Mpox Outbreak Escalates as WHO Considers Global Health Emergency Amid Surge in Africa

The recent Mpox outbreak in Africa has escalated into a significant global health crisis, prompting the World Health Organization (WHO) to consider declaring it a Public Health Emergency of International Concern. With 15 African countries, including Burundi, Kenya, Rwanda, and Uganda, now reporting confirmed cases of Mpox, the situation has grown increasingly dire. This outbreak has particularly affected countries such as Nigeria, the Democratic Republic of Congo (DRC), and the Central African Republic, where the disease has taken a severe toll.

Mpox, formerly known as monkeypox, is caused by the monkeypox virus (MPXV), an enveloped double-stranded DNA virus of the Orthopoxvirus genus in the Poxviridae family. This family includes other viruses such as variola (which causes smallpox), cowpox, and vaccinia. The monkeypox virus was first discovered in 1958 in monkeys kept for research in Denmark, with the first human case reported in 1970 in a nine-month-old boy in the DRC. Although initially a sporadic disease, the eradication of smallpox in 1980 and the cessation of smallpox vaccination allowed Mpox to steadily emerge across central, east, and west Africa. The natural reservoir of the virus remains unknown, though small mammals such as squirrels and monkeys are susceptible hosts.

Mpox is a zoonotic disease, spreading from animals to humans via bites, scratches, or handling infected animals. It can also spread between people through direct contact with lesions, respiratory droplets, or contaminated items. High-risk groups include those with multiple sexual partners due to close contact.

Symptoms of Mpox typically appear within a week of exposure, with a duration of 2–4 weeks, though it may last longer in those with weakened immune systems. Symptoms include fever, rash, sore throat, headache, muscle aches, back pain, low energy, and swollen lymph nodes. The rash starts as flat sores that develop into itchy or painful blisters before drying up and falling off, and can appear on various body parts.

Mpox can lead to severe complications, particularly in children, pregnant individuals, and those with weakened immune systems. Complications may include bacterial infections, pneumonia, corneal infections, severe dehydration, sepsis, inflammation of vital organs, and in extreme cases, death.

The recent surge in Mpox cases can be attributed to several factors, including increased human-animal interactions, a decline in vaccination coverage, and the virus's adaptability. Historically, Mpox was a relatively contained disease, but the current outbreak underscores the urgent need for greater surveillance and response systems. The WHO's emergency call signifies the seriousness of the situation and the necessity of a coordinated global approach to contain the outbreak.

According to the WHO, this outbreak may be nearing a critical point that could warrant its designation as an international emergency. Several key factors will influence this decision, including the cross-border spread of the disease, the potential strain on public health systems, and the effectiveness of current control measures.

The outbreak in the DRC has been particularly severe, with a new viral strain emerging in September 2023. This strain has now been detected outside the DRC, raising further concerns about the spread of the disease. In response, the WHO has issued an invitation for manufacturers of Mpox vaccines to submit an Expression of Interest for Emergency Use Listing (EUL). The EUL process is designed to expedite the availability of unlicensed medical products, such as vaccines, in public health emergency situations.

The outbreak has strained healthcare resources, leading to inadequate medical options in affected regions. Limited access to vaccines and treatments has hampered efforts to control the spread, while the need for extensive public health education has become more urgent than ever.

International bodies are mobilizing resources to assist affected nations, and governments, along with non-governmental organizations, are boosting vaccination campaigns and improving public healthcare facilities. However, success will require continued global collaboration and financial support.