New clade of Mpox unlikely to follow mild trajectory of 2022 outbreak, greater spread expected: Dr Rajeev Jayadevan

The WHO has declared Mpox a Public Health Emergency of International Concern (PHEIC). WHO director-general Dr Tedros Adhanom Ghebreyesus said in a statement, “The emergence of a new clade of Mpox, its rapid spread in eastern DRC and the reporting of cases in several neigbouring countries are very worrying. On top of outbreaks of other Mpox clades in DRC and other countries in Africa, it is clear that a coordinated international response is needed to stop these outbreaks and save lives.”

“Unsurprisingly, cases have already been detected on other continents, with the first being in Sweden, linked to travel to Africa,” Dr Jayadevan said. He pointed out that the 2022 global outbreak was caused by the milder clade 2 strain of Mpox, which had lower mortality and transmission potential and was largely confined to MSM (men who have sex with men) community.

“As a result, even though it reached India in 2022 via expatriates from the Middle East and individuals based in Africa, it did not spread further,” Dr Jayadevan said, adding that there was a need to understand that the current strain is almost like an all-new Mpox virus, having jumped from animals to man only in September 2023

“The pattern of infection, spread and mortality is distinctly different from the last outbreak of 2022, which originated in a different region in Africa. Unfortunately, the current strain spreads by sexual and close contact not only among men, but also in women and children. It carries a higher risk of death at 5-10%, which is markedly higher than the earlier strain,” he added.

Experts like Dr Madhukar Pai, inaugural chair of the Department of Global and Public Health at McGill University, Canada, and several others have taken to X, calling for urgent authentic global solidarity, equity and urgent support for African countries to mitigate Mpox outbreaks.

In their report in the British Medical Journal, both Pai and Ifedayo Adetifa, a Nigerian infectious diseases specialist and Director-General of Nigeria Centre for Disease Control and Prevention, wrote, “Following WHO’s declaration of this Mpox outbreak as a public health emergency of international concern, rich nations may resort to travel bans against the affected African nations, rather than offer genuine support. We worry about a resurgence of stigma and racism aimed at African nations as we saw during the Omicron wave and 2022 Mpox outbreak. We must not repeat the mistakes of HIV, Ebola or Covid.”

Dr I S Gilada, an HIV/STD consultant and secretary-general of People’s Health Organisation, told The Indian Express, that while there is no proven treatment, drugs like tecovirimat have been tried, adding that the Jynneos vaccine can prevent Mpox. “Those vaccinated for smallpox are immune to Mpox, hence people above 44 will not get it,” he said, stressing that India’s strength in vaccine production should be positively exploited.