Monkeypox Outbreak: Public Health Response, Vaccination Efforts & Recent Developments

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Brief Overview Of Monkeypox

Monkeypox (Mpox) is a viral zoonotic disease caused by the monkeypox virus, a member of the Orthopoxvirus genus.

The disease was first identified in laboratory monkeys in 1958, and the first human case was reported in 1970 in the Democratic Republic of the Congo (DRC).

This article briefly explores the recent public health responses in Africa and globally, including vaccination efforts and recent developments in the fight to curtail its spread.

Historical Background

“At least 13 African countries have reported clade I mpox infections, and in 2024 so far, there have been 2,863 cases and 517 deaths.” – Africa CDC.

Monkeypox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research, hence the name “Monkeypox.”

The first human case was identified in 1970 in the Democratic Republic of Congo.

Since then, sporadic cases and outbreaks have been reported, primarily in Central and West Africa.

However, in recent years, Monkeypox has been increasingly reported in non-endemic regions, raising global concerns.

Mpox can be spread from animals to humans and vice versa, making it a zoonotic disease.

The virus that causes mpox has been found in small rodents and other mammals living in these regions.

Virology Clade

There are two main types of Mpox virus.

1. Clade 1 (Congo Basin Clade).

This class of Mpox virus causes severe illness and increases the death rate. Research shows that some outbreaks have killed up to 10% of the people who get sick. Claude 1 is endemic to Central Africa and surrounding regions.

A new strain, Claud1b, has been identified as the most dangerous so far.

2. Clade 2 (West African Clade).

This type of Mpox virus is associated with milder disease outcomes. It shows less genetic diversity than Clade I. It has been the predominant strain in recent global outbreaks, including the 2022 international outbreak.

Both types of viruses mentioned can be spread through:

  1. Direct contact with infected animals.
  2. Direct, close or intimate contact with a person infected with the Mpox virus.
  3. Direct contact with infected materials.

Symptoms

Mpox symptoms start to show after 1-21 days following exposure. These symptoms may last up to 2-4 weeks but will last longer if the carrier has a low immune system.

Some of the symptoms are:

•Rash.

•Fever.

•Sore throat.

•Headache.

•Muscle pain.

•Back pain

•Low energy.

In addition, how mpox infects people is quite different.

Some people’s symptoms start with a rash, which begins with a flat sore and develops into a blister filled with liquids, which may be itchy and painful.

Some may start experiencing painful swelling on their rectum and difficulty urinating.

Children, pregnant women and even some HIV patients tend to have prolonged mpox episodes because of their low immunity.

Some Mpox patients can become very sick. For example, the skin can become infected, leading to abscesses or severe skin damage.

These damages can cause profound complications such as pneumonia, cornea infection with loss of vision, pain or difficulty swallowing, diarrhoea causing severe dehydration, sepsis, etc.


Read Also:

Monkeypox Outbreak In Africa: What You Need To Know


General Prevention Of Mpox

1. Avoid contact with infected, dead or frail-looking animals.

2. Avoid contact with material used or touched by an infected person, such as the bed or clothes of a carrier.

3. Properly cook foods containing animal meat or parts.

4. Refrain from persons who have contracted the Mpox virus.

5. Wear a mask that covers your nose and mouth (Nose mask) around others.

6. Practice safe sex (use condoms during sex).

7. Always clean and disinfect your environment regularly.

“In 2022, a global outbreak of Mpox affected 110 countries and regions. Although the World Health Organization declared that Mpox outbreaks no longer constituted “a Public Health Emergency of International Concern in May 2023.”

Public Health Response & Recent Developments

Credit: Arlette Bashizi/Reuters

We declare today this public health emergency of continental security to mobilise our institutions, our collective will, and our resources to act swiftly and decisively.” – Director General Jean Kaseya said in a briefing that was live-streamed on Zoom.

  • The African CDC has declared Monkeypox a Public Health Emergency of Continental Security (PHECS).

  • The World Health Organisation (WHO) has mobilised $ 1 million from its Emergency Contingency Fund to strengthen Africa’s response.
  • The African Union allocated $10.4 million to help support public health efforts to slow the spread of Mpox.
  • The World Health Organisation has not determined if the situation constitutes a Public Health Emergency of International Concern (PHEIC). A meeting was called today to that effect.

Vaccination Efforts

Monkeypox

Monkeypox is very similar to Smallpox but doesn’t have a vaccine designed to protect against it.

Though Smallpox was eradicated from the world in 1980, there are still “emergency stockpiles” of Smallpox vaccines stored away, which, of course, may not be appropriate to use in place for Monkeypox due mainly to the risk of potentially fatal side effects.

A more modern vaccine produced by Bavarian Nordic, which was used in the global outbreak in 2022, is a better option, but the problem is that the supply of the vaccine is limited, and the shots can be costly for poorer countries dealing with Mpox outbreaks in Africa.

In addition, many African nations face the challenge of inadequate health infrastructure, which makes it difficult to effectively distribute vaccinations to rural areas where disease outbreaks are common.

The biggest problem now is the supply of the vaccine.

According to Africa’s CDC, there’s a deal to supply 215,000 vaccines, with further plans to secure 3 million doses this year; even with that, there will still be a massive gap in the vaccine supply, which is more than 10 million doses.

Several hurdles must be overcome to increase vaccination access in Africa, such as availability, affordability, licensure, vaccination strategy, defining a target population, and raising awareness among the affected populations.

More News About Vaccination Availability

BioNTech’s BNT116 mRNA-based vaccine, which aims to prevent Mpox, has undergone a combined Phase 1/2 clinical trial (last year).

The development of BNT116 is part of BioNTech’s ongoing comprehensive intervention to develop innovative preventive vaccines for infectious diseases that affect low-income countries.

The Coalition for Epidemic Preparedness Innovations (CEPI) has committed up to $90 million to support the development of vaccine candidates, including BNT166, aimed at preventing Mpox and other potential future outbreaks.

What Are The Criteria To Consider If An Outbreak Merits A ‘PHEIC’ Designation?

According to experts:

  • If it is serious, sudden, unusual or unexpected.
  • If it has potential for international spread.
  • If it requires a coordinated global response.

In conclusion, Monkeypox is a concerning viral zoonotic disease that has led to significant public health responses globally, particularly in Africa.

Recent efforts have been focused on vaccination and mobilising resources to curtail its spread.

The need for public health interventions and vaccine production and distribution remains crucial in addressing the threat of Monkeypox, which isn’t just an African problem now but a global one.

Stay with us for more updates as regards the global fight to stop the spread of Monkeypox.


Selected References

  • About MPOX | MPOX | Poxvirus | CDC. (n.d.). https://www.cdc.gov/poxvirus/mpox/about/index.html
  • Africa Centres for Disease Control and Prevention. (2024, August 13). Africa CDC declares MPOX a public health emergency of continental security, mobilising resources across the continent – Africa CDC. Africa CDC. https://africacdc.org/news-item/africa-cdc-declares-mpox-a-public-health-emergency-of-continental-security-mobilizing-resources-across-the-continent/
  • Nigeria Health Watch. (2024, August 14). MPOX vaccine: Africa’s wait continues two years after global outbreak. https://articles.nigeriahealthwatch.com/mpox-vaccine-africas-wait-continues-two-years-after-global-outbreak/?amp=1
  • World Health Organization: WHO & World Health Organization: WHO. (2023, April 18). Mpox (Monkeypox). https://www.who.int/news-room/fact-sheets/detail/monkeypox.

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