WHO considers public health emergency as mpox cases mount in Africa

Mpox
mpox

NIAID/ Flickr CC

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, PhD,  said yesterday he is considering naming the ongoing mpox outbreak in Africa a public health emergency of international concern (PEHIC), the strongest designation for a public health outbreak.

"I am considering convening an International Health Regulations emergency committee to advise me on whether the outbreak of mpox should be declared a public health emergency of international concern," Tedros announced on X. "More funding and support for a comprehensive response are needed."

More funding and support for a comprehensive response are needed

The outbreak features infections caused by clade 1b of the virus, which was first detected last fall in the Democratic Republic of the Congo (DRC). Clade 1b is more deadly than clade 2, which was the virus strain that fueled the global outbreak of mpox seen among men who have sex with men (MSM) in 2022 and 2023.

South Africa reporting spillover outbreak 

The case-fatality rate (CFR) for clade 2 is 0.2%, while 1b’s CFR is roughly 3% to 6%. Clade 1 has the highest CFR, of around 10%.

The current outbreak has been concentrated in the DRC, but more and more African countries are reporting spillover outbreaks. The DRC outbreak stands at 13,791 cases (2,628 confirmed; 11,163 suspected) and 450 deaths (CFR: 3.3%),

Over the weekend South Africa said it now has 22 cases of the virus, including 3 deaths.  Clade 1b seems to be spreading in both household transmission patterns and among sexual networks. Uganda also reported its first two new cases of the virus, both imported from DRC.


The WHO declared a PHEIC for the 2022 mpox outbreak, which lasted from July 2022 to May 2023. That outbreak was subsequently contained in the United States and Europe with the widespread use of vaccines, but those vaccines have not been widely available in poorer African nations. 

According to a report in Science, the DRC recently approved two mpox vaccines and has 50,000 doses donated by the United States, but they have yet to be used. Late last month the Coalition for Epidemic Preparedness Innovations also announced it was testing mpox vaccines in the DRC in a post-exposure prophylaxis trial. 


 

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