The African Union’s Centers for Disease Control and Prevention (Africa CDC) recently declared a new strain of the Mpox virus, formerly Monkeypox, as a public health emergency. This crucial step in managing the disease on the continent was strongly supported by a committee of experts.
Urgent health measures to contain the spread
The virus is spreading rapidly in the Democratic Republic of Congo (DRC), with experts warning that it is the most dangerous variant they’ve encountered. As of late July, the Africa CDC recorded 37,583 cases since the beginning of 2022, with 1,451 deaths across 15 East African Community (EAC) member states.
The Africa CDC has raised alarms about a potential uncontrollable escalation and is calling for an increase in vaccine availability. « The problem is not limited to Africa; Mpox poses a global threat, without borders, race, or creed », said Jean Kaseya, Director-General of the Africa CDC.
Professor Marks, a leading expert, has noted significant transmission between neighboring countries like Rwanda, Uganda, and Burundi. He asserts that while Europe and America are not currently in danger, the true burden of the disease, including missed cases and actual mortality rates, remains unknown.
What is monkeypox ?
Monkeypox, caused by the Mpox virus, is a zoonotic disease that typically transmits from animals to humans. It is most commonly found in countries near tropical rainforests. Thousands of cases and hundreds of deaths are recorded annually in these regions. There are two main strains of the virus. The milder strain led to a global pandemic in 2022.
The more dangerous strain, endemic to Central Africa, is responsible for the newly discovered variant in the DRC, which is now spreading to Kenya, Rwanda, and Uganda.
What are the symptoms of monkeypox ?
Mpox is transmitted through close contact with infected individuals. Symptoms include fever, headache, swelling, back pain, and muscle aches. After the fever subsides, a rash may develop, often starting on the face before spreading to other body parts, particularly the palms and soles.
The rash, which can be painful, progresses through several stages before forming a crust that eventually falls off, potentially leaving scars. Typically, the infection clears up within 14 to 21 days.
In severe cases, the lesions can spread across the body, including the mouth, eyes, and genitals. According to the World Health Organization (WHO), individuals infected with the Mpox virus should remain isolated at home throughout the infection period until the crusts fall off. Protecting the wounds and wearing a medical mask can also help prevent the spread.
What constitutes a health emergency ?
Declaring a public health emergency allows governments to organize their response more effectively and potentially increase the flow of medical supplies and aid to affected areas.
Professor Marks from the London School of Hygiene & Tropical Medicine (LSHTM) explains that such an announcement aims to achieve multiple objectives, including helping African nations secure financial aid. Countries can trigger the release of specific funding mechanisms, such as the European Union’s recent supportive studies. Affected countries can also implement national measures by increasing the responsibilities of health ministries.
What about the new strain ?
Mortality rates differ significantly between West and Central Africa. Clade 2, present in West Africa, generally has a much lower mortality rate, below 1 %. In contrast, Clade 1, found in the DRC, has a higher mortality rate, ranging from 1 % to 10 %.
In the DRC, the mortality rate is currently 4 %, according to the latest situation report from the Africa CDC. However, Professor Marks cautions that this percentage could be much higher when combining case mortality rates (recorded cases) with infection mortality rates (new cases).
How is it transmitted and who is at risk ?
Transmission mainly occurs through direct contact with infectious skin lesions, which can happen during sexual relations or other close contact, such as with a child.
Professor Marks notes that while transmission can occur through various types of skin contact, « sexual contact plays a major role in this outbreak ». This has contributed to the spread of the virus across many African countries and has led to fatalities, particularly among young men in South Africa. In June, two individuals in South Africa died from Mpox within 24 hours of each other, marking the first reported deaths caused by the virus in the country. All six reported cases have been hospitalized, involving patients aged 30 to 39 who had not traveled to other affected countries, indicating local transmission.
What about vaccines ?
A major challenge in combating the outbreak is the limited supply of vaccines. Professor Marks highlighted the « blatant mismatch between the number of vaccine doses available in African countries and the population that needs to be vaccinated ».
Dr. Adeola Fowotade, a clinical virologist at the University College Hospital in Ibadan, noted that the DRC and Nigeria recently reported readiness to approve the necessary vaccines. « This is a commendable measure aimed at mitigating the spread of the virus in African countries, and I hope other countries will follow suit », she said.
The DRC has experience with large-scale vaccination efforts since the recent Ebola epidemics. According to Professor Marks, the country « clearly has the infrastructure needed to ensure large-scale vaccination ».
