The resurgence of mpox, formerly known as monkeypox, is once again a growing concern, particularly in Africa, where it has caused significant outbreaks. Just days after the World Health Organization (WHO) raised the alarm by declaring a global health emergency, cases of mpox have been detected in Sweden and Pakistan. The current outbreak, which is centered in the Democratic Republic of Congo (DR Congo), has claimed over 500 lives since the start of 2024. Here’s what we know so far about the spread of this new, more infectious strain.
The Rising Concern: A New Mpox Strain
Scientists are concerned that the recent spike in mpox cases is driven by a new variant of the virus, known as clade 1b. Unlike previous outbreaks, this strain seems more easily transmissible through routine close contact, including skin-to-skin interaction. WHO renamed the virus from monkeypox to mpox to avoid stigmatizing and discriminatory connotations associated with the original name.
Mpox Outbreak in Africa: The Epicenter
The Democratic Republic of Congo (DR Congo) is at the heart of this resurgence, where nearly 15,664 suspected cases and 548 deaths have been reported in 2024 alone. The virus has also spread to neighboring countries like Burundi, Kenya, Rwanda, and Uganda, raising concerns about further regional transmission. The scale of the outbreak led WHO to declare a Public Health Emergency of International Concern, the highest level of alert the organization can issue.
Spread Beyond Africa: Cases Reported in Sweden and Pakistan
The spread of the new mpox strain outside of Africa marks a significant development in this outbreak. On August 10, Sweden reported its first case involving clade 1b, making it the first confirmed infection of this variant outside the African continent. Pakistan quickly followed with a confirmed case just a day later. Health authorities are now stepping up efforts to prevent a wider outbreak.
Global Response and Rising Risk Levels
In light of these developments, the European Centre for Disease Prevention and Control (ECDC) has raised its mpox risk assessment from “low” to “moderate.” The agency emphasized that early detection and rapid response are essential to prevent widespread transmission in Europe and other regions. Meanwhile, China has initiated screening procedures at its borders, inspecting both people and goods for potential mpox infections.
A New, More Contagious Variant: Clade 1b
The outbreak in DR Congo began with the endemic clade 1 variant, but the more contagious clade 1b is now the primary cause of concern. Clade 1b, discovered in September 2023, has proven to be both more transmissible and more deadly than its predecessors. This strain is particularly worrying because it spreads not only through sexual contact but also through everyday close interactions.
Impact on Vulnerable Populations
While the 2022 global mpox outbreak predominantly affected gay and bisexual men, the current surge in Africa paints a different picture. Over 70% of reported cases in DR Congo involve children under 15, who also account for 85% of deaths. This shift highlights the virus’s broader reach in different populations, complicating efforts to contain it.
How Mpox Spreads: Transmission and Symptoms
Mpox is a zoonotic virus, meaning it can spread from animals to humans. However, human-to-human transmission is also common, occurring through close skin-to-skin contact, respiratory droplets, and even contaminated surfaces. The virus presents with flu-like symptoms such as fever, headaches, and cough, followed by a rash that can cover the body.
Global Vaccination and Preventive Measures
The WHO has ramped up its response, with Director-General Tedros Adhanom Ghebreyesus announcing emergency authorization for mpox vaccines in countries where they are not yet approved. Danish pharmaceutical company Bavarian Nordic has committed to producing up to 10 million doses of its mpox vaccine by 2025, aiming to curb the outbreak. The U.S. has also pledged to donate 50,000 vaccine doses to DR Congo, acknowledging that vaccination is critical to controlling the spread.
Lessons from the 2022 Outbreak: Why This Resurgence is More Concerning
The 2022 mpox outbreak, caused primarily by clade 2, led to around 90,000 cases worldwide, with 140 fatalities. Despite the global spread, the virus was relatively mild, leading WHO to end the emergency status in 2023. However, the current resurgence in Africa is driven by a far more contagious and lethal variant, making it an urgent global health issue.
The Need for a Coordinated Global Response
Experts stress that this outbreak should be a wake-up call for the international community. Professor Dimie Ogoina, chair of WHO’s Emergency Committee, warns that the resurgence of mpox is “just the tip of the iceberg,” and that a coordinated response is essential. The situation in Africa serves as a reminder that epidemics ignore borders, and collective action is needed to prevent a repeat of the global spread seen in 2022.
Conclusion: The Time to Act is Now
The resurgence of mpox, especially with the emergence of the more infectious clade 1b variant, underscores the importance of swift global action. As the virus continues to spread beyond Africa, the world must not repeat past mistakes. Increased awareness, early detection, vaccination, and international cooperation are crucial to containing this outbreak before it becomes a global crisis.
With the WHO and health agencies worldwide on high alert, the next steps taken will determine whether this outbreak can be contained or if we are facing another widespread epidemic. The message is clear: what happens in one part of the world affects us all.
