NAIROBI, Aug 20 (IPS) – A deadly outbreak of a new and more severe variant of mpox has emerged in the Democratic Republic of Congo (DRC), with at least one case confirmed in nearly a dozen African countries, including previously unaffected nations such as Kenya, Burundi, Uganda and Rwanda. mpox cases in these countries have passed 17,000, a significant increase from 7,146 cases in 2022 and 14,957 cases in 2023.
Many of these cases are in the DRC, where the number of mpox cases has been steadily increasing for more than a decade as the disease remained neglected as a rare infection confined to remote rural areas in tropical Africa. But a recent move by the World Health Organization (WHO) strongly suggests that this is no longer the case, as a deadly mpox variant has recently emerged with an alarming potential to spread very quickly and widely.
According to WHO Director-General Dr. Tedros Ghebreyesus, “the emergence of a new clade of mpox, its rapid spread in eastern DRC and the reporting of cases in several neighbouring countries are of great concern. Along with outbreaks of other mpox clades in DRC and other countries in Africa, it is clear that a coordinated international response is needed to stop these outbreaks and save lives.”
Dr Onyango Ouma, a medical researcher from Kenya, told IPS there are two endemic types of mpoxvirus: Clade I, which causes more severe illness and deaths. Some Clade I outbreaks have killed up to 10 percent of those infected and are highly endemic in central Africa, and Clade II, which caused the global mpox outbreak of 2022, is more endemic in West Africa.
More than 99.9 percent of people with Clade II survive the disease. The new variant is classified as Clade Ib and can spread through sexual contact. Most recently, on August 15, global health officials confirmed the presence of Clade Ib infection in Sweden, indicating that the viral infection has taken on an international dimension.
It is this new and highly contagious Clade Ib mpox, more severe than the deadly and endemic Clade I, that has spread to other African countries previously untouched by the virus infection. Kenya is on high alert and has activated all 26 public health emergency operations centres across the country, prepared laboratories for mpox testing and deployed 120 trained personnel to contain a possible outbreak.
More than 250,000 people have been tested so far since Kenya stepped up its MPOX screening earlier this month. Two Kenyans, in two different parts of the country, are currently undergoing testing for a skin condition that resembles the MPOX rash.
While there has only been one confirmed case of Clade Ib in Kenya so far, experts like Ouma say there are likely to be more cases, particularly given Kenya’s position as a hub for travel within the East African community. The mpox case involved a driver traveling from Uganda to the Kenyan coastal city of Mombasa.
Kenya has 35 entry and exit points or borders with five countries including Tanzania, Uganda, Ethiopia, Somalia, South Sudan and the international waters of the Indian Ocean. To avert a public health disaster, Kenya is set to receive what has been labelled a donor-funded Mpox war chest worth US$16 million (Kes 2 billion).
Discovered in captive monkeys in 1958, the first case of monkeypox—renamed mpox by the WHO in 2022—was identified in the Democratic Republic of Congo in 1970, and in 2022 mpox first spread globally. Scientists at the Centers for Disease Control and Prevention say the virus that causes mpox belongs to the same family as the virus that causes smallpox, but is not related to chickenpox. As a zoonotic disease, it can spread between animals and people.
Ouma says that while mpox is endemic in forest regions of East, Central and West Africa, the continued unprecedented spread and reach of the deadly Clade Ib variant raises concerns and positions mpox as a global health issue that deserves the attention of the global community of scientists and public health actors.
Stressing that “even the more than 517 people who died from MPOX this year, mostly in the DRC, have not increased the burden of the disease. African researchers have been sounding the alarm long before the 2022-2023 MPOX outbreak, calling for greater investment from the global public health community to improve diagnosis, prevention, treatment and control of the disease, but without much success.”
To put it in perspective, Ouma says WHO’s declaration that mpox is now a public health emergency of international concern raises the disease’s profile to the “highest level of alert relative to issues that pose a public health risk to other countries, and calls for an internationally coordinated response.”
WHO Regional Director for Africa, Dr Matshidiso Moeti, said: “Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to strengthen measures to contain mpox. As the virus continues to spread, we are scaling up further through coordinated international action to help countries end the outbreaks.”
Chair of the committee Professor Dimie Ogoina said: “The current surge of mpox in parts of Africa, coupled with the spread of a new sexually transmitted strain of monkeypox virus, is an emergency not only for Africa but for the entire world. Mpox, which originated in Africa, was neglected there and later caused a global outbreak in 2022. It is time to take decisive action to prevent history from repeating itself.”
Ouma says that while this is a step in the right direction, it also highlights the serious health disparities and inequalities in prevention and response to disease outbreaks. Because mpox has been confined to the African continent and remote rural areas of the DRC, communities have long struggled with the infectious disease without the much-needed investment in diagnostics, therapeutics and infection prevention.
Stressing that there is an urgent problem around “under-testing and under-reporting because we do not have the tools to tackle the disease. Clade I and II are endemic in Africa, but now that the deadly Clade Ib strain is sexually transmitted, suggesting it could spread globally, we have a flurry of activity to combat the infectious disease as others outside the continent are at risk. This response has taken too long and it seems that the lessons of COVID-19 have unfortunately faded with time.”
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© Inter Press Service (2024) — All rights reservedOriginal source: Inter Press Service
