Here’s what we know about this emerging crisis and its implications for global health.
Mpox, formerly known as monkeypox, is a viral infection that causes flu-like symptoms and a distinctive rash. Initially, symptoms include fever, chills, and muscle aches, followed by a rash.
This rash starts as raised spots, which develop into fluid-filled blisters before forming scabs. The disease can be severe and, in some cases, fatal.
Mpox has two main types, known as “clades.” Clade I, formerly called the Congo Basin clade, and Clade II, known as the West African clade. Historically, Clade I has a higher death rate compared to Clade II.
The Democratic Republic of the Congo (DRC) is facing a severe outbreak, with over 14,000 cases and 511 deaths reported so far in 2024.
This figure matches the total number of cases for all of 2023 and includes new areas previously unaffected by the virus. Other countries such as Burundi, Kenya, Rwanda, and Uganda are also reporting cases, some of which were not seen before.
The rise in cases is partly attributed to a new variant of Clade I called Clade Ib. This variant has been detected in the eastern part of the DRC and confirmed in neighboring countries.
Unlike previous strains that spread primarily through contact with infected animals, Clade Ib is transmitted more easily between people.
It spreads through physical contact, including sexual contact, and through contaminated items like bedding or towels.
Several factors contribute to the rising number of mpox cases. The DRC’s ongoing conflict and instability have made it difficult to control the outbreak.
Additionally, environmental changes due to the climate crisis are bringing humans into closer contact with wildlife, which may increase the risk of infection.
Experts also point out that Clade Ib, the new variant, spreads more efficiently. Although it is not yet clear if this variant is more transmissible, it is spreading through sexual networks and person-to-person contact, making it harder to contain.
The Africa Centres for Disease Control and Prevention (Africa CDC) is preparing to declare the outbreak a "public health emergency of continental security." This declaration would enable better coordination among countries and facilitate the sharing of information.
The World Health Organization (WHO) is also considering whether to declare the outbreak an "international public health emergency," a designation that would enhance global efforts to control the spread.
One of the major challenges in combating this outbreak is the shortage of vaccines. Africa CDC estimates that 10 million doses are needed to address the crisis effectively, but only 200,000 doses are currently available.
This shortage, combined with limited treatments and diagnostic tools, is impeding the response efforts. The WHO has authorized the emergency use of two vaccines, allowing organizations like Gavi and Unicef to procure and distribute them.
In the DRC, more than 70% of the reported cases are among children under the age of 18. This high percentage may be due to their weaker immune systems and higher rates of malnutrition, which leave them more susceptible to infections.
In contrast, older individuals may have some protection from previous smallpox vaccinations, which offer partial immunity against mpox.
The last major global mpox outbreak occurred in 2022 and primarily affected communities in Europe, particularly men who have sex with men.
The WHO declared a public health emergency at that time, and extensive vaccination and contact-tracing efforts were implemented. By May 2023, the emergency status was lifted after about 90,000 cases were reported worldwide.
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