Mpox has been declared a public health emergency in Africa – what is it and what is WHO doing?

The Africa Centers for Disease Control and Prevention declared this week that the growing spread of mpox across the continent is a health emergency, warning that the virus could eventually spread across international borders.

On Wednesday, the World Health Organization is convening its expert meeting to consider making a similar emergency declaration on mpox.

The UN health agency said there have been more than 14,000 cases and 524 deaths this year, already surpassing last year’s figures.

So far, more than 96% of all cases and deaths are in a single country – Congo. Scientists are worried about the spread of a new version of the disease out there that can be more easily transmitted to humans.

Here’s a look at what we know about mpox and what can be done to contain it:

What is mpox?

Mpox, also known as monkeypox, was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in monkeys.

Until recently, most human cases were seen in people in Central and West Africa who had close contact with infected animals.

In 2022, the virus was confirmed to be sexually transmitted for the first time and caused outbreaks in more than 70 countries that had not previously reported mpox.

Mpox belongs to the same family of viruses as smallpox, but causes milder symptoms such as fever, chills and body aches. People with more serious cases may develop lesions on the face, hands, chest and genitals.

What is happening in Africa that is causing all this concern?

The number of cases has increased dramatically. 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, the agency said cases are up 160% and deaths are up 19%.

Earlier this year, scientists reported the emergence of a new form of mpox in a Congolese mining town that can kill up to 10% of people and can spread more easily.

Unlike previous outbreaks of mpox, where lesions were mostly seen on the chest, hands and feet, the new form of mpox causes milder symptoms and lesions on the genitals. This makes detection more difficult, meaning people can also infect others without knowing they are infected.

The WHO said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All these outbreaks were linked to the Congo epidemic.

In Ivory Coast and South Africa, health authorities have reported outbreaks of a different, less dangerous version of mpox that spread worldwide in 2022.

What does an emergency declaration mean?

Director General of Africa CDC Dr. Jean Kaseya said the agency’s declaration of a public health emergency was intended to “mobilize our institutions, our collective will and our resources to act swiftly and decisively.”

He called on Africa’s international partners for help, saying Africa’s growing caseload had been largely ignored.

“It is clear that current control strategies are not working and there is a clear need for more resources,” said Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine. “If a (global emergency declaration) is the mechanism to unlock these things, then it’s warranted,” he said.

What is different about the current outbreak in Africa compared to the 2022 epidemic?

During the global outbreak of mpox in 2022, gay and bisexual men made up the vast majority of cases, and the virus was spread primarily through close contact, including sex.

Although some similar patterns have been seen in Africa, children under 15 now account for more than 70% of mpox cases and 85% of deaths in the Congo.

Ahead of its emergency mpox meeting, WHO Director-General Tedros Adhanom Ghebreyesus said officials were dealing with several mpox outbreaks in different countries with “different modes of transmission and different levels of risk”.

“Stopping these outbreaks will require a tailored and comprehensive response,” he said.

Greg Ramm, director of Save the Children’s Congo, said the organization was particularly concerned about the spread of mpox in overcrowded refugee camps in the east, noting there were 345,000 children “crammed into tents in unsanitary conditions”.

He said the country’s health system was already “collapsing” under the strain of malnutrition, measles and cholera.

Dr. Boghuma Titanji, an infectious disease expert at Emory University, said it was unclear why children were so disproportionately affected by mpox in Congo.

She said it could be because children are more susceptible to the virus or that social factors, such as overcrowding and exposure to parents who caught the disease, could explain it.

How can mpox be stopped?

The 2022 outbreak of mpox in dozens of countries was largely stopped by the use of vaccines and treatments in rich countries, in addition to persuading people to avoid risky behaviors.

But almost no vaccine or treatment has been available in Africa.

Marks, of the London School of Hygiene and Tropical Medicine, said immunization was likely to help – including vaccinating people against smallpox, a related virus.

“We need a large supply of vaccines so that we can vaccinate the most vulnerable populations,” he said, adding that this would mean sex workers, children and adults living in outbreak regions.

Congo has said it is in talks with donors about possible vaccine donations and has received some financial help from Britain and the US.

The WHO said it had released $1.45 million from its emergency fund to support the mpox response in Africa.