Mpox: WHO experts respond to questions on current outbreak

The WHO has declared the current Mpox outbreaks are of "International Concern," but how does the situation differ from previous public health emergencies?

This week World Health Organization (WHO) Director-General Dr. Tedros has declared a Public Health Emergency of International Concern (PHEIC) following the ongoing upsurge of mpox in the Democratic Republic of the Congo (DRC) and in a growing number of countries.

Within the African region, 13 countries have reported cases, this with current active outbreaks in 11 countries, including countries who had not reported cases before.

But what do we know about the virus driving the latest outbreaks, and what is the current public health response?

In a Q&A session, WHO experts including Dr. Maria Van Kerkhove, an Honorary Lecturer at Imperial College London's MRC Center for Global Infectious Disease Analysis, responded to key questions on the current outbreaks.

What is mpox?

Mpox is an infectious disease caused by the monkeypox virus which is a species of Orthopoxvirus.

Most common symptoms are fever, swelling of lymph nodes, mucosal lesions and skin rash. Most people recover, but some people develop more severe disease.

Mpox spreads from contact with infected people through touch (skin to skin contact), kissing or sex, but also contact with infected animals when hunting, skinning or cooking, or infected materials such as contaminated sheets, clothes or needles.

What is a 'public health emergency of international concern'?

The International Health Regulations (IHR) is an international agreement between 196 countries across the globe, including all the Member States of WHO.

IHR defines a public health emergency of international concern when it meets certain criteria including:

1. An extraordinary event: a new strain of mpox (clade 1b) was identified and we see an upsurge of mpox cases in DRC and a growing number of countries.
2. Constituting a public health risk to other States through the international spread of disease: This new strain has spread to neighboring countries, including those that have never reported mpox before. Limited testing and surveillance may mean there are cases we do not yet know about.
3. Requiring coordinated international response: To scale up ongoing efforts along with resources is needed to stop outbreaks and save lives.

What can I do to protect myself?

Dr. Van Kerkhove, advised, "First and foremost is to understand the risk that is there and if you have mpox yourself to avoid contact with others, cover lesions if you have and to seek medical care.

"The other thing is if someone has lesions or they are symptomatic to avoid having sex."

Is the mpox outbreak comparable to COVID-19?

Offering reassuring insights in response to questions of whether mpox "is the new COVID," Dr. Van Kerkhove said, "mpox is not the same virus, it does not spread the same way. We are not seeing the same situation unfold.

"Anyone can get infected with mpox if they are in contact with an infected individual, but that does not mean everyone will get infected with mpox. That is an important distinction. This is not the 'new' anything.

"We have experience with mpox, and right now with the declaration of PHEIC, there needs to be a concentrated, global effort to support the countries that are seeing this upsurge.

"There is a lot that we can do, we are all in this together and everyone has a role to play. It is about having that right information, make sure countries have the right resources, diagnostics and therapeutics that are available are used and vaccines are used in a targeted way."

Imperial College London and mpox

As a WHO collaborating center for Infectious Disease Modeling, the MRC Center for Global Infectious Disease Analysis at Imperial College London is actively supporting the response to mpox. The MRC Center collaborates with researchers and health organizations in affected regions to help provide robust analytical and modeling support.

As part of this real-time response, the MRC Center released two preprint publications on mpox in recent months, focusing on the burden of mpox among MSM in South Africa and age patterns of severity of clade I mpox.

Dr. Lilith Whittles of the MRC Center said, "The severity of mpox varies in different people. Exploring this helps to understand the burden of disease at population level, which will help identify where interventions such as vaccination are best targeted.

"In countries where zoonotic transmission has historically occurred, children under 15 who become infected with mpox are more likely to experience severe outcomes. We quantified the severity of infection by age and by smallpox vaccination status to assist with future vaccine prioritization."

For more information on the work of the MRC Center for Global Infectious Disease Analysis and their work on infectious disease outbreaks, visit the website.