WHO declares mpox outbreaks in Africa a global health emergency

The World Health Organization has declared mpox outbreaks in Congo and elsewhere in Africa a global emergency, with confirmed cases among children and adults in more than a dozen countries and a new form of the virus spreading. Few vaccine doses are available on the continent.

Earlier this week, the African Centers for Disease Control and Prevention declared the mpox outbreak a public health emergency, with more than 500 deaths, and called for international help to stop the spread of the virus.

“This is something that should concern us all… The potential for further spread within Africa and beyond is very worrying,” said WHO director-general Tedros Adhanom Ghebreyesus.

Africa’s CDC previously said mpox, also known as monkeypox, has been detected in 13 countries this year, and more than 96% of all cases and deaths are in Congo. Cases have increased by 160% and deaths have increased by 19% compared to the same period last year. So far, there have been more than 14,000 cases and 524 people have died.

“We are now in a situation where (mpox) poses a risk to many more neighbors in and around central Africa,” said Salim Abdool Karim, a South African infectious disease expert who heads the CDC’s Africa emergency group. He said the new version of mpox spreading from Congo appears to have a death rate of about 3-4%.

In 2022, the WHO declared mpox a global emergency after it spread to more than 70 countries that had not previously reported mpox, mostly affecting gay and bisexual men. In that outbreak, less than 1% of people died.

Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, said declaring these latest mpox outbreaks in Africa an emergency is warranted if it can lead to more support to control them.

“It is a failure of the global community that things had to go so badly to free up the necessary resources,” he said.

Officials at the Africa CDC said nearly 70% of Congo’s cases are in children younger than 15, who also accounted for 85% of the deaths.

Jacques Alonda, an epidemiologist working in Congo with international charities, said he and other experts were particularly concerned about the spread of mpox in refugee camps in the country’s conflict-torn east.

“The worst case I have seen is that of a six-week-old child who was only two weeks old when he contracted mpox,” Alonda said, adding that the baby had been in their care for a month. “He became infected because overcrowding at the hospital meant he and his mother had to share a room with someone else who had the virus, who was undiagnosed.”

Save the Children said Congo’s health system had already “collapsed” under the strain of malnutrition, measles and cholera.

The UN health agency said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All these outbreaks are linked to the one in Congo. In Ivory Coast and South Africa, health authorities have reported outbreaks of a different, less dangerous version of mpox that spread worldwide in 2022.

Earlier this year, scientists reported the emergence of a new form of the deadliest form of mpox, which can kill up to 10% of people, in a Congolese mining town that they feared could spread further. easy. Mpox is spread mainly through close contact with infected people, including sexual intercourse.

Unlike previous outbreaks of mpox, where lesions were mostly seen on the chest, hands and feet, the new form causes milder symptoms and lesions on the genitals. This makes detection more difficult, meaning people can also infect others without knowing they are infected.

Before the 2022 outbreak, the disease was seen mostly in sporadic outbreaks in Central and West Africa, when people came into close contact with infected wild animals.

Western countries during the 2022 outbreak largely shut down the spread of mpox with the help of vaccines and treatments, but very few of these have been available in Africa.

Marks of the London School of Hygiene and Tropical Medicine said that in the absence of mpox vaccines licensed in the West, officials may consider vaccinating people against smallpox, a related disease. “We need a large supply of vaccines so that we can vaccinate the most vulnerable populations,” he said, adding that this would mean sex workers, children and adults living in outbreak regions.

Congo has not received any of the mpox vaccines it requested.

Congolese authorities said they have requested 4 million doses, Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee, told The Associated Press. Osako said they will mainly be used for children under 18.

“The United States and Japan are the two countries that positioned themselves to provide vaccines for our country,” Osako said.

Dr. Dimie Ogoina, a Nigerian mpox expert who chaired the WHO emergency committee, said there were still significant gaps in understanding how mpox is spreading in Africa. He said knowing the biggest risk factors for transmission will help guide vaccination strategies.

Although the WHO’s emergency declaration is intended to spur donor agencies and countries into action, the global response to previous declarations has been mixed.

Dr. Boghuma Titanji, an infectious disease expert at Emory University, said the WHO’s latest mpox emergency declaration “did very little to move the needle” on getting things like diagnostic tests, drugs and vaccines to Africa.

“The world has a real opportunity here to act decisively and not repeat the mistakes of the past, (but) it will take more than a (emergency) declaration,” Titanji said.