India has reported the first case of Mpox clade 1 variant in a 38-year-old man in Kerala's Malappuram district. Reports suggest this is a "deadlier" strain of the virus first identified in Africa’s Democratic Republic of Congo. Quoting officials, PTI said that the patient - who recently returned from the United Arab Emirates and tested positive last week - is stable for now. It added that the man had a fever and rash similar to chickenpox on his body, after which the doctor got suspicious and sent a sample for testing. "This was the first case of the current strain that led the World Health Organization (WHO) to declare Mpox a public health emergency last month for a second time," the report quoted a source as saying. Before this, another person was suspected of having the infection in Delhi, later confirmed as a Clade II infection. Since the WHO's 2022 declaration of Mpox as a Public Health Emergency of International Concern, 30 cases have been reported in India. What is the clade 1b infection? Is it any different from other strains? Mpox is divided into clades—clade I and clade II—where clade generally refers to viral lineage, said Dr Ravi Shekher Jha, director of pulmonology, MD, MRCP Fortis Hospital, Faridabad. He added that clade 1 is the more virulent and deadlier version of Mpox. Infections from Clade II, the strain that caused the global outbreak in 2022, are less severe, with more than 99.9 percent of people infected surviving the disease. Mpox is caused by the monkeypox virus (MPXV), a member of the Orthopoxvirus genus, said Dr Jha. "Clade 1b refers to a genetic variant within the Central African (Congo Basin) clade, which is typically associated with more severe symptoms than the West African clade," said Dr Jha. He, however, clarified that clade 1b is not a variant name in itself but rather a genetic sublineage or classification within a broader clade. In the case of Mpox, the virus is divided into two primary clades: 1. Clade 1 (Congo Basin or Central African clade) 2. Clade 2 (West African clade) Transmission occurs through: Apart from sexual activity, the virus can enter the body through mucous membranes in the mouth, broken skin, eyes, or nose, said Dr Kirti Sabnis, infectious disease specialist, Fortis Hospital Mulund & Kalyan. "Also, it can even spread through direct contact with infected animals, particularly rodents, which are natural hosts of the virus," said Dr Sabnis. Symptoms Symptoms of Mpox in Clade 1b typically mirror those of other clades but may present with varying severity depending on the individual and circumstances. Common symptoms include: Fever Headache Muscle aches Back pain Swollen lymph nodes Chills Exhaustion One to three days after the fever begins, a rash develops, often starting on the face and then spreading to other parts of the body, including the palms and soles. “The rash progresses through several stages—macules, papules, vesicles, pustules—before finally forming scabs and falling off,” said Dr Jha. Treatment There is no specific treatment for mpox, but antiviral medications developed for smallpox, such as tecovirimat, may be used in severe cases, said Dr Jha. Most cases are self-limiting, meaning patients recover on their own within a few weeks with supportive care, which include: Hydration: Ensuring the patient stays hydrated. Pain management: Providing analgesics relieves pain from lesions and other symptoms. Secondary infections: Treating any bacterial infections that may arise from skin lesions. Dr Jha noted, “Vaccines originally developed for smallpox, such as JYNNEOS or ACAM2000, may offer protection and can be used in both prevention and post-exposure prophylaxis.” Should you be worried? Human-to-human transmission is less common than zoonotic transmission (from animals to humans). However, outbreaks can still occur, especially in regions where humans are in close contact with infected wildlife or individuals. Dr Jha explained, "Worry for India is that the case detected here is of clade 1b variant, and India is a densely populated country, where any epidemic of this type can be disastrous." Prevention Prevention is the key and as cases occur mainly due to coming in contact with an infected person while travelling, people should make sure to cover their mouths and wash their hands regularly, urged Dr Sabnis. "Also, people who have been sick with a recent travel history should isolate themselves and take appropriate medical guidance," said Dr Sabnis. Preventing Mpox, particularly clade 1b, involves several key strategies: Vaccination: For individuals at high risk, such as healthcare workers or those living in outbreak areas, vaccination can help prevent infection. Smallpox vaccines offer cross-protection. Avoiding contact: Reducing exposure to infected individuals or animals, particularly in outbreak zones. Avoid handling materials like bedding or clothing that could be contaminated. Hygiene: Maintaining good hygiene, including frequent handwashing with soap and water, especially after contact with infected individuals or animals. Isolation: Infected individuals should be isolated from healthy people to prevent further spread. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
