In July 2022, WHO declared an epidemic of monkeypox, a rare viral disease caused by the monkeypox virus. This infectious disease, typically transmitted by sexual contact, has become a public health emergency of international concern.
This epidemic was brought under control, and by May 2023, the state of emergency was lifted, providing some relief for health officials.
However, monkeypox has now become endemic in many parts of Africa, making a comeback with new strains emerging, causing alarm in the disease prevention community.
One strain, known as clade I, is particularly concerning as it appears to be more deadly and can spread through sexual contact, a first for this variant, as reported in a preprint article published in medRxiv.
There have been 241 suspected cases and 108 confirmed cases in conflict areas in the Democratic Republic of the Congo (DRC), with approximately 30% of cases among sex workers, highlighting the importance of sexual transmission as a vector.
Dr. Rosamund Lewis, the global mpox response technical leader and WHO emergency manager on the ground in the DRC, expressed concern about the evolved strain’s ability to evade testing and person-to-person transmission.
Since September 2023, the spread of this new strain, along with other endemic strains in the DRC, poses a significant challenge for health authorities.
Explaining the situation, Lewis mentioned the possibility of the virus traveling with people as they move and cross borders.
What is monkeypox?
Despite its name, monkeypox virus was first detected in laboratory monkeys in 1958 but is known to infect more than 50 mammal species and commonly persists in rodents rather than monkeys.
The virus can occasionally jump from animals to humans, with rare instances of human-to-human transmission. The 2022 global outbreak involved the less virulent clade II strains.
Common symptoms of monkeypox include fever, headache, muscle aches, skin rash, and swollen lymph nodes.
The virus is transmitted through sexual or physical contact with infected individuals, with majority transmission occurring among men who have sex with men.
Current Situation
The majority of current infections in the DRC are caused by the more virulent clade I strain, with 4,488 reported cases and 279 deaths as of March 29th in the country.
Children, particularly those under 15, are at higher risk, with 70% of infections and 88% of deaths in the DRC attributed to this age group.
The sexually transmitted clade I variant was first identified in Bukavu, South Kivu province, increasing the risk of spread to neighboring countries.
The European Center for Disease Prevention and Control (ECDC) has called for close monitoring due to the higher travel rates from Rwanda to Europe, potentially leading to global spread.
Despite alarming reports, genome sequences suggest that clade I has not spread beyond the DRC.
Can we stop the spread?
The emergency response in the DRC by local and international organizations like WHO has been strong, but cases continue to rise, with 23 out of 26 provinces affected.
Challenges in South Kivu province, including conflict, displacement, and food insecurity, hinder efforts to combat the outbreak.
Efforts are underway to decentralize access to laboratory diagnostics to better understand the epidemic and provide appropriate care.
Treatment involves basic clinical care and antibiotics, and vaccines for smallpox are effective against monkeypox and are now available, requiring larger-scale implementation.
Dr. Lewis emphasizes the need for international support and additional resources to control the outbreak.
About our experts
Rosamund Lewis is the emergency manager and technical lead for the global mpox response at WHO. She has expertise in immunization, infectious diseases, emergency response, and global health leadership.
Source: www.sciencefocus.com
