Health officials worldwide are sounding the alarm as a more lethal strain of mpox has been confirmed in four additional African countries.
The Democratic Republic of Congo (DRC) has reported over 14,000 cases and 511 deaths from mpox, previously known as monkeypox. This strain has now spread to four neighboring countries—Burundi, Kenya, Rwanda, and Uganda—that had not previously recorded cases, according to the World Health Organization (WHO).
In response, WHO officials are planning to convene an emergency committee to assess whether the outbreak constitutes a public health emergency of international concern.
The US Centers for Disease Control and Prevention (CDC) issued a health advisory urging physicians to maintain a heightened awareness for mpox, especially among those who have recently traveled from the DRC or its neighboring countries.
Mpox is a viral disease that spreads easily between people and from infected animals. It can be transmitted through close contact such as touching, kissing, or sexual activity, as well as through contaminated materials like sheets, clothing, and needles. Symptoms include fever, a painful rash, headache, muscle and back pain, low energy, and swollen lymph nodes.
Historically confined to Central and West Africa, mpox began spreading to Europe and North America in 2022.
Mpox is classified into two genetic clades: I and II. Clade I, particularly Clade Ib, which has been present in the DRC for years, is associated with more severe disease. While this strain is deadlier, there is no evidence to suggest it is more transmissible, according to Dr. Rosamund Lewis, WHO’s technical lead for the global mpox response.
Clade II was responsible for the global outbreak that began in 2022, according to the CDC.
Since January 2023, the DRC has reported over 22,000 suspected cases of Clade I mpox, with more than 1,200 deaths. The number of cases in the first half of 2024 matches the total for all of 2023, noted WHO Director-General Dr. Tedros Adhanom Ghebreyesus at a recent news conference.
The risk of further spread in the region is considered moderate for the general population but high in the DRC, Lewis stated. The WHO uses a risk assessment scale from low to very high and has not yet recommended travel restrictions for the affected countries.
No cases of Clade I mpox have been reported outside central and eastern Africa, and the CDC considers the risk of it reaching the US as “very low.” However, the CDC continues to recommend vaccination for those exposed to or at high risk of the virus.
The WHO has initiated the Emergency Use Listing process for approved mpox vaccines to facilitate access in lower-income countries lacking their own approvals. Nigeria and the DRC have approved mpox vaccines for emergency use.
The CDC advises anyone who has traveled to the DRC or its neighboring countries in the past 21 days and developed an unexplained rash to seek medical attention immediately and avoid contact with others.
Global efforts to contain the outbreak will require comprehensive international cooperation, said Dr. Tedros. WHO has developed a regional response plan needing $15 million and has allocated $1 million from its Contingency Fund for Emergencies to support the response.
Dr. Michael Ryan, executive director of WHO’s Health Emergencies Program, stressed the importance of better understanding the virus and ensuring adequate funding for international control measures. “We’re once again drawing from the contingency fund to begin the response. It’s crucial to act promptly and effectively to contain this virus,” he said.