The World Health Organization (WHO) has classified the escalating spread of mpox in Africa as a global health emergency, cautioning that the virus may eventually cross international boundaries.
Director-General Tedros Adhanom Ghebreyesus announced the designation following a meeting of the emergency committee for the UN health agency. This decision comes after the Africa Centers for Disease Control and Prevention (CDC) declared mpox a public health emergency on Tuesday.
According to WHO, over 14,000 cases and 524 fatalities linked to mpox have been reported in Africa this year, surpassing total figures from the previous year. The vast majority of these cases, more than 96%, are concentrated in the Democratic Republic of the Congo, where a new variant of the virus is raising concerns due to its potential for increased transmissibility among humans.
Mpox, previously known as monkeypox, was first identified in 1958 in monkeys during outbreaks of a pox-like illness. Human cases were primarily reported in central and West Africa, typically among individuals with close contact with infected animals. However, in 2022, it was confirmed that mpox could also spread through sexual contact, leading to outbreaks in over 70 countries where it had not previously been reported.
The symptoms of mpox are generally milder than those of smallpox, including fever, chills, and body aches, with some individuals developing lesions on parts of the body such as the face, hands, chest, and genitals. The recent surge in cases is alarming; the Africa CDC reported last week that mpox has now been identified in at least 13 African nations, with a 160% increase in cases and a 19% rise in deaths compared to the same timeframe last year.
In a Congolese mining town, a new strain of mpox has emerged, which can be fatal in up to 10% of cases and may spread more easily than previous strains. Unlike earlier outbreaks characterized by lesions on the chest and limbs, this new variant tends to manifest milder symptoms and lesions in more concealed areas, complicating detection and increasing the likelihood of unknowingly spreading the virus.
The WHO noted the recent identification of mpox in four East African countries—Burundi, Kenya, Rwanda, and Uganda—all of which have connections to the epidemic occurring in Congo. Tedros emphasized concern over the potential for the disease to spread further within and outside Africa.
Reported outbreaks of a less severe form of mpox have also occurred in Ivory Coast and South Africa, first seen in the global outbreak of 2022. The WHO’s emergency declaration seeks to galvanize donor agencies and nations to take prompt action, although responses to previous declarations have been inconsistent.
Dr. Jean Kaseya, Director General of the Africa CDC, stated the organization’s public health emergency declaration aimed to rally resources and collective efforts to address the crisis effectively. He appealed for international support, emphasizing that the growing number of mpox cases in Africa has largely gone unnoticed.
Michael Marks, a London School of Hygiene and Tropical Medicine professor, remarked that current control strategies are proving ineffective and stressed the need for additional resources. He indicated that a global emergency declaration could help unlock necessary assistance.
The 2022 outbreak predominantly affected gay and bisexual men, circulated through close contact, particularly during sexual activity. However, recent patterns in Africa show that over 70% of mpox cases and 85% of deaths in Congo are now among children under 15 years old.
Ahead of the emergency meeting, Tedros reported multiple mpox outbreaks with varying modes of transmission and risk levels across different countries, underscoring the need for a tailored response.
Save the Children’s Congo director, Greg Ramm, expressed concern about mpox spreading in overcrowded refugee camps, highlighting the dire conditions for approximately 345,000 children living in tents and unsanitary environments. He noted that the health system in Congo was already under severe strain due to malnutrition, measles, and cholera.
Dr. Boghuma Titanji, an infectious diseases specialist at Emory University, indicated that the reasons for the disproportionate impact on children in Congo remain unclear, suggesting either increased susceptibility to the virus or social factors such as overcrowding and family transmission.
While the previous global outbreak of mpox was managed in wealthier nations through vaccines and treatments, very few resources have reached Africa. Marks stressed the necessity for widespread vaccination efforts, including the potential use of smallpox vaccines.
Congo is in negotiations with donors for vaccine supplies and has received some financial aid from the UK and the US. WHO has already allocated $1.45 million from its emergency fund to assist with Africa’s mpox response but requires an initial $15 million to effectively address the situation.