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UPSC Issue at a Glance is a new initiative of UPSC Essentials to focus your prelims and mains exam preparation on an issue that has been in the news. Every Thursday, cover a new topic in Q&A format and don’t miss MCQs, Points to Ponder and key takeaways. Also, don’t forget to check the answers of MCQs towards the end of the article. This week’s topic is Mpox outbreak and Public Health Emergency. Let’s get started!
Recently, India confirmed its first mpox case. Last month, the World Health Organisation (WHO) classified Mpox as a global public health emergency, following a surge in cases in the Democratic Republic of the Congo and the spread of the virus to neighbouring countries. With the growing cases of viral diseases and the threats presented by them to mankind, it becomes crucial to understand Mpox and the significance of a public health emergency from a broader perspective.
UPSC Syllabus:
Preliminary Examination: Current events of national and international importance; General Science
Mains Examination: GS-II, GS-III: Government policies and interventions, Health, Science and Technology
Other areas of relevance: UPSC Aspirants will find it useful in Essays, and Current affairs for their Personality tests.
What will you learn from this article? |
| 1. What is Mpox and how is it transmitted? 2. What is the history of Mpox outbreaks? 3. How is Mpox different from COVID-19? 4. What does the WHO’s declaration of a Public Health Emergency of International Concern (PHEIC) mean? 5. Which diseases have been declared PHEICS by WHO? |
Mpox, previously known as monkeypox, is a self-limiting viral infection caused by mpox virus (MPXV). The most common symptoms of mpox include fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes, along with pox-like rashes that last for two to three weeks. It is a self-limiting disease but can lead to death, especially among children and those with weak immune systems.
| What are the different virus clades of Mpox and how do they differ in impact? |
According to WHO, there are two broad clades of the Mpox virus: clade I and II. Clade I leads to more severe disease and death than clade II in the populations where it is endemic. Clade II was behind the global mpox outbreak that began in 2022. At least 99,176 cases and 208 deaths due to monkeypox have been reported from 116 countries since 2022, according to WHO data.
 A new offshoot of clade I virus, called clade Ib, was first reported in the Democratic Republic of the Congo in 2023, and has been spreading through sex and other types of close contact. |
How mpox is transmitted?
From person to person: Mpox spreads from person to person mainly through close contact with someone who has mpox. Close contact includes skin-to-skin and mouth-to-mouth, or mouth-to-skin contact, and can also include being face-to-face with someone who has mpox (such as talking or breathing close to one another, which can generate infectious respiratory particles).
It is also possible for the virus to persist for some time on clothing, bedding, towels, objects, electronics and surfaces that a person with mpox has touched. Someone else who touches these items may become infected. The virus can also spread during pregnancy to the fetus, during or after birth through skin-to-skin contact, or from a parent with mpox to an infant or child during close contact.
From animals to humans: Someone who comes into physical contact with an animal that carries the virus, such as some species of monkeys or a terrestrial rodent (such as the tree squirrel) may also develop mpox.
From humans to animal: According to WHO, Since many species of animals are known to be susceptible to the virus, there is the potential for spillback of the virus from humans to animals in different settings. People who have confirmed or suspected mpox should avoid close physical contact with animals, including pets (such as cats, dogs, hamsters, gerbils), livestock and wildlife.
Points to Ponder:
— Why does stigma related to Mpox matter?
On 14th August WHO declared Mpox as a Public Health Emergency of International Concern but this is not the first time we have seen the mpox outbreak. The history of mpox outbreaks dates back to the 1970s.
According to the WHO,
Caused by an Orthopoxvirus, mpox was first detected in humans in 1970, in the DRC. The disease is considered endemic to countries in central and west Africa.
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The World Health Organization (WHO) reports that mpox has occurred sporadically in Central and East Africa (clade I) and West Africa (clade II) since 1970. In 2003, an outbreak in the United States of America was linked to imported wild animals (clade II). Since 2005, thousands of suspected cases have been reported in the Democratic Republic of the Congo (DRC) every year.
In 2017, mpox re-emerged in Nigeria and has since spread within the country and to other destinations. In May 2022, an outbreak of mpox appeared suddenly and rapidly spread across Europe, the Americas, and then all six WHO regions. In 2022, outbreaks of mpox due to Clade I MPXV occurred in refugee camps in the Republic of the Sudan. A zoonotic origin has not been found.
Since January 1, 2022, mpox cases have been reported from 121 countries, including 20 WHO member-states across Africa. As of September 5, 2024, a total 1,03,048 laboratory-confirmed cases, including 229 deaths, have been reported from across the world since January 1, 2022. On Monday, India confirmed its first mpox case, which was a travel-related infection.
| Do you know? |
| This is the second time that mpox has been declared a Public Health Emergency of International Concern (PHEIC). The global outbreak of mpox was first declared a PHEIC on July 23, 2022. However, the current threat is more severe. The number of cases has skyrocketed this year, with the Democratic Republic of Congo alone reporting over 14,000 mpox cases and 524 deaths. |
With the WHO declaration of Mpox as a Public Health Emergency of International Concern (PHEIC), concerns have emerged regarding the severity of the disease. In this context, understanding the differences between Mpox and COVID-19 is crucial for better preparedness in controlling the viral infection.
“Mpox spreads very slowly unlike the coronavirus. Shortly after the coronavirus was identified in China, the number of cases jumped exponentially from several hundred to several thousand; in a single week in January, the case count increased more than tenfold.
By March 2020, when WHO described COVID-19 as a pandemic, there were more than 126,000 infections and 4,600 deaths — about three months after the coronavirus was first identified.
In contrast, it’s taken since 2022 for mpox cases to hit nearly 100,000 infections globally, with about 200 deaths, according to WHO.
| Are there vaccines for Mpox? |
| There are at least two vaccines currently in use for mpox, which have been recommended by the WHO’s Strategic Advisory Group of Experts on Immunization.
Last week, an Emergency Use Listing for mpox vaccines was triggered by the WHO, which will accelerate vaccine access for lower-income countries which have not yet issued their own national regulatory approval. This listing also enables bodies such as GAVI and UNICEF to procure vaccines for distribution in these countries. |
There are vaccines and treatments available for mpox unlike in the early days of the COVID-19 pandemic. “We have what we need to stop mpox,” said Dr. Chris Beyrer, director of Duke University’s Global Health Institute. “This is not the same situation we faced during COVID when there was no vaccine and no antivirals.”
Points to Ponder:
— What is the difference between Pandemic, Epidemic, and Endemic?
The WHO’s declaration of a Public Health Emergency of International Concern (PHEIC) is its highest level of alert. A PHEIC is defined in the International Health Regulations(IHR) (2005) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”. This definition implies a situation that is serious, sudden, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.
Under the IHR — a legally-binding agreement that commits governments to certain actions when responding to the international spread of disease — the declaration of a PHEIC permits the WHO to issue temporary recommendations to national governments to support a coordinated and effective global response to such events.
By designating a disease outbreak as a PHEIC, the WHO can expedite research, funding, and global public health efforts to control and contain the disease.
Points to Ponder:
— Is PHEIC only confined to infectious diseases and may it cover events caused by chemical agents or radioactive materials?
— What are the criteria for declaring PHEIC?
Since the IHR took effect in 2007, the following diseases have been declared PHEICS: H1N1, Ebola, Polio, a second Ebola outbreak, Zika, COVID-19, Mpox (Declared PHEICS twice . i.e., 2022 and 2024)
1. H1N1 Influenza: According to WHO, before the H1N1 pandemic in 2009, the influenza A(H1N1) virus had never been identified as a cause of infections in people. Genetic analyses of this virus have shown that it originated from animal influenza viruses and is unrelated to the human seasonal H1N1 viruses that have been in general circulation among people since 1977. The H1N1 (2009) virus continues to circulate as a seasonal virus and is included in the vaccines against seasonal influenza.
2. Ebola: It is a virus that can spread quickly and can be fatal in up to 90% of cases. Symptoms include fever, vomiting, diarrhoea, muscle pain and at times internal and external bleeding and can start to occur between two and 21 days from infection, according to WHO. The virus is most often spread by close contact with bodily fluids of people exhibiting symptoms and with contaminated objects such as sheets.
3. Polio: According to the US Centers for Disease Control and Prevention (CDC), “Polio is a crippling and potentially deadly disease that affects the nervous system… Because the virus lives in the faeces (poop) of an infected person, people infected with the disease can spread it to others when they do not wash their hands well after defecating (pooping). People can also be infected if they drink water or eat food contaminated with infected feces.
The virus multiplies in the intestine, from where it can invade the nervous system and can cause paralysis. Once that happens, the patient is crippled for life because there is no treatment for the affliction. Polio infection, however, can be easily prevented by a vaccine.
4. Zika: A mosquito-borne disease—Zika virus—has gained global attention in recent years due to its potential to cause serious health complications, particularly in pregnant women and their unborn children. It mainly occurs in tropical and subtropical areas of Africa, the Americas, Southern Asia, and the Western Pacific.
It is infected by Aedes species mosquitoes, which are the same ones that spread dengue and chikungunya viruses, and bite during the first week of infection. It is primarily transmitted through mosquito bites, sex, and breastfeeding.
5. COVID-19: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The most common symptoms of COVID-19 are fever chills, sore throat.
Points to Ponder:
— What are the different strains of polio?
POST READ QUESTIONS
Prelims
(1) With reference to the Mpox, consider the following statements:
1. It was first discovered in humans in Nigeria.
2. It is not transmitted from animals to humans.
3. The vaccines developed for smallpox are up to 80% effective against mpox.
4. The World Health Organization (WHO) classified mpox as a global public health emergency.
How many of the statements given above are correct?
(a) Only one
(b) Only two
(c) Only three
(d) All four
(2) Among the following, which were frequently mentioned in the news for the outbreak of Ebola virus recently? (UPSC CSE 2015)
(a) Syria and Jordan
(b) Guinea, Sierra Leone and Liberia
(c) Philippines and Papua New Guinea
(d) Jamaica, Haiti and Surinam
(3) H1N1 virus is sometimes mentioned in the news with reference to which one of the following diseases? (UPSC CSE 2015)
(a) AIDS
(b) Bird flu
(c) Dengue
(d) Swine flu
(4) With reference to the vaccine-derived polio infection, consider the following statements:
1. It is a strain related to the weakened version of the live poliovirus contained in the oral polio vaccine.
2. No cases of vaccine-derived polio infection have been reported in India.
Which of the statement(s) given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2
Mains
(1) COVID-19 pandemic accelerated class inequalities and poverty in India. Comment. (UPSC CSE 2020)
| PRELIMS ANSWER KEY |
| 1. (b) 2. (b) 3. (d) 4. (a) |
(Source: http://www.who.int, Why WHO has called the latest mpox outbreak an ‘emergency of international concern’, WHO declares Mpox a global health emergency again, Mpox declared a global health emergency: will it trigger another pandemic?)
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