Mpox: Everything you need to know about the 2024 outbreak

The World Health Organization (WHO) has declared the ongoing MPOX (formerly known as monkeypox) outbreak in Central and West Africa a Public Health Emergency of International Concern. This is the second time in two years that the disease has spread sufficiently to prompt a WHO declaration. On August 15, Swedish health authorities confirmed the first cases of infection outside of Africa with the MPOX strain currently causing the outbreak.

What is mpox?

Mpox is an infectious disease caused by a virus in the same family as the virus that causes smallpox. It spreads regularly among animals such as rodents and monkeys in Central and West Africa, but occasionally infects humans, causing small-scale epidemics.

MPOX has two distinct lineages, lineage I and lineage II. Lineage I is associated with more severe disease and a higher risk of death. A subtype of lineage I, lineage Ib, is driving the current outbreak, while the global MPOX outbreak in 2022 and 2023 was driven by a lineage II subtype.

So far there is no evidence to suggest that lineage Ib is more dangerous than the original lineage I strains, Jonas Albanaz of the UK’s Pirbright Institute said in a statement.

How many cases of MPOX were there in 2024?

The Africa Centers for Disease Control and Prevention reported more than 17,000 suspected cases across the continent on Aug. 13. “This is only the tip of the iceberg, given the many weaknesses in surveillance, testing and contact tracing,” the center said in a statement.

According to the WHO, the Democratic Republic of the Congo alone has reported 15,664 cases and 537 deaths to date — more than the entire year of 2023 combined, according to a statement by Tedros Adhanom Ghebreyesus at the WHO on August 15.

Where was mpox found?

The current outbreak began in a small mining town in the Democratic Republic of Congo (DRC). MPOX variants have now spread to at least 11 other African countries, including four where MPOX had not previously been reported (Kenya, Rwanda, Burundi, and Uganda), and one patient in Sweden has also been found to have MPOX.

What is the survival rate for mpox?

More than 99.9 percent of people survive infection with lineage II, but up to 10 percent of MPOX outbreaks caused by lineage I die. Children, immunocompromised individuals, and pregnant women are particularly susceptible to severe illness.

What are the symptoms of MPOX?

The first symptom of MPOX is usually a rash, which begins as flat sores that later develop into itchy, painful blisters. The rash begins on the face and then spreads throughout the body, including the hands and feet. Lesions may also appear inside the mouth, genitals, and anus.

The rash or lesions usually last for 2-4 weeks and are often accompanied by other symptoms such as fever, headache, muscle and back pain, fatigue, and swollen lymph nodes. Symptoms usually appear within a week of exposure to the virus, but can appear anywhere from 1 to 21 days after exposure. However, some people can be infected with the virus without experiencing any symptoms.

How does mpox spread?

Mpox is transmitted through close contact with a person who has the disease. Usually, this occurs through skin-to-skin contact, such as sexual intercourse, kissing, or touching. The virus can also be transmitted through respiratory droplets or contact with contaminated materials, such as sheets, other linens, and sharp objects, such as needles. You remain infectious until all wounds have healed.

Mpox is spread through contact with infected animals via bite or scratch, or when people hunt or eat the animals.

Young people and children are being hit the hardest by this outbreak, a trend not seen in the 2022-2023 outbreak, with children under the age of 15 accounting for up to 69 per cent of suspected cases in some provinces of the Democratic Republic of the Congo.

How is mpox treated?

Treatment consists mainly of managing symptoms and preventing complications such as secondary infections. Some antiviral drugs developed to treat smallpox have also been used to treat MPOX in the past. However, recent clinical trial results of the antiviral drug tecovirimat, used in previous outbreaks, found that the drug is ineffective against lineage I viruses. People infected with MPOX should self-isolate and wear masks. They should also avoid scratching wounds, as scratching can make wounds heal more slowly and increase the risk of secondary infections, which can spread to other parts of the body.

Is there an MPOX vaccine?

The mpox vaccine provides maximum protection when given in two doses. Smallpox vaccines are also known to protect against mpox, but it is not clear whether any of these vaccines are effective against the new mpox variants.

It is only recommended that people get vaccinated if they are at high risk of contracting MPOX. For people in areas not affected by the current outbreak, the risk remains very low.

Jimmy Whitworth of the London School of Hygiene and Tropical Medicine said in a statement that African countries currently have little or no vaccine supplies, but the region is estimated to need 10 million doses.