The World Health Organization (WHO) has allayed fears that a serious Mpox outbreak could occur outside Africa. “Mpox is not the new Covid,” said WHO Director for Europe Hans Kluge in a video conference this week. “We know how to control Mpox and know the ways to prevent transmission in the European region.” Lockdowns, face masks or mass vaccinations are not to be expected, said Kluge.
However, the virus is spreading rapidly in Africa, particularly in the Democratic Republic of Congo. According to the latest data from the African Union Center for Disease Control and Prevention (Africa CDC), twelve African countries have reported almost 19,000 cases of infection, 3,000 of which have been confirmed. More than 90 percent are in Congo, where almost all of the 541 deaths have been reported. Outside of Central Africa, there are isolated cases in the affected countries. The WHO declared the increase in Mpox cases on the continent an international health emergency a week ago.
As the aid organization Save the Children found, young people are most frequently and most severely affected. Almost three quarters of the cases identified in Congo are children and adolescents under the age of 15. This is a new development compared to the last global Mpox outbreak two years ago. The probability of dying from the disease is also higher in children than in adults. This could be due to a weaker immune system or confusion with childhood diseases such as chickenpox in the early stages.
Devastating situation in Eastern Congo
The situation in the conflict areas in eastern Congo is devastating, especially in the refugee camps, where residents live close together, cannot isolate themselves and are extremely weak, says Katharina von Schröder, who works for the aid organization in Congo. At the same time, health centers are sometimes very poorly equipped, and even face masks and gloves are missing in some places. The ongoing violence in eastern Congo has made millions of people displaced in their own country.
Since there is also a shortage of testing staff and test kits, the number of cases is likely to be much higher. Many people also do not want to be tested, says von Schröder, out of concern for their survival if they can no longer work, cultivate their fields or provide for themselves. “As with previous Ebola outbreaks, you have to go from house to house, convince people to isolate themselves and offer help to prevent entire families from becoming infected.” The aid organization has around 300 employees in the huge central African country.
Mother-child transmission is likely
The high infection rate among children suggests mother-to-child transmission, for example through breastfeeding. There are also suspicions that the virus spreads not only through bodily fluids but also through touching contaminated objects. In 2022, the virus seemed to be transmitted primarily through sexual intercourse between men. However, the virus strain that has now emerged in the Congo Basin is a new variant, called clade I b. It was previously only known as a zoonosis; these are diseases that are transmitted from animals to humans or vice versa. Infections with the previous clade II b still occur in Europe, but they have fallen sharply.
There is currently no reason to worry outside Congo, says Wolfgang Preiser, virologist at Stellenbosch University, to the FAZ. However, there is an urgent need for action in Congo. The number of suspected cases is far higher than the number of confirmed cases. Much more testing is needed to better understand the epidemic and prevent it from spreading to neighboring countries and beyond.
In 2017, the virus, clade II b, initially spread largely unnoticed in Nigeria until it suddenly spread globally in 2022. Although the virus variant is less harmful than the one from Congo, three people with inadequately treated HIV infections died from it in South Africa this year. Sweden recently reported the first case of infection outside Africa with clade I b from Congo.
The Africa CDC is currently trying to obtain vaccines. Ten million doses should be available by the end of 2025, said Africa CDC Director Jean Kaseya. To this end, talks are underway with the Danish manufacturer Bavarian Nordic, which is also passing on the technology to produce the vaccine in Africa. The EU is also providing 215,000 doses through its humanitarian emergency initiative.
Mpox was first discovered in captive monkeys in 1958, which is why the disease was previously called monkeypox. The first human infection occurred in 1970. Two years ago, the disease was renamed Mpox.
