The Emerging Threat of Mpox: Current Developments and Global Response

Virus observed under the microscope

The recent resurgence of mpox (formerly known as monkeypox) has prompted significant concern among global health authorities, leading to renewed efforts to control the spread of this zoonotic virus. Originating primarily in Central and West Africa, mpox has historically been a localized disease with occasional outbreaks. However, since 2022, the virus has expanded its reach globally, affecting countries that had previously reported few or no cases. The outbreak has brought to light several challenges and developments in managing this re-emerging threat.

As of August 2024, the World Health Organization (WHO) has declared a global health emergency due to the increasing spread of a more virulent clade of the mpox virus, known as Clade I. This variant has a higher mortality rate than the Clade II variant, which was primarily responsible for the 2022 global outbreak. The spread of Clade I, particularly in regions with poor healthcare infrastructure, such as rural parts of Central Africa, has made containment efforts challenging. The situation has been exacerbated by limited access to vaccines and antiviral treatments in these areas, despite ongoing negotiations by the Africa CDC to secure doses of the JYNNEOS vaccine, which has shown efficacy against mpox (1, 2).

In the United Kingdom, the latest epidemiological data indicates a fluctuating number of cases throughout 2023 and 2024. Although the peak of the outbreak in 2022 saw over 1,300 cases in a single month, recent months have reported significantly lower numbers, suggesting that while the outbreak is ongoing, it may be stabilizing. However, continued vigilance is required, as sporadic cases and localized outbreaks still pose a risk, particularly in populations with low immunity to the virus (3).

Mpox primarily spreads through direct contact with infected bodily fluids, lesions, or contaminated materials. Recent studies have highlighted the potential for sexual transmission, particularly in networks of men who have sex with men (MSM), where the virus has been most prevalent outside of Africa. The virus can also spread from pregnant women to their fetuses and from infected individuals to children during or after birth. The symptoms of mpox often include fever, headache, muscle aches, and a characteristic rash that can spread across the body. In most cases, the illness is self-limiting, resolving within two to four weeks. However, in individuals with compromised immune systems or in regions with limited healthcare access, the disease can lead to severe complications and even death (4, 5).

Currently, there is no specific treatment for mpox, but supportive care is critical. The antiviral drug tecovirimat (TPOXX), originally developed for smallpox, has been approved for use in treating mpox under certain conditions. Its availability, however, remains limited outside of high-income countries, raising concerns about equitable access to lifesaving treatments (5).

Vaccination remains a cornerstone of mpox prevention. The JYNNEOS vaccine, which was initially stockpiled for potential smallpox outbreaks, has been repurposed to combat mpox. While the vaccine rollout has been effective in many high-income countries, significant gaps remain in regions like Africa, where the need is most acute. The WHO and other global health organizations have emphasized the importance of distributing vaccines equitably and avoiding the stockpiling issues that plagued the early stages of the COVID-19 pandemic (1, 6).

Public health agencies continue to advocate for targeted vaccination campaigns, especially in high-risk populations, alongside efforts to increase public awareness and education about the disease. The Pan American Health Organization (PAHO) has been particularly active in the Americas, working with countries to strengthen surveillance and response systems in anticipation of potential outbreaks (7).

The ongoing mpox outbreak highlights several critical challenges in global health. The disparity in access to vaccines and treatments between high-income and low-income countries remains a significant barrier to controlling the spread of the virus. Additionally, the emergence of more virulent strains underscores the need for robust surveillance systems and rapid response capabilities.

Moving forward, global health authorities must prioritize equitable access to medical countermeasures, enhance international cooperation, and invest in research to better understand the virus's transmission dynamics and potential mutations. Only through a coordinated and comprehensive approach can the global community hope to bring the mpox outbreak under control and prevent future pandemics.

Literature Cited:

1. "Growing mpox outbreak prompts WHO to declare global health emergency." Nature. Retrieved from www.nature.com (Accessed August 2024).

2. "Mpox (monkeypox) outbreak: epidemiological overview, 8 August 2024." GOV.UK. Retrieved from www.gov.uk (Accessed August 2024).

3. "Health Alert Network (HAN) - Mpox Caused by Human-to-Human Transmission." CDC. Retrieved from emergency.cdc.gov (Accessed August 2024).

4. "Mpox - PAHO/WHO." Pan American Health Organization. Retrieved from www.paho.org (Accessed August 2024).

5. "Vaccination and clinical management of mpox." CDC. Retrieved from www.cdc.gov (Accessed August 2024).

6. "Mpox in the Americas: Strengthening surveillance and response." PAHO. Retrieved from www.paho.org (Accessed August 2024).

7. "Current state and future challenges of the mpox outbreak." WHO. Retrieved from www.who.int (Accessed August 2024).