Towards a state of maximum emergency? This is in any case the path envisaged by the WHO, which is concerned about the spread of a new strain of Mpox, or monkeypox, in the Democratic Republic of Congo (DRC). A meeting will take place next Wednesday, the organization informed, to discuss this possibility.
« Given the spread of Mpox outside the DRC (Democratic Republic of the Congo) and the possibility of further international spread within and outside Africa, I have decided to convene an emergency committee (…) to advise me on whether the outbreak constitutes a public health emergency of international concern. “, said the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, on Wednesday.
A public health emergency of international concern is the highest alert that WHO can issue. It can be declared by the head of WHO, on the advice of the committee.
In total, at least 16 countries on the continent, out of 55, have already recorded cases of this new strain of Mpox – discovered in September 2023 – with 887 cases recorded in the last week alone, and five deaths. A surge that is due, in large part, to the mode of transmission of this new variant.
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Higher mortality?
And if the health authorities are particularly concerned, it is because the current epidemic is caused by a new strain, called Clade 1b, transmitted between humans by the lesions it causes, particularly in the genitals. It is a mutation of the Clade 1 subtype, first discovered in humans in 1970 in what is now the DRC (formerly Zaire) and which was transmitted from infected animals to humans. The new mutation that changes the mode of transmission is reminiscent of that of the Clade 2b strain in 2022 which had spread outside the African continent, mainly affecting homosexual and bisexual men. The epidemic had caused some 140 deaths out of around 90,000 cases.
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The similarity of transmission of this new variant is the reason for the WHO’s great concern. Especially since it is more deadly and more transmissible than the previous ones according to certain institutions. As of August 3, a total of 14,479 cases have been confirmed or suspected in Africa, leading to 455 deaths, i.e. a lethality rate of around 3%, according to the African Union Africa CDC (African Centers for Disease Control and Prevention), mainly in Kenya, Burundi, Rwanda and Ivory Coast. But for the time being, the DRC is the most affected country. Figures that need to be qualified, according to Professor Antoine Gessain, director of the “Epidemiology and physiopathology of oncogenic viruses” research unit at the Pasteur Institute:
« It is difficult to know whether this virus is more deadly, because the population affected is also more vulnerable. In fact, it concerns sexual populations with multiple partners, including sex workers and many people with HIV. »
Clade 1b causes rashes all over the body, while previous strains were characterized by localized rashes and lesions on the mouth, face or genitals. Transmission between humans, mainly through sexual intercourse, is very rapid in these populations, which are not very aware of the symptoms of the virus.
$15 million to prevent disease
Faced with this resurgence of cases similar to those spread outside Africa in 2022, the WHO wants to react quickly. If the organization declares the level of public health emergency, this will make it possible to raise funds quickly and mobilize countries on a continental scale. The institution has estimated the regional action plan to prevent the disease at $15 million. For its part, the United States announced on Wednesday $10 million in aid for the DRC, intended to “health care” to respond to the current epidemic.
This plan, as in Western countries during the contamination by Clade 2b, should consist of vaccination, taking an antiviral called Tecovirimat as well as knowledge of the disease leading to behavioral modification to limit the spread. All these provisions have made it possible to very quickly stop the spread of the virus outside Africa. Problem: ” To date, there is no monkeypox vaccination available in these countries, on a small or large scale. ” regrets Professor Antoine Gessain.
In view of the recent surge in cases, the WHO last night invited smallpox vaccine manufacturers to submit dossiers for emergency evaluation to speed up distribution.
