Preventing an Mpox Outbreak in Africa: Strategies to Stop a Potential Pandemic
Alarmed by the surge in mpox cases, the Africa Centres for Disease Control has taken the unprecedented step of declaring the outbreak sweeping through African countries a continental public health emergency. The World Health Organization (WHO) is also meeting to decide whether to trigger its highest global alert level over the epidemic. These moves come after a virulent strain of the disease spread rapidly to 16 countries and six new countries were affected in 10 days. There have been 15,132 mpox confirmed cases in Africa since the beginning of 2024. Some of the countries affected are Burundi, Cameroon, Congo, Ghana, Liberia, Nigeria, Rwanda, the Democratic Republic of Congo, South Africa, Uganda, and Kenya.
Virologist Cheryl Walter sets out some of the reasons the mpox outbreaks are so worrying.
How Many Strains of Mpox Are There and Which Ones Should We Be Worried About?
Mpox is one species of pox virus, characterized by a rash followed by bumps that appear on the skin. With mpox, the bumps then fill with liquid and eventually scab over. Like other viruses, pox viruses can change genetically and mutate quickly. Mpox is no different, although pox viruses typically mutate much more slowly compared to other viruses.
There are two strains of mpox — clade I and clade II. Clade II is far less dangerous with a case fatality rate of about 0.1%. In contrast, clade I has a case fatality rate of anything from 3% to 4%. Many cases are children. Scientists are seeing thousands of cases of clade I being reported in 16 countries in Africa, indicating a potentially more dangerous strain.
Pox viruses are oval shaped and have double-strand DNA. There are many types of pox virus, including chickenpox, mpox, and smallpox, which was eradicated in the 1970s.
How Does the Disease Spread to New Areas?
The virus spreads through contact such as sharing utensils, plates, towels, and bedding. Women and children are disproportionately affected through skin-to-skin contact because they are close to each other every day. Viruses also spread easily in densely populated, low-income areas where people cannot isolate themselves due to economic reasons.
Additionally, the longer incubation period and vague symptoms of mpox contribute to its rapid spread. The incubation period ranges from five to up to 21 days, during which an infected person can unknowingly spread the virus. Initial symptoms such as swollen glands, fever, and feeling run down may be mistaken for other illnesses. Children with rashes may be misdiagnosed with chickenpox or other childhood diseases, delaying proper treatment.
What Emergency Measures Need to Be Put in Place to Ensure the Outbreak Doesn’t Explode into a Pandemic?
African health agencies face challenges in containing the virus due to limited resources and a shortage of vaccines. Testing is crucial in identifying cases and tracing contacts. Simple lateral flow tests can provide results within 30 minutes, aiding in community surveillance and control.
Messaging to communities is vital in educating people on symptoms to look out for and appropriate actions to take. Vaccination using existing smallpox vaccines is recommended, but stockpiles are limited. The WHO has called for fast approval and distribution of vaccine candidates to combat the spread of mpox.
These measures need to be implemented urgently to contain and suppress the epidemic before it escalates into a global pandemic. The collaboration of international health organizations and governments is essential in preventing a widespread outbreak.
In conclusion, the mpox outbreak in Africa poses a significant public health threat that requires immediate action. By implementing testing, messaging, and vaccination strategies, countries can work together to prevent the spread of the virus and protect vulnerable populations. It is crucial to prioritize resources and coordinate efforts to curb the outbreak and prevent a potential pandemic.
