Explained: Why mpox is sparking global concern again

Just as the effects of the COVID pandemic begin to wane, a new alert has emerged regarding another disease primarily found in Africa but now reported outside the continent. While Mpox spreads more slowly than the novel coronavirus, it can still be lethal, depending on the strain.

Cases detected in Sweden, Pakistan
Sweden said a person who had got back from Africa has tested positive for mpox. The case was identified a day after World Health Organization (WHO) declared the latest outbreak of the disease as a public health emergency of international concern and warned that Europe could see more imported cases.

On Friday, Pakistan became the second country outside Africa to report a positive case. The patient had returned from a Gulf country. Pakistani health authorities said tests were underway to determine the variant involved.


With a more lethal strain around
The recent outbreak features a new variant named 'clade Ib', a derivative of clade I, which is native to Congo in Africa.

Swedish authorities said clade Ib is spreading primarily through household contacts and frequently infects children. Clade IIb, which had prompted the previous WHO global warning in 2022, spread mainly through sexual contact. The July 2022 outbreak affected nearly 100,000 people, primarily gay and bisexual men, in 116 countries and killed about 200 people. India had reported 27 cases and one death.

While clade Ib causes a similar illness to clade IIb, it is considered capable of spreading faster and killing more people. Clade II, which originates in West Africa, has a fatality rate of up to 1% (roughly one in 100 are expected to die from it), but reports say clade I has a fatality rate of up to 10%.

Largely confined to Africa
There have been 27,000 cases and more than 1,100 deaths, mainly among children, in Democratic Republic of the Congo (DRC) since the current outbreak began in January 2023. Over half of those cases (15,664) and a chunk of deaths (548) in DRC have come since the beginning of this year. The rise in cases and fatalities was accompanied by the spread of the disease to Burundi, Kenya, Rwanda and Uganda.

Smallpox, but milder
Mpox belongs to the same family of viruses as smallpox. It commonly causes blisters or sores that may last for 2 to 4 weeks. The disease may start with, or be followed by, fever, headache, muscle aches, back pain, low energy and swollen glands. The blisters can occur in the face, palms, soles of the feet, groin, genital and/or anal regions and also appear in the mouth, throat, and on the eyes. The symptoms mostly go away on their own within a few weeks with medicines to address pain or fever. But in some people, mpox can lead to complications and even death.

Spreads slower than Covid
Mpox spreads through close contact with infected people. Being face-to-face (talking or breathing close enough for droplets to carry) with an infected person or having skin-to-skin contact, including sex and mouth-to-mouth or mouth-to-skin contact are among the risk factors. The disease can also spread to people from infected animals such as some species of monkeys and rodents through bites or scratches. Skinning such animals or eating their meat if it's not cooked thoroughly also exposes one to the disease. People with low or compromised immunity are at a higher risk of developing severe mpox or dying.

Covid spreads through tiny droplets in the air by breathing, talking, sneezing, or coughing and is extremely infectious.

Has vaccines borrowed from Smallpox
Tecovirimat, an antiviral developed to treat now-eradicated smallpox, was okayed in Jan 2022 by the European Medicines Agency for the treatment of mpox. WHO says such medicines are usually prescribed for rare cases.

There are also three vaccines for mpox - MVA-BN, LC16 and OrthopoxVac - which, too, were first developed to combat smallpox. But WHO says only those at risk, for example, close contacts of infected people, should be considered for vaccination. WHO has not called for mass inoculations.

(With TOI inputs)