Mpox Outbreak Explained With 12 Key Questions As WHO Declares Latest Public Health Emergency

Mpox Outbreak: WHO has declared mpox (monkeypox) a public health emergency due to a surge in cases in Africa, particularly in the DRC and neighbouring countries. Here is everything you need to know.

Mpox Outbreak: The recent surge in mpox (formerly known as monkeypox) cases in Africa, particularly in the Democratic Republic of the Congo (DRC) and neighbouring countries, has prompted the World Health Organization (WHO) to declare it a public health emergency of international concern (PHEIC). A case has been recorded outside the African continent also, with Sweden's public health agency reporting a patient, and claiming that the person contracted the infection during a stay somewhere in Africa.

Previously known as monkeypox, Mpox transmits through close contact. Symptoms are like those of flu, but skin lesions can be fatal, according to WHO, which says four in 100 cases may lead to death. 

With the global alert in place, here are answers to some key questions about the disease and the ongoing situation, based on information shared by WHO.

1. What is mpox and where did it originate?

Mpox, previously known as monkeypox, is a viral disease caused by an Orthopoxvirus. It was first detected in humans in 1970 in the DRC and is considered endemic in parts of central and west Africa. The disease has gained global attention after causing a worldwide outbreak in 2022.

2. What are mpox symptoms?

Common symptoms of mpox include rashes, sore throat, fever, headache and muscle aches, back pain, swollen lymph nodes, and low energy. The first symptom some patients show is a rash, but different symptoms may also appear first. This rash usually begins as a "flat sore" but becomes a "blister filled with liquid" that can be itchy or painful. These skin lesions, one or multiple, can appear anywhere on the body but mostly palms of hands and soles of feet. They can also appear on the face and mouth, or in the throat, groin and genital areas, and anus, WHO said in a 2023 update about mpox.

3. How does mpox spread?

The Orthopoxvirus that causes mpox transmits through physical contact with contaminated materials, an infected person, or infected animals. Human-to-human transmission occurs via direct contact with infectious lesions (e.g., skin, mouth, genitals), face-to-face interactions (talking, breathing), skin-to-skin (touching, sex), mouth-to-mouth (kissing), or respiratory droplets from close contact. The virus enters through broken skin, mucosal surfaces, or the respiratory tract. People with multiple sexual partners fall in the high-risk category. Animal-to-human transmission happens through bites, scratches, or contact with infected animals during hunting or eating. Contaminated objects like clothing, linens, and sharp tools also pose risks.

4. Why has WHO declared mpox a public health emergency again?  

WHO Director-General Dr. Tedros Adhanom Ghebreyesus declared mpox a Public Health Emergency of International Concern (PHEIC) due to a rapid upsurge in cases in eastern DRC and neighbouring countries. The spread of a new strain, clade 1b, and increasing numbers in several African countries have raised global concern.

5. What is new about this mpox outbreak?

The current outbreak is particularly concerning because it involves the spread of a new strain, clade 1b, in the DRC, and it is being transmitted primarily through sexual contact. This strain has already been reported in countries that had never previously seen mpox cases, including Burundi, Kenya, Rwanda, and Uganda.

6. Why is this outbreak different from the global outbreak in 2022?  

The 2022 outbreak spread rapidly through sexual contact in non-endemic countries, prompting a global alert. This current outbreak, while centered in Africa, involves the emergence of a new clade, and its spread to neighboring countries highlights the risk of another international spread if not contained.

7. How serious is the current situation in Africa?  

Mpox cases in the DRC have been steadily rising for over a decade. This year alone, more than 15,600 cases and 537 deaths have been reported, surpassing last year’s total. The disease’s spread to new countries in the region makes the situation especially concerning.

8. What are the different clades of mpox and how do they spread?  

Several clades (or strains) of mpox exist, each with distinct transmission methods. While some spread through animal contact, the new clade 1b is primarily transmitted through sexual networks. 

9. What steps are being taken to control the outbreak?

WHO is coordinating a global response, working closely with affected countries, vaccine manufacturers, and international partners. The goal is to ensure that vaccines, diagnostics, and treatments are available where they are needed most, especially in lower-income countries.

10. Are vaccines available for mpox?

Yes, there are two vaccines recommended by WHO for mpox. WHO has initiated the Emergency Use Listing process to fast-track vaccine access for countries that have not yet approved them. This will enable agencies like Gavi and UNICEF to procure and distribute vaccines more quickly.

11. Is funding needed to combat the outbreak?

The WHO has estimated a preliminary funding need of $15 million to enhance surveillance, preparedness, and response efforts. An emergency allocation of $1.45 million has already been released from the WHO Contingency Fund for Emergencies, but more resources are required to fully address the crisis, it has said.

12. What are the next steps in managing this global health threat?  

WHO, national governments, and local health authorities are ramping up testing, surveillance, and public health interventions to prevent further spread. The agency has said a coordinated effort is critical to curbing this outbreak and ensuring that affected communities receive the necessary support.