Mpox's 1st cases outside Africa trigger alarm; WHO sounds emergency: What's next?

The decision will trigger a coordinated international response to an extraordinary event and the mobilisation of resources, such as vaccines and diagnostic testing, to curb the spread of this infectious disease.

It has also revived memories of the Covid pandemic. However, it is too early to call mpox a pandemic. The WHO has also refrained from doing so. Currently, it is focusing on the measures designed to prevent it from becoming one.

What triggered this latest alert?

Mpox, which was once known as monkeypox, is a viral infection closely related to smallpox. Its cases were spreading rapidly in Africa, prompting the Africa Centres for Disease Control and Prevention to declare it a public health emergency.

The reason for concern is the new strain of mpox, which is said to more contagious and deadly than the one that affected West Africa earlier.

There are two types or clades of mpox. Clade II, which originates in west Africa, is less severe. It has a fatality rate of up to 1 per cent (in other words, roughly one in 100 are expected to die from it). But clade I, from central Africa, has a fatality rate of up to 10 per cent (up to one in ten die). In contrast, the Omicron variant of Covid had a 0.7 per cent fatality rate.

Mpox symptoms and how it spreads

Mpox is a zoonotic disease, which means that it can be spread from people to animals. Both strains spread via close contact with an infected person or animal or contact with contaminated materials.

Both strains have similar symptoms, including flu-like symptoms. Some of the early symptoms can include a fever, headache, swelling of the lymph nodes and muscle ache. A typical rash follows, mainly on the face, hands and feet.

The infection can be transmitted through close physical/intimate skin-to-skin contact, including sex. It can also spread through contact with contaminated materials (towels, bedding and clothing) and even respiratory droplets.

First mpox cases outside Africa

Pakistan's Khyber Pakhtunkhwa on Thursday reported its first cases of the mpox virus, Dawn has reported. This comes a day after Sweden became the first country to report an mpox case outside Africa.

Dawn reported that three cases of mpox have been detected in Pakistan so far. It was not immediately clear which variant was detected in the patients. The patients had returned from the United Arab Emirates (UAE).

Earlier, Sweden said that the person who was infected had returned after a stay in the part of Africa where there is a major outbreak of the more infectious mpox.

What's next?

The rising cases of mpox, which is an epidemic currently, do raise a concern for countries around the world. Especially after the learnings of the Covid pandemic, which spread rapidly to every corner of the world within months after the first case was detected.

Controlling it at the source is the best measure, and WHO’s latest declaration will help mobilise the required resources.

Surveillance for spread of this more serious version of mpox is also essential, bearing in mind that many countries do not have the capacity for widespread testing. So we’ll have to rely on “suspected cases”, based on a clinical definition, to keep track of the epidemic.

Open-source epidemic intelligence – such as using AI to monitor trends in rash and fever illness – can also be used as an early warning system in countries with weak health systems or delayed reporting of cases.

(With inputs from agencies)