Global Efforts Intensify as New Mpox Variant Spurs Increased Surveillance and Research

 

As the global response to mpox intensifies, recent developments reveal a troubling escalation in cases and a disappointing trial result for a new treatment. The European Centre for Disease Prevention and Control (ECDC) has raised its risk level assessment for mpox, previously known as monkeypox, from low to moderate. This decision follows Sweden’s report of the first case of clade Ib outside Africa, signaling a troubling new phase in the outbreak.

In response to the rising threat, Pakistan has also confirmed its first mpox case, and China has announced it will begin screening travelers for the virus. The UK Health Security Agency has reported no current cases within the country but is actively planning for potential future incidents.

The ECDC, based in Stockholm, anticipates more imported cases in Europe due to the strong connections between Europe and Africa. ECDC Director Pamela Rendi-Wagner emphasized the need for preparedness, noting, “Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases.”

The World Health Organization (WHO) has declared the surge in mpox cases a public health emergency. This declaration follows the spread of the virus from the Democratic Republic of the Congo (DRC) to neighboring regions. Mpox is characterized by two main variants: clade II, which was responsible for the 2022 global outbreak, and clade I, endemic to parts of Africa and historically more severe. The mutated clade Ib, which appears to be spreading through sustained human-to-human transmission, is causing increased concern.

So far this year, Africa has reported over 14,000 mpox cases and 524 deaths, surpassing last year’s totals. The DRC has been the most affected, with the virus’s impact extending to neighboring countries.

Recent trials of the antiviral drug tecovirimat, conducted by the US National Institutes of Health, have shown that the drug did not significantly reduce the duration of mpox lesions among patients with clade I. Despite this, the study revealed a lower death rate of 1.7% among participants compared to the higher overall death rate of 3.6% observed in the DRC. This suggests that supportive medical care plays a crucial role in patient outcomes. Siga Technologies, the manufacturer of tecovirimat, has indicated that the drug may be more effective when administered early or in severe cases, warranting further research.

Global health experts are calling for more research, particularly in the DRC, to better understand the transmission dynamics of clade Ib. Dr. Jonas Albarnaz from the Pirbright Institute noted the need to investigate whether this variant is more transmissible or causes more severe disease compared to other clade I viruses.

Humanitarian officials are urging for urgent shipments of diagnostic kits, treatments, and vaccines to Africa. Bronwyn Nichol of the International Federation of Red Cross and Red Crescent Societies highlighted the critical shortage of these resources, which is hampering containment efforts. Gavi, the Vaccine Alliance, is coordinating with countries holding large vaccine stockpiles and expects to have around 65,000 doses available in the short term.

Danish drugmaker Bavarian Nordic, which produces one of the existing mpox vaccines, is seeking European approval to extend its use to children aged 12 to 17. The company has announced plans to produce 10 million vaccine doses by 2025 and currently has about 500,000 doses in stock.

The global community continues to grapple with mpox, as the situation evolves and efforts to control the outbreak and understand the new variant press forward.