses, including mpox, are also eligible for vaccination.
Availability may vary by region, and it's often distributed through public health departments, clinics, and hospitals. If you believe you are at risk or are part of a high-risk group, it's advisable to consult with a healthcare provider to discuss eligibility and access to the mpox vaccine.
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