The World Health Organization (WHO) has declared mpox a “public health emergency of international concern,” potentially leading to a coordinated global response.
Mpox is part of the same virus family as smallpox. While the symptoms are similar, mpox tends to be less severe. Vaccines and treatments created for smallpox are effective against mpox, but as seen with COVID-19, ensuring equitable distribution of these resources will pose a significant global challenge.
A rise in mpox cases in Africa, particularly in the Democratic Republic of the Congo (DRC), has prompted this declaration. This year alone, the DRC has recorded over 14,000 cases, including about 12,600 suspected cases and 580 fatalities since 2023, marking a substantial increase compared to previous years, according to the CDC.
The WHO initially designated mpox as a “public health emergency of international concern” on July 23, 2022, a status that remained until May 2023 when cases were under control. The last similar declaration by the organization was in January 2020 regarding COVID-19.
Shyam Bishen, the Head of Health and Healthcare at the World Economic Forum, stated that this latest declaration necessitates significant investment from countries to manage the outbreak effectively. He highlighted that while smallpox vaccines are promising against mpox, the supply is limited. He called for nations to collaborate in sharing vaccines and treatments and emphasized the need for a partnership involving the private sector, governments, and international organizations to ramp up production of vaccinations and therapeutics for mpox.
Europe was the hotspot for the initial mpox outbreak in 2022, reporting over 80% of global cases, with no recorded deaths outside of Africa, where five fatalities have been documented. Although the risk is considered high in Europe, the overall global risk remains moderate, with travel and trade disruptions deemed unlikely.
Discovered in 1970, mpox cases had primarily been reported in Africa, with sporadic cases outside the continent typically linked to infected travelers or animals.
Mpox has two distinct genetic clades: the Congo Basin clade, known for causing more severe disease and presumed higher transmissibility, and the West African clade, recent cases of which have been linked to the latter.
Mpox is classified as a zoonotic disease transmitted between humans and animals, often emerging in tropical areas with animal carriers like squirrels, dormice, certain monkeys, and rats. Transmission can occur through bites, scratches, or preparation of bushmeat.
Human-to-human transmission is limited, primarily occurring through direct contact with bodily fluids or skin lesions and indirectly via contaminated items such as bedding or clothing. It can also spread through respiratory droplets, but this requires close, prolonged contact with an infected person.
Common symptoms of mpox include fever, rash, and swollen lymph nodes, with early signs including headache, backache, and muscle pain. A rash typically develops 1-5 days after initial symptoms, starting as raised spots before evolving into fluid-filled blisters that eventually crust over.
In most cases, mpox symptoms resolve on their own within 2-4 weeks, but recent mortality rates have been between 3-6%, particularly affecting young children and those with weakened immune systems. The cases diagnosed thus far have been mostly mild.
All confirmed cases have undergone PCR testing, and genomic sequencing has been utilized for tracking strains, such as a case in Portugal.
Currently, no specific medication exists for the mpox virus, although antiviral drugs like cidofovir, brincidofovir, and tecovirimat may be used.
The WHO is actively assessing vaccination strategies and implementing various public health responses, including contact tracing and clinical management in non-endemic countries where cases have emerged. They are employing genomic sequencing to identify the specific virus clades involved in recent infections.
Vaccines, where available, are being administered to close contacts, such as healthcare workers, alongside robust surveillance and infection control measures. The WHO has allocated emergency funding to nations needing testing capabilities and resources for identifying and sequencing the mpox virus.
Bishen reiterated that while vaccine availability is a positive development in combating mpox, global challenges of equitable distribution and access remain, particularly between high-income and low-to-middle-income countries. In response, the World Economic Forum has partnered with the Coalition for Epidemic Preparedness Innovations and the US National Academy of Medicine to create the Distributed Vaccine Manufacturing Collaborative, aiming to address vaccine access disparities by establishing a sustainable network of manufacturing facilities capable of producing vaccines for current and future health emergencies.