In response to new and resurgent empox outbreaks in multiple African countries, the Centers for Disease Control and Prevention in Africa announced mpox is a continent-wide public health emergency Tuesday. Although many countries outside of Africa quickly experienced an empox epidemic that began in 2022, large outbreaks continued in West and Central Africa. And now, a deadly strain is spreading across Africa’s borders.
Mpox, formerly known as monkeypox, is an infectious disease closely related to smallpox but far less severe than smallpox, and is suspected to have originated African rodents and non-human primates. Mpox spreads Through close contact with an infected person, including sexual and skin-to-skin contact. Pregnant people can also transmit the virus to their children during pregnancy and after birth. most common Symptoms mpox is a blister-like rash that usually lasts two to four weeks. Other symptoms include fever, fatigue, muscle aches, cough and sore throat.
For decadesmpox has caused sporadic cases and outbreaks in Nigeria, the Democratic Republic of Congo, and other African countries. There are two main strain mpox’s: Clade Iwhich causes more severe disease and was historically restricted to Central Africa, and a second clade, which historically caused infections in West Africa.
in May 2022Countries outside Africa suddenly began recording empox cases caused by the clade II type. That July, the World Health Organization declared the epidemic a public health emergency of international concern. By May 2023, more than that 100 countries About 90,000 empox cases and more have been recorded 150 deaths.
Fortunately, public health agencies around the world have acted quickly to improve disease surveillance efforts, increase awareness among high-risk populations, particularly men who have sex with men, and encouraging Practice safe sex. In the United States and Europe, where there were more than 30,000 and 25,000 empox cases between May 2022 and May 2023, respectively, officials also campaigned on a million As a result of vaccine doses, mpox infections have declined rapidly in most countries. in May 2023The World Health Organization has lifted the emergency.
Today, outbreaks of empox, although not currently considered an international health emergency, are still ongoing, and countries around the world continue to report cases. As of June 2024, 175 cases were reported across North, Central, and South America; 100 cases have been reported in Europe and 11 cases in Southeast Asian countries, according to one Situation report Published by the World Health Organization.
But as global understanding of mpox improves, Outbreak The situation in the Democratic Republic of the Congo in Central Africa continues to worsen. Unlike other parts of the world, the Mpox strain that causes infection in the DRC is more severe clade I type. As of May 2024, has been 7,851 mpox cases and 384 deaths in the country.
In the last two months, Four countries in East Africa — Burundi, Kenya, Rwanda, and Uganda — reported Clade I mpox cases for the first time, raising concerns that a deadly mpox epidemic may be on the horizon. Other African countries are also facing resurgent empox outbreaks caused by clade II viruses. In May, the total was 465 mpox cases have been recorded across all African countries and were 567 in June, an increase of 22 percent.
The increase in Mpox cases has prompted the African CDC to designate Mpox as a public health emergency for the continent. Africa CDC Public Health organization of the African Union, which represents 55 African states. The agency has declared an outbreak a continental emergency for the first time.
“We are declaring this public health emergency of continental protection to mobilize our institutions, our collective will and our resources to act quickly and decisively,” Africa CDC director-general Jean Kaseya told a press briefing on Tuesday.
But outbreak response efforts in the DRC and other African countries have once again been hampered by the same challenges that health officials have faced during previous outbreaks and pandemics, including Covid: a lack of global coordination and reluctance to share life-saving resources. Vaccines are only now beginning to enter the DRC, even as vaccine doses spread rapidly in the US and Europe in 2022. But even then, only a few hundred thousand vaccines will be available for the majority of the population 100 million people
Gradually, national governments and multinational organizations such as the African Union are working to improve domestic public health infrastructure and technical capacity and reduce dependence on donor countries. While the unprecedented move by CDC in Africa to designate the Mpox outbreak a regional health emergency signals the continuation of these efforts, it is unclear whether the designation will help spur the rapid flow of resources needed to respond to Mpox outbreaks.
The origin of Mpox is unknown
Mpox was first discovered in 1958 in a colony of monkeys at a research center in Denmark, and the first case of mpox in a human – a nine-month-old baby – had not yet been documented. 1970 In the Democratic Republic of the Congo. Researchers and doctors can not determined exactly how the child was infected; However, infection can occur through close contact with infected monkeys. Small rodents, monkeys and mammals can pass The virus is among humans but outbreaks usually stop when people infect each other.
In 2005, additional human empox cases were recorded in the DRC, and thousands of suspected cases have been reported each year since then. As of 2017, mpox also causes frequent infections in Nigeria.
Although mpox has been around for a long time, there are still many unknowns about how the virus spreads and why it suddenly spread around the world in 2022. What researchers do know is that the virus has been mutating rapidly in recent years.
Interestingly, and perhaps alarmingly, while most genetic mutations have no effect, some may be more effective in causing or spreading the virus. When the geneticists compared the 2022 MPX genome to a sample collected in 2017, they found something 40 genetic Mutation happened There are some researchers Recommended That these mutations have improved how easily the virus can spread from person to person, however, appears to be unconfirmed Consensus yet
In September 2023, an entirely new mpox clade I variant, tentatively called clade IB, discovered In the DRC. The World Health Organization has not confirmed that the new variant causes more serious disease or can spread more easily.
Rosamund Lewis, the World Health Organization’s empox technical lead, says genetic mutations are not behind the sudden global increase in empox. Instead, he suggests that the virus began infecting new populations — sex workers and men who have sex with men — and thereby spurred widespread transmission. Mpox is reminiscent of the origin of HIV, while chimpanzee Infected people in southwest Cameroon before taking firm original In the growing urban center of DRC’s capital Kinshasa — and a large sex worker population
Sexual transmission in adults can only be one of the main drivers of mpox infection. In the DRC, some 70 percent Among the mpox cases recorded this year were among children who were possibly infected through close contact with infected animals or family members.
One of the biggest risk factors for severe empox infection and death pre-existing HIV infection. Unfortunately, about 25.6 million More people in Africa have HIV than any other region in the world. This means that many African countries may experience severe outbreaks compared to other parts of the world. The dual burden of empox and HIV was also a major factor that prompted the Africa CDC to declare the empox outbreak a continental emergency, Kaseya explained.
There is a shortage of Mpox vaccine. Will urgent designation help?
There is at least one vaccine – GeniusesAlso called Imvanex In Europe – it is effective against mpox. US Food and Drug Administration allowed Vaccines for use against smallpox and pox in 2019.
When the United States and Europe began recording mpox cases in 2022, health officials quickly distributed millions of doses of the existing vaccine. For the first two years of the epidemic, however, no vaccine was available in the DRC.
The DRC, like most African countries, not have It can neither have its own vaccine manufacturing infrastructure nor pay for millions of doses. (The Mpox vaccine costs just $100 per dose, according to Casey; GDP per capita DRC is only $649.) So, these countries must rely on donations from the US, Europe and other countries. Following the Covid-19 pandemic, the Africa CDC began to take the lead effort To fill this important gap, but progress has been slow.
In the vacuum, officials in the Democratic Republic of Congo and other African countries continue to respond to their outbreaks without vaccines. It wasn’t until last month that the first shipments of Genios started arriving in the DRC. But the country has only received 200,000 doses, according to Lewis, forcing workers to come together to outline how they will use such limited resources. Kaseya did not elaborate on how the Africa CDC would assist in the process.
Donor governments are providing technical and financial support for responses to mpox outbreaks in Africa. Last week, the US Agency for International Development, or USAID, announced that it would increase $10 million in funds to support the mpox response in the DRC.
It remains unclear whether Africa CDC’s designation of mpox as a continental emergency will have any impact on mpox vaccine availability. Nevertheless, the Africa CDC appears to be leading the way in directing domestic resources toward the MPX response. The African Union released earlier this month $10.4 million Funding for Mpox response.
“This is a fight for all Africans and we will fight it together,” Kaseya said.
