Why the World Health Organization has declared the current mpox outbreak a "global health emergency"

On Wednesday, the World Health Organization issued a Public Health Emergency of International Concern, the highest level of alert. The infection has been designated as PHEIC twice in as many years; the first instance occurred during the July 2022–May 2023 pandemic.

Following an increase in instances reported from the Democratic Republic of the Congo (DRC) and its neighboring nations, the decision was made to sound the alert. The WHO reports that since 2022, at least 99,176 cases and 208 fatalities from mpox have been documented from 116 countries.

Mpox: What is it?
The mpox virus, which was once known as monkeypox, is the source of this self-limiting viral infection. Fever, headaches, aches in the muscles, back discomfort, low energy, enlarged lymph nodes, and rashes that resemble the pox and continue for two to three weeks are the most typical symptoms of mpox. Although it is a self-limiting illness, people with weakened immune systems and youngsters are most susceptible to mortality.

Although human infections with the virus have been documented since 1970, until 2022, the majority of cases occurred in endemic regions of Africa.

What is causing the recent Mpox concern?
The MPXV's clade Ib, which is primarily distributed through sexual interaction, is the source of the current worry.

Clade-related organisms have shared ancestry. Clade I and Clade II are the two distinct clades of mpox, with Clade I being more deadly than Clade II.

A study that was published in the journal Emerging Infectious Disease in January states that there has never been any prior documentation of the sexual transmission of clade I diseases. In the past, clade I illnesses have been spread by zoonotic spillovers, which occur when animals and humans are in close proximity to one another. The DRC's endemic regions are still affected by Clade Ia infections that propagate in this manner.

Currently, more than 100 instances of clade 1b infections have been documented in four neighboring DRC countries: Burundi, Kenya, Rwanda, and Uganda. These nations had not previously reported occurrences of mpox. Given that a large percentage of people with symptoms may not have had tests, the figures are probably greater. This is concomitant with an increase in the overall count of cases with MPOVX. Thus far this year alone, there have been reports of almost 15,600 illnesses and 537 deaths.

"The rapid spread of a new mpox clade in the eastern Democratic Republic of the Congo, along with the reports of cases in multiple neighboring countries, are extremely concerning." WHO Director-General Dr. Tedros Adhanom Ghebreyesus stated on Wednesday that "it's evident that a coordinated international response is needed to stop these outbreaks and save lives, in addition to outbreaks of other mpox clades in the DRC and other countries in Africa."

The virus has diversified into numerous unique lineages in the human population, where it is rapidly acquiring many new mutations, according to research published in the journal Nature late last year. The research also suggests that human-to-human transmission is the primary cause of current instances.

Is there danger for India?
On Thursday, news from Sweden revealed the first incidence of the highly contagious haplogroup Ib mpox infection outside of Africa. Due to associated international travel, cases may also spread to other nations.

India also recorded instances of mpox during the global outbreak of 2022, however these were of the less fatal clade II kind. Initially, some Keralans with a history of outside travel were reported to have contracted illnesses. But later on, in Delhi, infections occurred even in people who had never traveled abroad. The WHO data shows that at least 27 laboratory-confirmed illnesses and one fatality were reported in India.

"The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the virus, is an emergency, not only for Africa, but for the entire globe," stated Professor Dimie Ogoina, Chair of the IHR Emergency Committee. Originating in Africa, mpox was ignored there until 2022, when it spread over the world. It's time to take serious action to stop history from happening again.

Exist vaccinations against mpox?
The WHO's Strategic Advisory Group of Experts on Immunization has endorsed at least two of the mpox vaccines that are now in use.

The WHO last week initiated the process of creating an Emergency Use Listing for mpox vaccinations, which will expedite vaccine access for lower-income nations that have not yet received their own national regulatory approval. Additionally, organizations like UNICEF and GAVI are able to get vaccines for distribution in these nations because to this designation.

In order to enable fair access to vaccinations, treatments, diagnostics, and other instruments, WHO is collaborating with states and vaccine producers on possible vaccine contributions. The organization also noted that it is coordinating with partners through the temporary Medical Countermeasures Network.