Why WHO declared MPOX global health emergency and how to prevent its spread?

Last week, the World Health Organization (WHO) declared mpox (formerly known as monkeypox) a Public Health Emergency of International Concern.

This decision underscores the escalating threat posed by the virus, which surged globally in 2022 but has since seen a troubling resurgence, particularly in Africa.

The WHO’s move aims to galvanize a coordinated international response to contain and mitigate the spread of mpox, a virus with significant public health implications.

Mpox, a member of the same viral family as smallpox, is a rare but severe infection. It manifests through symptoms akin to chickenpox, including fevers, swollen lymph nodes, and notably, painful skin lesions.

Two primary strains exist: clade 1 and clade 2. Clade 1, which predominates in Central and East Africa, is more virulent with a fatality rate of approximately 3.6per cent.

Clade 2, which fueled the 2022 outbreak, is less severe, with a fatality rate under 0.2per cent. The recent uptick in cases, especially in Burundi, Kenya, Uganda, and Rwanda, along with sporadic cases in Europe, prompted the WHO’s emergency declaration.

The WHO's action reflects mounting concerns over the virus’s geographical spread and increased case counts.

Although the full reasons behind the rise are still under investigation, possible factors include enhanced surveillance and changes in transmission dynamics.

By declaring mpox a global emergency, the WHO aims to focus resources on improved surveillance, enhanced response strategies, and clinical preparedness across affected regions.

Despite these concerns, mpox is not likely to evolve into a pandemic akin to COVID-19. Effective vaccines and antiviral treatments, such as Jynneos and Tecovirimat (TPOXX), are available to control and mitigate the virus.

These interventions play a crucial role in preventing severe outcomes and curbing the virus’s spread.

Mpox primarily spreads through direct human-to-human contact with infected skin lesions. The 2022 global outbreak highlighted that mpox can also transmit through sexual contact, particularly among men who have sex with men.

 Animal-to-human transmission remains a factor, particularly in regions where people come into contact with infected wildlife.

Although mpox is not an airborne disease, it can spread via contaminated objects like clothing and bedding, though this is less common.

Understanding when mpox is most contagious is essential for prevention. The virus is most transmissible when lesions are present.

Vulnerable populations, such as those in densely populated areas like refugee camps in Sub-Saharan Africa, face a higher risk due to limited healthcare access and other socio-economic challenges.

However, individuals with weakened immune systems, such as those undergoing immunosuppressive treatments or living with HIV, also need to exercise caution.

The fatality rate of mpox is lower than that of smallpox, but it still poses a risk, particularly in areas with limited access to medical resources.

In regions like the Democratic Republic of the Congo, where clade 1 is prevalent, the mortality rate can reach 3.6per cent. The availability of vaccines and antivirals is critical in managing the disease and preventing severe cases and deaths.

Vaccination with Jynneos has proven effective in preventing mpox infections and mitigating the severity of the disease.

For those already infected, antiviral medications can help reduce symptoms and aid recovery.

Given the virus's potential to spread and the risk it poses to vulnerable populations, it is crucial that global health systems enhance their response mechanisms and ensure equitable access to vaccines and treatments.

The WHO’s declaration serves as a vital reminder of the importance of global vigilance and coordinated efforts in managing infectious diseases.

By addressing mpox with robust public health strategies, improved surveillance, and equitable healthcare access, we can mitigate the impact of this virus and prevent further public health crises

The current emergency declaration is not just a call to action but an opportunity to reinforce our global health infrastructure and prepare for future challenges.

The writer is Resident Physician Internal Medicine, The Nairobi West Hospital