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It’s official. The World Health Organization has declared Mpox (previously called Monkeypox) a public health emergency of international concern. Understandably, many have drawn parallels to the not-too-distant Covid-19 pandemic. This begs the question then: Are we doomed to have a repeat of history in so soon of a timespan?
What is Mpox?
Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. It is an enveloped double-stranded DNA virus in the Poxviridae family, which includes variola, cowpox and vaccinia.
There are two distinct clades of the virus:
Clade I (with subclades Ia and Ib): Causes more severe illness and deaths and is endemic to Central Africa (it is the new strain that has caught the world’s attention)
Clade II (with subclades IIa and IIb): Caused the global outbreak that began in 2022, is less severe (~99.9% of people survive), and is endemic to West Africa.
Common symptoms are:
A skin rash or mucosal lesions which can last 2–4 weeks
This can be accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.
Transmission includes:
Close contact with someone who has mpox, with contaminated materials, or with infected animals.
The natural reservoir of the virus is not known, but some small mammals such as squirrels and monkeys are plausible candidates
What’s the Difference?
According to Bruno Ciancio, head of the European Centre for Disease Prevention and Control (ECDC) surveillance section, the Mpox virus has “existed for several decades” and there are “effective and safe vaccines” for the disease. This virus also “requires close contact for transmission from person to person”.
As such, he states “This is a completely different situation than what happened with the emergence of COVID-19, i.e. a new virus, easily transmissible from person to person, and against which there wasn’t any available vaccine.”
Pierre Tattevin, a French infectious diseases specialist, also emphasized how health authorities faced a big struggle with COVID-19 as an infected person could spread it while being asymptomatic, which made screening and contact tracing more challenging.
On the contrary, with mpox, an infected person cannot transmit the disease to others until they exhibit symptoms (in particular these patients will first show skin rashes that usually appear within ~ 3 weeks which is the maximum incubation period).
Thus, there is no need for travel and other restrictions, per Tattevin, a professor of infectious diseases at the University of Rennes 1.
How Are We Dealing With It?
Another key difference with Covid-19 is that, unlike Covid-19 which had no vaccines at the beginning of its pandemic since it was a novel virus, there are already vaccines that protect against Mpox.
A live-attenuated vaccine, JYNNEOS, is the most widely used vaccine. JYNNEOS is a 2-dose vaccine developed to protect against mpox and smallpox. Mpox vaccination efforts focus on people who have been exposed to mpox or who are more likely to get mpox.
The vaccine is injected subcutaneously, i.e. injected in the fat layer underneath the skin on the back of your upper arm.
The most common side effects after JYNNEOS vaccination are :
Pain, redness, and itching at the spot where the vaccine is given.
Might also experience fever, headache, tiredness, nausea, chills, and muscle aches.
These just mean your immune system is responding, not that you’re getting sick!
Currently, there are no specific treatments for the disease. Commonly, mpox is simply treated with supportive care for symptoms such as pain and fever, with close attention to nutrition, hydration, skin care, prevention of secondary infections, and treatment of co-infections, including HIV where present.
Although mpox is spreading, health organizations are ramping up staffing in affected countries and boosting surveillance, prevention, and response strategies in African countries hardest hit by the outbreak. Also developed nations can and should, German donate mpox vaccines to affected countries from stocks held. Doing so will not only benefit others in affected countries but also be an excellent opportunity for global leaders to commit to strategic and timely partnerships in the face of adversity.
Reference List
Barron, M. (2022). Monkeypox vs. COVID-19. [online] ASM.org. Available at: https://asm.org/Articles/2022/August/Monkeypox-vs-COVID-19.
CDC (2022). Mpox in the U.S. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/poxvirus/mpox/about/index.html.
CDC (2023). Mpox Vaccine Recommendations. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/poxvirus/mpox/vaccines/vaccine-recommendations.html.
Cleveland Clinic (2022). Monkeypox: Causes, Symptoms, Treatment and Prevention. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/22371-monkeypox.
CNA. (2024). WHO says mpox outbreaks ‘can be stopped’. [online] Available at: https://www.channelnewsasia.com/world/mpox-strain-clade-1b-world-health-organization-outbreaks-4568571 [Accessed 27 Aug. 2024].
Erturk. (2024). Mpox spread, COVID-19 surge not at a worrying stage: Experts. [online] Aa.com.tr. Available at: https://www.aa.com.tr/en/europe/mpox-spread-covid-19-surge-not-at-a-worrying-stage-experts/3313493 [Accessed 27 Aug. 2024].
Globaltimes.cn. (2024). Thailand confirms Asia’s first known case of more contagious and deadlier version of mpox - Global Times. [online] Available at: https://www.globaltimes.cn/page/202408/1318699.shtml [Accessed 27 Aug. 2024].
The Associated Press (2024). WHO launches plan to stanch mpox transmission and says the virus can be stopped. [online] ABC News. Available at: https://abcnews.go.com/International/wireStory/launches-plan-stanch-mpox-transmission-virus-stopped-113148303 [Accessed 27 Aug. 2024].
Who.int. (2024). item. [online] Available at: https://www.who.int/news-room/questions-and-answers/item/mpox.
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