A more virulent strain of mpox is spreading globally, with Sweden reporting its first case on Thursday. This announcement follows the World Health Organization’s declaration of mpox as an international public health emergency for the second time in two years. The U.S. Department of Health and Human Services has since assessed the risk to the general public in the U.S. as “very low.”
Mpox, formerly known as monkeypox, is an infectious disease linked to smallpox and is believed to have origins in African rodents and primates. The disease transmits through close contact with an infected individual, which includes sexual and skin-to-skin interaction. Infected pregnant individuals can also transmit the virus to their babies. Common symptoms include a rash that resembles blisters, fever, fatigue, muscle aches, cough, and sore throat, lasting two to four weeks.
Historically, mpox has caused occasional outbreaks in countries like Nigeria and the Democratic Republic of the Congo (DRC). However, in May 2022, cases began to appear in countries outside Africa, prompting the WHO to declare it a public health emergency of international concern in July of that year. Over the following year, more than 100 countries reported nearly 90,000 cases and over 150 deaths.
In response, public health authorities worldwide tightened disease surveillance, increased awareness among high-risk populations, and distributed over a million vaccine doses in the U.S. and Europe. By May 2023, the WHO lifted the emergency status for mpox, with ongoing cases reported but at significantly lower numbers than during the peak of the crisis. However, the situation remains dire in the DRC, which as of May 2024 has reported 7,851 cases and 384 deaths, leading the Africa Centres for Disease Control and Prevention to declare a continent-wide public health emergency.
The strain circulating in the DRC, clade I, differs from the clade II strain that led to the global outbreak in 2022 and 2023. Clade I has begun to spread to neighboring East African countries and now Sweden, raising concerns about a potential new wave of a more deadly mpox pandemic. The Africa CDC’s declaration is the first of its kind for a continental emergency, highlighting ongoing mpox outbreaks, particularly in the context of resurgent cases of the milder clade II strain.
Outbreak responses in the DRC and other African nations face significant challenges, reminiscent of issues encountered during past pandemics, including a lack of global cooperation and access to crucial resources. Vaccine distribution has been painfully slow, with only a limited number of doses available for the population of over 100 million in the DRC.
As international organizations strive to strengthen public health systems on the continent, the impact of the Africa CDC’s declaration remains uncertain. The origins of mpox trace back to a 1958 discovery in monkeys, with human cases first documented in 1970. Despite its long history, scientists still uncover new details about its transmission and mutations, including the recent emergence of a novel variant in the DRC.
Currently, there are two vaccines effective against mpox: Jynneos and LC16. While the U.S. and Europe successfully rolled out vaccine campaigns amid the 2022 outbreak, the DRC lacked access to vaccines during the critical early stages and has only begun receiving doses.
In addition to foreign aid, the Africa CDC and WHO are mobilizing financial resources to combat mpox. Shortly after the announcement of the public health emergency, the African Union allocated $10.4 million for the response, alongside WHO’s commitment of $1.45 million to assist ongoing efforts.
The situation remains fluid, and it is essential for both local and international health authorities to expedite responses and enhance resource availability to combat the escalating mpox outbreaks effectively.