The mpox virus, also known as monkeypox, has managed to cross the borders of Central and Western Africa, where it had traditionally been confined, to appear in various nations in Asia and Europe. This dangerous cousin of smallpox, which remained virtually unknown until its discovery in 1958, has triggered deep concern in the international medical and scientific community.
The World Health Organization (WHO) has again declared mpox a global health emergency as it spreads across central Africa, including in countries where it has never been detected before. After warning of the rapid spread of the deadly clade 1b variant from the Democratic Republic of the Congo (DRC) to other African countries, the WHO has urged pharmaceutical companies to increase vaccine production. Meanwhile, the Stockholm-based European Centre for Disease Prevention and Control (ECDC) on Friday raised its risk level from “low” to “moderate”, a day after the first infection caused by a new strain of the virus outside Africa was confirmed in Sweden, followed by the reappearance of more sporadic cases in the EU.
This is the second time in three years that the WHO has declared a monkeypox epidemic a public health emergency of international concern. The first time was in July 2022, when the outbreak affected nearly 100,000 people in 116 countries, causing around 200 deaths. Now, the threat has become even more serious. Since the beginning of this year, some 15,600 cases and 537 deaths have been recorded in the Democratic Republic of the Congo alone. The most vulnerable groups are women and children under 15 years of age.
In Asia, the sheer size of the population and limited rollout of the MPOX vaccine have raised concerns in the international medical community. Following the first case of the new strain being reported in Europe, the strain’s ability to spread rapidly across borders was highlighted. Meanwhile, Pakistan’s Khyber Pakhtunkhwa region has confirmed three cases. While countries such as India and the United Arab Emirates (UAE) have yet to report new cases, they have heightened surveillance levels due to the large volume of international travelers they receive. Meanwhile, the Philippines detected a new case, its first since December last year, its health department reported on Monday. The case is a 33-year-old Filipino man with no history of travel outside the country.
In the case of China, it is taking a proactive approach to try to contain the spread of the virus within its borders, and implementing strict health controls at its border crossings. Customs authorities reported that all flights and vessels, including cargo and containers from affected countries or regions, must comply with strict health control measures upon entering the country. Those people who have been in contact with confirmed cases or who present related symptoms must declare this upon entering the Asian giant. These control measures will be valid for 6 months, and the list of affected countries will be updated periodically according to the information provided by the WHO on the evolution of the epidemiological situation at a global level.
The 2022 global mpox outbreak allowed experts to identify a characteristic pattern of disease presentation. Initial symptoms include high fever, headaches, muscle aches, swollen lymph nodes, and exhaustion. A skin rash then appears, starting on the face and spreading to the rest of the body, including the genitals. Skin lesions develop from spots to painful vesicles that then form crusts. The infection typically lasts 2 to 4 weeks, and patients are contagious until symptoms subside. Documented complications include gastrointestinal problems, pneumonia, and bacterial infections that can lead to sepsis.
There are currently three vaccines available to protect against monkeypox: MVA-BN (made by Bavarian Nordic), LC16 (made by KM Biologics) and OrthopoxVac (licensed in Russia). All of these vaccines have their origins in smallpox immunisations. The two viruses are closely related, and some experts have hypothesized that mpox has flourished because of the decline in immunity to smallpox, which was eradicated in 1980 following a global vaccination campaign.
This virus was discovered in 1958 when two outbreaks of a smallpox-like disease were reported in colonies of monkeys bred for research. Although it was named “monkeypox,” the exact origin of this pathogen remains unknown. Scientists suspect that African rodents and nonhuman primates, such as monkeys, could be the natural hosts of the virus and a source of infection for humans. The first confirmed human case of monkeypox was detected in 1970 in the Republic of the Congo. After remaining largely confined to certain regions of Africa for decades, mpox burst onto the world stage two years ago, spreading to multiple countries.