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How does mpox spread and what is the risk to the rest of the world?

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Mpox has been declared a global emergency by the World Health Organization (WHO), with a new strain spreading across Africa at an alarming rate.

Officials announced on Wednesday that an outbreak of the strain in the Democratic Republic of the Congo was now a “public health emergency of international concern”.

It is the second time in three years that the WHO has designated an mpox epidemic as a global emergency.

It comes as the number of cases reported so far this year has already exceeded last year’s total, with more than 15,600 cases and 537 deaths according to the WHO.

Image:
A man in the Democratic Republic of Congo has lesions on his face after contracting mpox in the latest outbreak. Pic: Reuters

But what is mpox, what are the symptoms, how is it treated and what’s being done about the outbreak?

The viral disease occurs mostly in central and western Africa. The recent outbreak has spread to 13 African countries, including some that have never reported mpox cases before.

It was first identified in laboratory monkeys, according to the US Centers for Disease Control and Prevention (CDC).

It used to be known as monkeypox, but was renamed in 2022 by the World Health Organisation (WHO) after receiving complaints that the original name was “racist and stigmatising”.

A man in the DRC infected with mpox. Pic: Reuters
Image:
A man in the Democratic Republic of Congo has lesions on his face after contracting mpox in the latest outbreak. Pic: Reuters

Most cases are mild but it can be deadly.

The disease spreads through close contact with infected people, including via sex, with the latest outbreak in the continent beginning with the spread of an endemic strain known as Clade 1.

The new variant that has emerged, known as Clade 1b, appears to spread more easily through close contact, particularly among children.

Jean Claude Udahemuka, from the University of Rwanda, said last month that Clade 1b is “undoubtedly the most dangerous so far of all the known strains of mpox”.

An enhanced image of mpox particles (red) found within an infected cell (blue). Pic: AP
Image:
An enhanced image of mpox particles (red) found within an infected cell (blue). Pic: AP

What are the symptoms?

Common symptoms of mpox are a skin rash or pus-filled lesions which can last two to four weeks.

The rashes can be located anywhere on the body and some people may only have one, while others can have hundreds or more.

These are other symptoms listed by the CDC:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Exhaustion
  • Muscle aches and backache
  • Headache
  • Respiratory symptoms (e.g., sore throat, nasal congestion, or cough)

The WHO says people may start to feel unwell before they get a rash or skin lesions, while for others the skin symptoms can be the first or only sign.

A suspected case of mpox. File pic: Reuters
Image:
A suspected case of mpox. File pic: Reuters

The new strand has the same symptoms as others but they are more severe, according to Leandre Murhula Masirika, a research coordinator in South Kivu province.

An analysis of patients hospitalised from October to January in eastern Congo suggested the new form of mpox initially caused milder symptoms and lesions mostly on the genitals, making it harder to spot.

How is it treated?

Currently there is no treatment approved specifically for mpox infections, according to the CDC.

It says that for most patients with mpox who have intact immune systems and don’t have a skin disease, supportive care and pain control will help them recover without medical treatment.

However, a two-dose vaccine has been developed to protect against the virus, which is widely available in Western countries but not in Africa.

Scientists from the Africa Centres for Disease Control and Prevention (Africa CDC) say they need more than 10 million vaccine doses but only 200,000 are available.

How did things get worse in Africa?

Mpox has been endemic in parts of Africa for decades after it was first detected in humans in DR Congo in 1970.

But the Clade 1b strain first emerged in September among sex workers in the DRC mining town of Kamituga, about 170 miles (273km) from the border with Rwanda.

Africa CDC has said 96% of all cases and deaths were in Democratic Republic of Congo (DRC), but it has also spread to neighbouring countries, with 18 nations reporting cases.

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Could this affect the UK and the rest of the world?

A milder version of the virus spread to more than 100 countries in 2022, largely through sexual contact, prompting the WHO to declare a public health emergency of international concern on 23 July 2022 – its highest level of alert.

A total of 2,137 cases had been confirmed in the UK at that stage, but by 31 December 2022 that number had soared to 3,732 cases – 3,553 were in England, 34 in Northern Ireland, 97 in Scotland and 48 in Wales.

The WHO ended the emergency 10 months later, saying the health crisis had come under control.

Infections have since slowed down significantly in the UK, with only 239 cases detected in 2023 and 2024 (up to 30 June) – 225 in England, nine in Scotland, four in Northern Ireland and one in Wales.

There were no reported deaths in the UK during the entire outbreak.

Maria Van Kerkhove, who leads WHO’s outbreak department, has called for an urgent response.

“We do not want the world to sit and watch and wait,” she said. “The time [to act] is now.”

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