For the second time since 2022, mpox has been labeled a global health emergency because the virus is spreading quickly across Africa and might reach other continents.
On Wednesday, the World Health Organization (WHO) issued its highest alert for the disease, noting that over 14,000 cases and 524 deaths in Africa this year have already surpassed last year's numbers. This announcement followed a statement from the Africa Centers for Disease Control and Prevention (CDC), which also declared mpox a public health emergency.
So, what is mpox, how does it spread, and how serious is this outbreak compared to previous ones? Here's what you need to know:
What is mpox?
Mpox is a virus that infects both humans and animals. It belongs to a group of viruses called "Orthopoxvirus," which generally cause pox-like illnesses. These diseases often result in a rash with raised bumps or blisters filled with fluid or pus, which eventually scab over and heal. Mpox is similar to smallpox, which has been eliminated, and other poxviruses like cowpox and vaccinia.
The disease was first named “monkeypox” when it was discovered in monkeys in 1958. These monkeys were in a lab in Denmark. The first human case was recorded in 1970, involving a nine-month-old boy in the Democratic Republic of Congo. In 2022, WHO recommended changing the name to “mpox” to avoid stigma and because the disease can infect other animals, like rodents, as well as humans.
How does mpox spread?
Mpox spreads to humans through close contact with an infected animal or person.
- When animals infect humans, it usually happens through bites, scratches, or direct contact with the blood, body fluids, or wounds of an infected animal.
- When humans infect other humans, it can happen through direct contact with an infected person's skin, body fluids, or respiratory droplets. It can also spread through touching items like bedding or clothes that have been contaminated, but this is rare.
The virus can enter the body through broken skin, the respiratory system, or mucous membranes* (which include the eyes, nose, and mouth).
What are the symptoms of mpox?
Symptoms include fever, headache, muscle pain, and a distinctive rash that can appear on the face, hands, feet, and other parts of the body. The rash eventually forms pustules, which are small, raised bumps filled with pus, before healing and scabbing over.
Lymph nodes, which are small glands that help the immune system, can also swell as they fight the virus. You can find these under your arms and on the sides and back of your neck. In rare cases, mpox can be fatal.
The infection usually lasts between two to four weeks. Symptoms can take three to 21 days to appear after exposure. However, a person can spread the disease to others one to four days before they even show symptoms. Mpox can be diagnosed by testing a fluid sample taken from the rash.
Why has mpox been declared a global emergency?
On Wednesday, WHO declared mpox a global health emergency due to a new variant of the virus and reports of cases in countries like Kenya and Rwanda. WHO Director-General Tedros Adhanom Ghebreyesus expressed concerns about the disease spreading further in Africa and possibly to other parts of the world after the United Nations health agency’s emergency committee met. This emergency declaration is meant to encourage countries and donors to act quickly.
“There is a real attempt right now to mobilize resources, and that’s part of why WHO called for the public health emergency,” said Amita Gupta, the head of the Division of Infectious Diseases at the Johns Hopkins School of Medicine. WHO had also declared mpox a global health emergency in July 2022 when the virus spread through sexual contact and was found in more than 70 countries. Once cases decreased, WHO lifted the emergency status in May 2023.
Where has mpox spread?
Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries. Compared to the same period last year, cases have risen by 160 percent, and deaths have increased by 19 percent.
So far, more than 96 percent of cases have been reported in Congo. Earlier this year, scientists there discovered a new version of the virus that causes milder symptoms, including lesions on the genitals. This makes it harder to detect, so people might spread it without knowing they are infected. There is not much international travel in and out of the Democratic Republic of Congo (DRC), so the risk of global spread has been low. However, if the disease spreads more widely in Africa, it could become a bigger global concern.
While the 2022 outbreak was driven by Clade (a group of viruses that share a common origin) II of mpox, the current outbreak is driven by Clade I, which can be more deadly, according to Otim Patrick Ramadan, a health official at WHO’s Africa regional office. So far, cases of this new Clade I variant have not been reported outside Africa.
Is there a vaccine for mpox?
While mild cases of mpox can clear up on their own, there are no specific treatments or vaccines approved for mpox. The antiviral drug tecovirimat (TPOXX), which was originally developed for smallpox, is being studied for use against mpox. The United States Food and Drug Administration (FDA) has also approved a smallpox vaccine called JYNNEOS (also known as Imvamune or Imvanex) for severe mpox cases in people aged 18 years and older. However, around 60 percent of cases in Congo involve people under 18, according to Ramadan.
The CDC recommends getting vaccinated and isolating if you’ve been exposed to someone with mpox. Gupta noted that although “a lot has been learned from COVID” and the ability to track diseases has improved worldwide, many African countries where the virus is spreading still lack the resources for quick diagnosis and access to alternative treatments.
Footnote
Mucous membranes refer to the soft, moist tissues lining body cavities, including the mouth, nose, eyes, and other parts of the body, that are often exposed to the environment. These membranes are a common entry point for viruses and bacteria.