The Rising Threat of Mpox in Africa: Calls for Urgent Action to Avert a Global Crisis

Africa is currently experiencing a significant outbreak of mpox, a contagious virus related to smallpox. With the number of confirmed cases shooting up to 15,132 across the continent, the Africa Centres for Disease Control and Prevention (Africa CDC) has classified it as a continental public health emergency. The escalation of the crisis has further triggered the World Health Organization (WHO) to contemplate a declaration of the highest global alert status over the mpox epidemic.

The rapid spread of a particularly virulent strain of the virus has been seen in 16 African countries, with six new countries reporting infections within a span of 10 days. Highly affected nations include Burundi, Cameroon, Congo, Ghana, Liberia, Nigeria, Rwanda, the Democratic Republic of Congo, South Africa, Uganda, and Kenya.

According to virologist Cheryl Walter, the mpox virus, characterized by a rash and fluid-filled bumps, is undergoing genetic changes that could potentially increase its virulence and transmissibility. Distinct from other poxviruses like cowpox and smallpox in terms of mutation rates, mpox's two strains, clade I and clade II, have traditionally been stable. However, recent observations indicate the emergence of new subclades, which is worrying the scientific community.

Of particular concern is clade I, responsible for thousands of cases and exhibiting a case fatality rate of 3-4%—higher than that observed during the Covid-19 emergency period. The most alarming aspect is the impact on children, who are disproportionally represented among the victims.

Similar to Covid-19, early mpox symptoms are non-specific, which hinders the timely identification and isolation of affected individuals. The virus transmission occurs through direct contact, often in densely populated settings, hampering containment efforts.

Challenges are further compounded by resource limitations in African health systems and a dire shortage of vaccines. Current estimates suggest a gap between the meager 200,000 available doses against an overwhelming demand of at least 10 million.

Despite these hurdles, virologists emphasize the importance of several key interventions:

1. Testing through lateral flow assays can pinpoint cases and facilitate contact tracing.

2. Community-specific messaging must correct misconceptions that mpox is solely a sexually transmitted disease, as current outbreaks also significantly affect women and children.

3. Vaccination strategies leveraging the existing smallpox vaccine offer a promising preventive measure, albeit limited by available stockpiles.

The WHO's push for the swift approval and distribution of new vaccine candidates underscores the urgency of a coordinated global response. These measures, alongside others, require immediate implementation to control the spread of this burgeoning health crisis and prevent it from escalating into a global pandemic.