WHO Declares Global Emergency Due to New Mpox Outbreak
The epidemic is primarily concentrated in the Democratic Republic of Congo, but the virus has now spread to a dozen other African countries.
A laboratory nurse handles samples taken from a patient with a suspected case of mpox near Goma, Democratic Republic of Congo. Credit: Arlette Bashizi/Reuters
The rapid spread of mpox, formerly known as monkeypox, in several African countries has prompted the World Health Organization (WHO) to declare a global health emergency on Wednesday. This marks the second instance in three years that the WHO has designated an mpox epidemic as a global emergency, the previous declaration occurring in July 2022. That outbreak affected nearly 100,000 people across 116 countries, predominantly gay and bisexual men, and resulted in approximately 200 deaths.
The current threat poses a more significant danger. Since the beginning of this year, the Democratic Republic of Congo has reported 15,600 mpox cases and 537 deaths. The most vulnerable populations include women and children under 15. Dr. Tedros Adhanom Ghebreyesus, the WHO's director general, expressed deep concern over the new clade of mpox detected in eastern DRC and its spread to neighboring countries that had not previously reported cases. The potential for further transmission within Africa and beyond is alarming.
The outbreak has extended to 13 countries in Africa, including some with no prior history of mpox cases. On Tuesday, the Africa Centers for Disease Control and Prevention declared a “public health emergency of continental security.” This unprecedented step underscores the seriousness of the situation and the urgent need for coordinated action.
Dr. Nicole Lurie, executive director for preparedness and response at the Coalition for Epidemic Preparedness Innovations, emphasized the importance of controlling the outbreak quickly to prevent further global spread. In response, the Centers for Disease Control and Prevention in the United States has urged vigilance among clinicians and the public.
The WHO's declaration of a "public health emergency of international concern" aims to mobilize member countries to prepare for the virus’s appearance and facilitate the sharing of vaccines, treatments, and other essential resources with poorer nations. Gregg Gonsalves, an epidemiologist at Yale University, highlighted the necessity of concerted international efforts to address this novel outbreak.
The 2022 outbreak primarily affected tight sexual networks among gay and bisexual men, and was curtailed through a combination of behavioral changes and vaccination. In contrast, the current mpox strain circulating in Congo is more virulent, with a death rate of about 3%, compared to 0.2% in the 2022 outbreak. The infection causes fever, respiratory symptoms, muscle aches, swollen lymph nodes, and a rash. Previously, mpox spread mainly through the consumption of contaminated meat or close contact with infected animals and people. Most fatalities have occurred in children, who are already vulnerable to malnutrition and other infectious diseases.
Experts believe that should the outbreak spread globally, children in developed countries may be less susceptible to severe illness. Notably, last year saw the first documented cases of sexual transmission of this mpox strain, with cases evenly split between young men and women. Genetic analyses indicate that the virus acquired mutations around September that enhanced its transmission among humans, including through heterosexual prostitution.
Although this viral type has not been detected outside Africa, over 17,500 presumed and confirmed mpox cases have been reported in 13 countries, with the majority in Congo. Anne Rimoin, an epidemiologist at UCLA, supported the declaration of a global health emergency, citing the virus's rapid spread.
In response to the rising numbers, Congo has approved two mpox vaccines: LC16 from Japan and Jynneos, used in the 2022 outbreak in the United States and Europe. However, Congo has yet to implement a vaccination plan. The WHO has invited vaccine manufacturers to apply for an gt emergency use listing, enabling organizations like Gavi to purchase and distribute the vaccines in low-income nations. Bavarian Nordic has donated 15,000 doses of Jynneos, but this is insufficient compared to the 10 million doses needed, according to Africa CDC.
Dr. Dimie Ogoina, chair of the WHO’s mpox emergency committee, stressed the inadequacy of current vaccine supplies even for high-risk individuals. Clinical trials are underway to evaluate the effectiveness of Jynneos in children and those already exposed to the virus. Additionally, efforts are being made to develop a new mRNA vaccine by BioNTech to protect against mpox and related viruses.
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