Category: Monkey Pox

News Release

Thursday, August 15, 2024

NIH-cosponsored study examined tecovirimat in mpox-endemic country.

The antiviral drug tecovirimat did not reduce the duration of mpox lesions among children and adults with clade I mpox in the Democratic Republic of the Congo (DRC), based on an initial analysis of data from a randomized, placebo-controlled trial. However, the studys 1.7% overall mortality among enrollees, regardless of whether they received the drug or not, was much lower than the mpox mortality of 3.6% or higher reported among all cases in the DRC. This shows that better outcomes among people with mpox can be achieved when they are hospitalized and provided high-quality supportive care. The trial is sponsored by the National Institutes of Healths (NIH) National Institute of Allergy and Infectious Diseases (NIAID) and co-led through a government-to-government partnership with the DRCs Institut National de Recherche Biomdicale (INRB). Further analyses and detailed results will be released through scientific channels.

These findings are disappointing, but they give us essential information and reinforce the need to identify other therapeutic candidates for mpox while we continue research on tecovirimat use in other populations with mpox, said NIAID Director Jeanne Marrazzo, M.D., M.P.H. We remain committed to developing safe and effective interventions, including treatments and vaccines, that can ease the devastating mpox burden in Central Africa and address the milder form of the virus that is circulating globally.

Mpox has occurred in West, Central and East Africa for decades, with the first human case identified in 1970. Two types of the virus that causes mpox have been identified. Clade I, studied in this trial, is endemic in Central Africa and can cause severe illness. Clade II, endemic in West Africa, tends to result in milder illness. A clade II subtype virus caused a global mpox outbreak in 2022. People with compromised immune systems, children, and people who are pregnant are especially vulnerable to severe mpox regardless of the virus clade.

Reports of clade I mpox are increasing in Central African countries, particularly in the DRC. A recent report from the Centers for Disease Control and Prevention (CDC) indicated that 67% of suspected DRC mpox cases and 78% of suspected mpox deaths have occurred in people aged 15 years and younger. Tecovirimat, also known as TPOXX, was initially developed and approved by the Food and Drug Administration to treat smallpox a virus closely related to, but far more serious than, mpoxbut the drugs safety and efficacy as an mpox treatment have not been established. It is currently available for mpox treatment in the United States as part of a separate NIAID-sponsored trial called STOMP and through a CDC expanded access Investigational New Drug (EA-IND) request process. Tecovirimat is authorized in Europe and the United Kingdom for the treatment of smallpox, mpox, and other indications.

In October 2022, NIAID and INRB launched the PALM007 trial to examine the safety and efficacy of tecovirimat for mpox treatment in adults and children. The study enrolled 597 people with laboratory-confirmed mpox at two sites in the DRC. Study participants were randomly assigned to receive tecovirimat or placebo and were admitted to a hospital for at least 14 days, where they were monitored closely for safety and resolution of mpox lesions. All participants received supportive care including nutrition, hydration, and treatment for secondary infections.

Tecovirimat was well-tolerated with no drug-related serious adverse events. Overall, mortality was lower, and lesions resolved faster than anticipated regardless of whether participants received tecovirimat or placebo. Study participants are being notified of the initial results and offered the opportunity to participate in an ongoing extension study providing further supportive medical care. Additional analyses are planned to better understand outcomes observed in the study, including whether there were any significant differences in clinical outcomes by days of symptoms prior to enrollment, severity of clinical disease, participant characteristics, or the genetic variant of mpox being treated.

This study delivered urgently needed evidence to guide the mpox response in Central Africa said co-principal investigator Jean-Jacques Muyembe-Tamfum, M.D., Ph.D., director-general of INRB and professor of microbiology at Kinshasa University Medical School in Kinshasa, DRC. Although not what we had hoped for, the results show that study clinicians provided exceptional supportive care to all participants, which is a testament to the knowledge and skill that Congolese clinicians have acquired on managing mpox-related disease.

The PALM007 study demonstrated the importance and value of testing investigational mpox treatments through robust clinical trials in the DRCs endemic setting, said Lori Dodd, Ph.D., NIAIDs PALM project lead for the DRC. Well continue to evaluate the trial data to determine whether additional studies of tecovirimat in patient subgroups are warranted.

The PALM007 trial is led by co-principal investigators Professor Muyembe-Tamfum and Placide Mbala, M.D., Ph.D., operations manager of the PALM clinical research partnership, and head of the Epidemiology and Global Health Department and the Pathogen Genomic Laboratory at INRB. NIAIDs Veronique Nussenblatt, M.D. and Olivier Tshiani, M.D. of Leidos Biomedical Research were protocol co-chairs. The trial was implemented in Tunda (Maniema province) and Kole (Sankuru province) with support from Congolese staff, the Mitchell Group and the NIHs Frederick National Laboratory for Cancer Research. Collaborating institutions include the U.S. CDC, the Institute of Tropical Medicine Antwerp (ITM), the aid organization Alliance for International Medical Action (ALIMA) and the World Health Organization (WHO). The U.S. Embassy in the DRC and DRC-based U.S. CDC staff supported logistics and operations for shipments, travel and regional security. SIGA Technologies, Inc., based in New York, provided tecovirimat for the study.

The Pamoja Tulinde Maisha or PALM clinical research partnership was established in response to the 2018 Ebola outbreak in DRC. The collaboration has continued as a multilateral clinical research program composed of NIAID, the DRC Ministry of Health, INRB and INRBs partners.

NIAID and the INRB thank the extraordinary team of individuals who carried out this study in remote regions of the DRC, the members of the independent study Data and Safety Monitoring Board, and most importantly, the study participants and their families. For more information about PALM007, please visit ClinicalTrials.gov using the study identifier NCT05559099.

Given the differences in populations affected by the two mpox clades, the types of clinical disease that are appearing and the ongoing spread of both clades, its very important that we continue with the STOMP trial and other related studies, so that we can develop treatments that benefit all people with mpox, said Dr. Marrazzo.

The international STOMP trial is examining the safety and efficacy of tecovirimat against clade II mpox. For more information about the STOMP trial, please visit ClinicalTrials.gov using the study identifier NCT05534984. An additional study, UNITY, sponsored by ANRS Emerging Infectious Disease, is evaluating tecovirimat with a similar study design to STOMP in Argentina, Brazil and Switzerland. More information about the UNITY study can also be found on ClinicalTrials.gov using the identifier NCT05597735. Both studies will continue to enroll participants and work in close collaboration.

NIAID conducts and supports researchat NIH, throughout the United States, and worldwideto study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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The antiviral tecovirimat is safe but did not improve clade I mpox resolution in Democratic Republic of the Congo - National Institutes of Health...

The World Health Organization on Wednesday declared mpox a global public health emergency for the second time in two years, following an outbreak of the viral infection in the Democratic Republic of Congo that has spread to neighboring countries in Africa.

A public health emergency of international concern, or PHEIC, is the WHOs highest level of alert, and it can accelerate research, funding and international public health measures and co-operation to contain the disease.

Earlier this week, Africastop public health bodysimilarly declared mpox, formerly known as monkeypox, an emergency after warning that the viral infection was spreading at an alarming rate.

More than 17,000 suspected mpox cases and 517 deaths have been reported on the African continent so far this year, a 160% increase compared to the same period last year, the Africa Centers for Disease Control and Prevention said. Cases have been reported in 13 countries.

Mpox has two distinct viral clades, I and II. Both versions can spread through close contact with an infected person or via direct contact with infected animals or contaminated materials.

The outbreak in Congo began with the spread of clade I, a strain that is endemic in central Africa and known to be more transmissible. Clade I can also cause more severe infections; previous outbreaks have killed up to 10% of people who got sick.

A new version of that strain, clade Ib, is now spreading and appears to be more easily transmissible through routine close contact, including sexual contact. It has spread from Congo to neighboring countries, including Burundi, Kenya, Rwanda and Uganda, triggering the action from the WHO.

Its clear that a coordinated international response is essential to stop these outbreaks and save lives, said WHO Director-General Tedros Adhanom Ghebreyesus.

A strain of clade II, meanwhile, was responsible for the global spread of mpox in 2022, which prompted the WHO to declare a public health emergency. Infections from that clade are far milder than those from clade I more than 99.9% of people survive, according to the U.S. Centers for Disease Control and Prevention. But it's still capable of causing severe illness, particularly in people with weakened immune systems.

The version that spread in 2022 largely through sexual contact among men who have sex with men was known as clade IIb.

The WHO ended that emergency declaration 10 months later. In the U.S., mpox cases have declined considerably since their peak in 2022. Average daily cases fell to zero in the week ending Aug. 1.

However, given the virus' spread in the DRC and its bordering countries, the CDC asked doctors last week to be on alert for mpox among people with characteristic symptoms who have recently spent time in the area. No cases of clade I have been reported outside central and eastern Africa, the agency said, but it warned about the risk of further transmission.

The CDC has also issued an advisory for people traveling to the DRC and its neighboring countries. According to the agency, these people should practice enhanced precautions and seek immediate medical care if they develop a skin rash.

The U.S. Department of Health and Human Services said Wednesday that the country is well prepared to detect and manage any clade I cases that might arise, since health officials monitor for mpox through clinical testing and wastewater surveillance.

If a clade I cases were detected, "we expect it would cause lower morbidity and mortality in the United States than in the DRC," HHS said in a press release.

Mpox usually starts with a rash that can look similar to chickenpox, syphilis or herpes. The rash typically progresses to small bumps on the skin, then to blisters that fill with whitish fluid. The illness is often accompanied by fever, headache, muscle aches, back pain, low energy and swollen lymph nodes.

A vaccine for mpox is available in the U.S. but not generally available in the DRC. The U.S. is donating 50,000 doses to address that gap, HHS said.

The CDC recommends that people who are exposed to the monkeypox virus or who belong to groups with an elevated risk of infection, such as men who have sex with men receive two doses of the vaccine. It is effective against both clades of mpox.

Originally posted here:

WHO declares mpox a global public health emergency for second time in two years - NBC News

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Sweden confirmed its first case of mpox, formerly known as monkeypox. It is the first known infection of the strain outside of Africa. The World Health Organizationdeclared mpox a global public health emergency. NBC News medical contributor Dr. John Torres details the symptoms to look out for as concerns for the viruses rise.Aug. 15, 2024

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What you need to know about mpox and parvovirus - NBC News

Updated 12:10 p.m. Friday

The World Health Organization (WHO) declared the mpox outbreaks in Congo and elsewhere in Africa a global emergency on Wednesday, with cases confirmed among children and adults in more than a dozen countries and resulting in more than 500 deaths in 2024.

Earlier this week, the Africa Centers for Disease Control and Prevention (CDC) announced that the outbreaks of mpox formerly known as monkeypox were a public health emergency, calling for international help to stop the virus spread. The Africa CDC said mpox has been detected in 13 countries this year, and more than 96% of all cases and deaths are in Congo.

Mpox mostly spreads via close contact with infected people, including through sex. There is a vaccine for the disease, but few doses are available on the African continent.

This is something that should concern us all The potential for further spread within Africa and beyond is very worrying, WHO director-general Tedros Adhanom Ghebreyesus said.

The CDC recommends that any person who has traveled to Congo or any bordering countries in the last 21 days and who develops a new, unexplained skin rash should seek medical evaluation and avoid physical contact with others. On Thursday, Swedish health officials announced theyd identified the first case of a person with the more infectious form of mpox first seen in Congo.

The Bay Area experienced its own mpox outbreak in 2022, but the strain of the virus now spreading from Congo is different in several ways. Keep reading for what you need to know about mpox in 2024, including the the symptoms of mpoxand understanding this global emergency declaration.

In 2022, WHO declared mpox to be a global emergency after it spread to more than 70 countries that had not previously reported mpox, mostly affecting gay and bisexual men. In that outbreak, fewer than 1% of people died. Before this outbreak, the disease had mostly been seen in sporadic outbreaks in central and West Africa when people came into close contact with infected wild animals.

The 2022 mpox global outbreak in the United States which particularly affected gay and bisexual men as well as trans and nonbinary people who have sex with men was caused by a version of the mpox virus known as clade II.

The mpox outbreak spreading from Congo is caused by another type of the virus, called clade I, which causes more severe illness and higher fatality rates than the clade II type thats been circulating in the U.S. albeit at low levels since the 2022 outbreak.

Data from Stanford Universitys WastewaterSCAN project, which monitors the presence of viruses including mpox in human sewage across the U.S., shows that two years after the initial 2022 outbreak, this clade II strain of mpox is still occasionally detected in the Bay Areas wastewater. Most recently, clade II mpox was detected on Aug. 11 and 12 at San Franciscos two wastewater plants, but WastewaterSCANs Ali Boehm confirmed that these detections were low level and not related to the the clade I outbreak spreading in Congo.

So far, in 2024, there have been more than 14,000 cases of clade I from the Congo outbreak, and 524 people have died. Cases are up 160% and deaths are up 19% compared with the same period last year. Salim Abdool Karim, a South African infectious diseases expert who chairs the Africa CDC emergency group, said the new version of mpox spreading from Congo appears to have a death rate of about 3%-4%.

On Thursday, the Swedish public health agency said that the clade I case identified in that country was a patient who recently sought health care in Stockholm after traveling to the part of Africa where there is a major outbreak, according to the agency. Officials said the risk to the general public was considered very low and that they expected sporadic imported cases to continue.

According to data from multiple local health departments, the overwhelming majority of mpox cases in the Bay Area during the 2022 outbreak were reported among gay men and other men who have sex with men. At the peak of the 2022 outbreak, San Francisco health officials saw dozens of new mpox cases each week in July of that year.

Around the same time, the city declared a public health emergency the first city in the country to do so. The White House soon followed suit and declared mpox a public health emergency in August, when more than 6,000 cases had been confirmed in the U.S.

In 2022, organizers from the LGBTQ+ community quickly mobilized to pressure public health officials at every level of government to make vaccines and treatment widely available to this vulnerable population. The San Francisco AIDS Foundation (SFAF) helped spearhead these efforts and has continued to provide free mpox vaccines. (Jump straight to where to find an mpox vaccine in the Bay Area.)

We are aware of the mpox health emergency in Africa, and although mpox rates in the Bay Area are currently at low levels, we know that infection rates can change or increase sometimes rapidly, said Jorge Roman, senior director of clinical services at SFAF in a statement to KQED.

Soon after the WHO declared the global emergency on Wednesday, San Francisco public health officials confirmed that the risk of this new strain remains relatively low in the Bay Area.

In a statement, the San Francisco Department of Public Health (SFDPH) said that the overall risk to the general population in the United States is considered to be very low. The agency said it will continue to closely monitor the situation alongside our federal and state partners.

Cases of clade II mpox remain low in San Francisco, SFDPH said, and we will continue to update the community if further actions are needed to protect health.

Officials at the Africa CDC said nearly 70% of cases in Congo are in children younger than 15, who also accounted for 85% of deaths.

Jacques Alonda, an epidemiologist working in Congo with international charities, said he and other experts were particularly worried about the spread of mpox in camps for refugees in the countrys conflict-ridden east.

The worst case Ive seen is that of a 6-week-old baby who was just two weeks old when he contracted mpox, Alonda said, adding the baby has been in their care for a month. He got infected because hospital overcrowding meant he and his mother were forced to share a room with someone else who had the virus, which was undiagnosed.

Earlier this year, scientists also reported the emergence of a new form of the deadlier clade I form of mpox, which can kill up to 10% of people in a Congolese mining town that they feared might spread more easily.

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form causes milder symptoms and lesions on the genitals. That makes it harder to spot, meaning people might also sicken others without knowing theyre infected.

Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, said declaring these latest mpox outbreaks in Africa an emergency is warranted if that might lead to more support to contain them.

Its a failure of the global community that things had to get this bad to release the resources needed, he said.

The U.N. health agency said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks are linked to the one in Congo. In Ivory Coast and South Africa, health authorities have reported outbreaks of the less dangerous clade II version of mpox that spread worldwide in 2022.

The mpox virus spreads through close contact with someone who is infected. This could be direct contact with the infectious rashes or scabs someone with mpox develops, scabs, having intimate physical contact with someone who has mpox, such as kissing, cuddling or sex. Coming into contact with infected bodily fluids or items that have been touched by rashes or fluids from an infected person can also expose you to the virus.

Mpox symptoms often start as flu-like conditions, SFPDH said which is worth bearing in mind during this current COVID-19 surge.

The mpox virus also appears as a rash or sores or spots that can resemble pimples or blisters on the skin anywhere on the body, including the face, inside the mouth, hands, feet, chest, genitals and anus. These spots often start as red, flat spots that then become bumps before the bumps become filled with pus and turn into scabs when they break. These symptoms can be extremely painful. If youre unsure about recognizing an mpox rash, the CDC has a photo guide.

Mpox can have a long incubation period that is, the time between when youre exposed to mpox and when you start to develop symptoms that can range from three to 17 days, according to the CDC.

If you suspect you might have mpox symptoms even if theyre subtle see your health care provider right away or consult one of SFPDHs clinics for mpox testing. See more on what to do if you suspect you have mpox.

The mpox vaccine is available to anybody in the Bay Area, with no eligibility requirements to meet. (In the early days of the 2022 outbreak, public health officials were originally only offering vaccines to people whod been exposed to mpox or were categorized as being in a specific group more at risk from mpox, but rest assured that those criteria are no longer in effect.)

We recommend that all people who may be at risk of mpox receive both doses of the Jynneos mpox vaccine, Roman of the San Francisco Aids Foundation said. Vaccines are plentiful and easily available at this point in time, from San Francisco AIDS Foundation and other City and community partners. Mpox vaccination is not recommended at this time for those who have previously been infected.

SFDPH said that previous mpox outbreaks have predominantly affected communities of gay and bisexual men and men who have sex with men (MSM), as well as trans and nonbinary people who have sex with men. City health officials also especially recommend the mpox vaccine for all people living with HIV and anyone taking or eligible to take HIV PrEP.

The mpox vaccine was also originally only available for people aged 18 and older, but in 2022 the Food and Drug Administration (FDA) issued an emergency-use authorization that allows providers to also give the vaccine to young people aged under 18 who are determined to be at high risk of infection.

The vaccine currently available in the U.S. (brand name: Jynneos) is a two-dose series, with roughly a month between doses. Maximal immunity will build two weeks after your second dose.

If youve already had both doses of the mpox vaccine, even back in 2022:

Youre all up to date and you dont need to get another mpox vaccine in 2024. Theres no recommendation at this time to get an mpox booster.

If you havent already had the mpox vaccine:

Go ahead and get your first dose as soon as possible, then get your second dose around 28 days later. But if you forget or get overwhelmed by events, dont stress too much about timing: Just go get your mpox vaccine when you can.

If you already have your first dose but forgot to get your second, go get that last dose as soon as possible even if you got Dose 1 back in 2022.

Your mpox vaccine will be 100% free, and you dont need health insurance to receive one. As with the COVID-19 vaccine, receiving an mpox vaccine wont make you a public charge or affect any future immigration processes you may enter into, and you wont be asked about your immigration status to receive the mpox vaccine.

If you have a regular health care provider, SFDPH recommends you ask them first about getting the mpox vaccine. Your vaccine will be free, but you may be charged a regular copay for seeing your provider.

If you dont have a regular health care provider or insurance, you can find the mpox vaccine free at clinics around the Bay Area. You can opt to schedule an appointment or choose a walk-in clinic, depending on what works best for you.

If you live in or near San Francisco:

See a full list of mpox vaccine sites near you in San Francisco. SFDPH confirms that you dont have to be a city resident to get vaccinated for mpox in San Francisco.

Mpox vaccination sites elsewhere in the Bay Area and California:

SFAF will also administer free first and second doses of the vaccine at the upcoming Castro Street Fair on Oct. 6, with no appointment needed. You can find the SFAF booth at 470 Castro St., San Francisco.

Associated Press writers Gerald Imray in Cape Town, South Africa, Christina Malkia in Kinshasa, Congo and Mark Banchereau in Dakar, Senegal contributed to this report. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Science and Educational Media Group. The AP is solely responsible for all content.

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Mpox is Declared a Global Emergency Again. Here's What to Know - KQED

Mpox was declared a global health emergency on Wednesday for the second time in three years, as the World Health Organization urged action on a virus spreading rapidly through more than a dozen African countries.

The outbreak is most severe in the Democratic Republic of Congo, which has reported 15,600 mpox cases and 537 deaths, according to the U.N. agency. The mpox epidemic there has already proved more deadly than one in 2022, the last time an emergency was announced.

Here is what to know about mpox, which was known as monkeypox before health officials, responding to complaints about the word, recommended its current name in 2022.

The mpox virus is endemic to Central and Western Africa. The disease is similar to smallpox but less contagious, and the virus is spread primarily through close contact with infected animals or people, and the consumption of contaminated meat.

Mpox can also be spread through sexual contact, and there is a risk of transmission to a fetus.

Ninety-six percent of the mpox deaths reported in June were in Congo, a country already assailed by an internal conflict and humanitarian crisis. But the disease has now been identified in 13 countries, including for the first time in the East African nations of Burundi, Kenya, Rwanda and Uganda.

There are differences between the outbreaks in various regions and countries, depending on the circumstances in each community, according to Dr. Sylvie Jonckheere, an adviser on emerging infectious diseases for Doctors Without Borders. But they share a common feature, she said: We do not know how to control this outbreak.

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Mpox Outbreak: What to Know About Symptoms and Risks - The New York Times

The new form of the mpox virus transmits through close contact (Representational)

The World Health Organization declared mpox a global public health emergency for the second time in two years, following an outbreak of the viral infection in the Democratic Republic of Congo that has spread to neighbouring countries.

A new form of the virus, clade Ib, triggered global concern as it seems to be spreading quickly and little is known about the strain. The disease transmits through close contact.

The following are the countries that have reported cases of clade Ib mpox:

Democratic Republic Of Congo

Two strains of mpox are spreading in the Democratic Republic of Congo - the endemic clade I and the new clade Ib, which spreads more easily through close contact, including sexual.

The current outbreak has seen 27,000 cases and more than 1,100 deaths since January 2023, largely among children.

Sweden

Global health officials on August 15 confirmed an infection with a new strain of the mpox virus in Sweden, the first sign of its spread outside the African continent.

Swedish health officials said at a press conference that the person was infected while in Africa with the clade Ib type of mpox involved in the recent outbreak. The person is receiving treatment.

Burundi

Burundi's Ministry of Health has investigated and confirmed 61 cases of clade Ib mpox distributed across several districts as of August 9. No deaths had been documented at the time of reporting, according to WHO data.

Kenya

On July 29, Kenya's health ministry confirmed one case of clade Ib mpox, the first-ever case of mpox identified in the country. No deaths had been reported as of August 8, according to WHO data.

Rwanda

As of August 7, four confirmed clade Ib mpox cases and zero deaths had cumulatively been reported by the country, according to WHO data.

Uganda

Uganda identified two cases of clade Ib mpox, the first confirmed mpox cases identified in the country. Investigations revealed that transmission occurred outside Uganda and no secondary transmission had been linked to the two cases as of August 2.

No deaths have been reported as of August 8, according to WHO data.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

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Full List Of Countries With Confirmed Cases Of New Mpox Variant - NDTV

For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent and risks entering other continents.

The World Health Organization (WHO) on Wednesday issued its highest level of alert for the viral disease, noting that more than 14,000 cases and 524 deaths in Africa this year have already exceeded last years figures.

The announcement came a day after the Centers for Disease Control and Prevention (CDC) in Africa declared mpox a public health emergency.

So what is mpox, how is it transmitted, and how serious is its current spread compared with previous outbreaks?

Heres what you should know:

Mpox is a viral infection that primarily affects humans and animals.

It belongs to the group of viruses classified as Orthopoxvirus genus. These typically cause pox-like disease, which includes a rash with raised bumps or blisters on the skin. The bumps are often filled with fluid or pus and can eventually crust over and heal.

Mpox is similar to the now eradicated smallpox, and and other poxviruses like cowpox and vaccinia.

It was originally named monkeypox when first identified in monkeys in 1958. These captive research monkeys were in Denmark at the time. In 1970, the first reported human case was a nine-month-old boy in the Democratic Republic of Congo.

In 2022, the WHO recommended updating its name to mpox to reduce stigma and association with monkeys, as the disease can also infect rodents and humans.

The mpox virus is transmitted to humans through close contact with an infected animal or person.

Animal-to-human transmission typically occurs through bites, scratches, or direct contact with the blood, body fluids, or wounds of an infected animal.

Human-to-human transmission can happen through:

The virus enters the body through broken skin, the respiratory tract, or mucous membranes (which include eyes, nose, and mouth).

Symptoms include fever, headache, muscle aches, and a distinctive rash that can appear on the face, hands, feet, and other parts of the body. The rash eventually forms pustules and scabs before healing.

A pustule which looks like a big white or yellow pimple is a small, raised bump on the skin that is filled with pus.

Lymph nodes, bean-shaped glands that are part of the immune system, can also swell up as they try to fight the virus. Some of the places these are located include under each arm, and the sides and back of the neck.

In rare cases, an infection may be deadly.

Overall, an infection can last two to four weeks. It can take three to 21 days to develop symptoms after being exposed to the virus. However, a person can transmit the disease to others one to four days before symptoms appear.

Mpox can be identified by testing a sample of fluid swabbed from the rash.

On Wednesday, the WHO declared mpox a public health emergency of international concern (PHEIC) its highest level of alert due to a new variant of mpox being found and cases being reported for the first time in several countries, such as Kenya and Rwanda.

WHO Director-General Tedros Adhanom Ghebreyesus said there was concern for the further spread of the disease within Africa and beyond, after after a meeting of the United Nations health agencys emergency committee.

An emergency declaration from the WHO is meant to spur donor agencies and countries into action.

There is a real attempt right now to mobilise resources and that is why in part WHO called for the public health emergency now, said Amita Gupta, director of the Division of Infectious Diseases at the Johns Hopkins School of Medicine.

The WHO declared mpox a global health emergency in July 2022 as well, when the virus was first found to spread through sexual contact and was reported in more than 70 countries across the world. Once cases declined, the WHOlifted the emergency status in May 2023.

Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries. Compared with the same period last year, the agency said cases are up 160 percent and deaths have increased by 19 percent.

So far, more than 96 percent of cases have been reported in Congo, where earlier this year scientists found a new form of the virus that causes milder symptoms and lesions on the genitals. That makes it harder to spot, meaning people might transmit it to others without knowing theyre infected.

There is not much international mobility in/out of the DRC so the risk of spread has been low. However, if the spread goes more widely in Africa then the risk of more global spread becomes a concern, Gupta told Al Jazeera.

While the 2022 outbreak was driven by clade (or group) II of mpox, the current outbreak is being fueled by clade I which can be more deadly, Otim Patrick Ramadan, Health Emergency Office at WHO regional office for Africa, told Al Jazeera.

Cases of the new clade I variant outbreak have not yet been reported outside Africa.

While mild cases can resolve on their own, there are no approved treatments or vaccines specifically for mpox.

The antiviral drug tecovirimat (TPOXX), originally for smallpox, is being studied for treating mpox. The United States Food and Drug Administration has also approved JYNNEOS (also known as Imvamune or Imvanex), a smallpox vaccine for severe mpox cases in people aged 18 years and older.

However, some 60 percent of the cases in Congo, the country most overwhelmed by mpox are in people aged below 18, according to Ramadan.

The CDC has recommended getting vaccinated and isolating once exposed to someone with mpox.

Gupta said that while much has been learned from COVID and surveillance capacity across the world has increased, rapid diagnosis and access to substitute treatments is lacking in African countries where the virus is spreading.

Originally posted here:

What is mpox and why has WHO declared it a global health emergency? - Al Jazeera English

Sweden is the first country outside of Africa to report a case of mpox caused by the novel clade 1, the variant fueling a massive outbreak in the Democratic Republic of the Congo (DRC) and neighboring nations, while US officials report disappointing DRC trial results for a key drugTpoxx, or tecovirimatagainst the more lethal strain.

Rwanda, Uganda, Burundi and Kenya, are the other African countries with clade 1b detections.

Swedish patient had recently visited Africa

According to a press release from the Public Health Agency of Sweden, the case-patient sought medical attention in Stockholm but had recently visited Africa. In 2022 and 2023, Sweden saw an outbreak of clade 2 cases linked primarily to sexual transmission among men who have sex with men, eventually recording about 300 cases.

This is the first clade 1 case identified in the country. The European Centre for Disease Prevention and Control said today it will soon update its risk assessment for the clade 1 mpox outbreak in Africa.

"This case does not require any additional infection control measures in itself, but we take the outbreak of clade I mpox very seriously," said Magnus Gisslen, MD, PhD, chief epidemiologist at the Public Health Agency of Sweden. "We are closely monitoring the outbreak and we are continuously assessing whether new measures are needed."

The announcement of the Swedish case comes a day after the World Health Organization declared the outbreak in Africa a public health emergency of international concern (PHEIC).

The declaration comes 2 years after the WHO declared the global spread of clade 2 mpox cases a PHEIC, resulting in the widespread use of mpox vaccine in Europe and the United States to curtail the outbreak. Getting vaccine doses to Africa has proven more challenging; at least 10 million vaccine doses are needed for the current outbreaks in Africa, but so far only the DRC and Nigeria have taken the first regulatory steps to allow supplies to be used.

Yesterday Tim Nguyen, MPH, who heads the WHO's High Impact Events Preparedness unit, said there are about 500,000 doses of Bavarian Nordic's Jynneos vaccine available, with another 2.4 million doses that could be produced by the end of the year if there are orders. The company said it could produce another 10 million doses in 2025.

Several international scientists and public health experts weighed in today on the WHO PHEIC via the Science Media Centre.

"The situation is concerning because of the spread of the clade 1b virus, which is considered to cause more severe disease, and because there are many children being infected in DRC during this new outbreak," said Brian Ferguson, PhD, an associate professor of immunology at the University of Cambridge, said. "40% of cases are in children under 5 years old."

The situation is concerning because of the spread of the clade 1b virus, which is considered to cause more severe disease, and because there are many children being infected in DRC during this new outbreak.

Josie Golding, PhD, head of epidemics and epidemiology in Wellcome's Infectious Disease team, said, "We should not wait for diseases to escalate and cross borders before acting. Effective outbreak control requires sustained, coordinated efforts worldwidefrom local and national governments, and public and private industry to funders, regulators and NGOs."

Jonas Albarnaz, a poxvirus researcher at the Pirbright Institute, added, "Little is known about the natural history and transmission dynamics of the new clade 1b variant, and this information is key to inform the control strategies."

In a news release today, the US National Institutes of Health (NIH) said that, in a new trial, the antiviral drug Tpoxx did not reduce the duration of mpox lesions among children and adults with clade 1 mpox in the DRC, but it was safe.

"These findings are disappointing, but they give us essential information and reinforce the need to identify other therapeutic candidates for mpox while we continue research on tecovirimat use in other populations with mpox," said Jeanne Marrazzo, MD, MPH, director of the National Institute of Allergy and Infectious Diseases, which is part of the NIH. "We remain committed to developing safe and effective interventions, including treatments and vaccines, that can ease the devastating mpox burden in Central Africa and address the milder form of the virus that is circulating globally."

However, the case-fatality rate seen in the study was 1.7%much lower than the 3.6% or higher reported in the DRC, which shows the benefit of good hospital care for case-patients. And Tpoxx maker Siga said the drug did provide benefit for those treated early, and those with severe disease (100 or more skin lesions). Early treatment was defined as within 7 days of symptoms.

"We believe these data warrant further investigation and support our view that post exposure prophylaxis will be vital for treatment of severe cases of mpox and all cases of smallpox," said Dennis Hruby, PhD, Sigas chief scientific officer in a press release.

We believe these data warrant further investigation and support our view that post exposure prophylaxis will be vital for treatment of severe cases of mpox and all cases of smallpox

Since November of 2023, the DRC has reported more than 16,000 new mpox cases, as well as more than 500 deaths this year.

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Sweden reports first clade 1 mpox case outside of Africa as NIH shares disappointing Tpoxx results - University of Minnesota Twin Cities

A fast-spreading mpox outbreak in Africa was declared a continent-wide public health emergency, as the regions main health advisory body invoked this power for the first time as it moved to marshal resources.

The declaration will prompt countries in the region to share timely information on mpoxs spread with the Africa Centres for Disease Control and Prevention, helping it to better tap financial aid, Jean Kaseya, director general of the Addis Ababa-based agency, said on Tuesday.

Today I commit to you that African citizens will lead this fight with every resource at our disposal, he told a virtual press briefing. Well work with government, international partners and local communities to ensure that every African, from the bustling cities to the remote area, is protected.

A mutated mpox strain has spread to at least six African countries, infecting about 15,000 people and killing more than 500 in the Democratic Republic of the Congo this year alone. The variant was first reported in the DRC less than 12 months ago.

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While mpox vaccines are available, few have made their way to Africathe only continent where the disease is endemic. At about $100 per dose, the vaccines are currently very expensive, Kaseya has previously said. Africa will need about $4 billion to fight mpox, money that we are confident that we can leverage, he said.

About 200,000 doses will begin to be distributed in countries that are the most severely affected in the next two weeks, and work is under way to secure more than 10 million shots that it is expected the continent will ultimately need, according to Kaseya.

The move by the Africa CDC came a day before a panel of advisers convened by the World Health Organization is due to meet to help determine whether the deadly outbreak constitutes an international emergency.

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The WHO last declared mpox a public health emergency of international concern in May 2022 when cases of a milder strain erupted globally, but Africa didnt get appropriate support, Kaseya said. When the agency lowered its alert level a year later, cases in Africa continued to increase and today we are facing the consequence of no assistance, he said.

Africa CDC was only given the mandate to call regional public health emergencies in 2023, even as WHO warned it could also trigger travel and trade restrictions that would isolate the continent. Still, there is no reason to close borders or stop trading, Kaseya said.

What we were doing before didnt work, he said. We call upon our international partners to take this mpox as an opportunity to act differently and to work closely with African CDC and African countries to provide appropriate support to affected people.

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Mpox Is Officially a Health Emergency in Africa - TIME

A new and deadlier version of mpox is spreading internationally. In recent months, cases and deaths were being detected only in parts of central and east Africa, but on Thursday, Sweden confirmed its first case. The announcement comes just one day after the World Health Organization declared mpox an international public health emergency for the second time in two years.

The risk to the general public in the US is very low, the Department of Health and Human Services stated in the wake of the World Health Organizations announcement.

Mpox, previously known as monkeypox, is an infectious disease closely related to but much less severe than smallpox, and is suspected to originate in African rodents and non-human primates. Mpox spreads through close contact with an infected person, including from sexual and skin-to-skin-contact. Pregnant people can also pass the virus to their child during pregnancy and after birth. The most common symptom of mpox is a blister-like rash that typically lasts for two to four weeks. Other symptoms include fever, fatigue, muscle aches, cough, and sore throat.

For decades, mpox has caused sporadic cases and outbreaks in Nigeria, the Democratic Republic of the Congo, and several other African countries. But in May 2022, countries outside of Africa, including many that had never dealt with mpox, suddenly started recording cases. That July, the World Health Organization declared the pandemic a public health emergency of international concern for the first time. In just one year, more than 100 countries had recorded nearly 90,000 mpox cases and over 150 deaths.

Fortunately, public health agencies around the world acted quickly to improve disease surveillance efforts, increasing awareness among high-risk populations, particularly men who have sex with men, and encouraging safe sex practices. In the US and Europe, where there were just over 30,000 and 25,000 mpox cases respectively between May 2022 and May 2023; officials also disseminated over a million vaccine doses. Consequently, mpox transmission in most countries quickly dwindled.

In May 2023, the World Health Organization lifted the emergency status and although at the time the public health body no longer considered mpox an international health emergency, countries around the world continued to report cases but much fewer than at the height of the epidemic. In June 2024, there were 175 cases reported across North, Central, and South America; 100 cases were reported in Europe, and 11 cases were reported in Southeast Asian countries, according to a situation report published by the World Health Organization.

In the Democratic Republic of the Congo in central Africa; however, the outbreak continued largely unabated. As of May 2024, there have been 7,851 mpox cases and 384 deaths reported in the country. On Tuesday, the Africa Centres for Disease Control and Prevention declared mpox a continent-wide public health emergency.

The version of the virus circulating in the DRC was different than the one that spread globally. There are two main strains of mpox: clade I, which causes more severe illness and has historically been confined to central Africa, and clade II, which has historically caused infections in west Africa. Clade II was the version that spread to over 100 countries in 2022 and 2023. But clade I was spreading in the DRC. And it is clade I that has now started spreading out of the DRC into four countries in east Africa Burundi, Kenya, Rwanda, and Uganda and now Sweden.

Vox diligently covered the outbreak of mpox, formerly known as monkeypox, back in 2022. Check out our previous work here:

The new international spread of mpox clade I is spurring concerns that a deadlier mpox pandemic might be on the horizon and triggered the Africa Centres for Disease Control and Prevention and the World Health Organization to designate the ongoing mpox outbreaks as health emergencies.

Africa CDC is the public health agency of the African Union, which represents 55 African states. It is the first time the agency has designated any outbreak a continental emergency. Other African countries are also facing resurging mpox outbreaks caused by the clade II virus. In May, there were a total of 465 mpox cases documented across all African countries and in June there were 567, a 22 percent increase.

We declare today this public health emergency of continental security to mobilize our institutions, our collective will, and our resources to act swiftly and decisively, said Africa CDC Director General Jean Kaseya in a press briefing Tuesday.

Outbreak response efforts in the DRC and other African countries have once again been hamstrung by the same challenges health officials faced during previous outbreaks and pandemics, including Covid: a lack of global solidarity and an unwillingness to share life-saving resources. While vaccine doses were rapidly disseminated in the US and Europe in 2022, vaccines are only now starting to trickle into the DRC. But even so, only a couple hundred thousand vaccines will be available for a population of more than 100 million people.

Slowly, national governments and multinational organizations such as the African Union are working to improve domestic public health infrastructure and technical capacity and to reduce dependency on donor countries. While Africa CDCs unprecedented move to designate the mpox outbreaks a regional health emergency signals a continuation of these efforts, it is unclear if the designation will help spur the rapid influx of resources needed to respond to the mpox outbreaks.

Mpox was first discovered in 1958 in a colony of monkeys in a research facility in Denmark, and the first case of mpox in a human a nine-month-old infant was not documented until 1970 in the Democratic Republic of the Congo. Researchers and physicians could not determine exactly how the infant became infected; however, close contact with an infected monkey may have caused the infection. Small rodents, monkeys, and mammals can pass the virus on to humans but outbreaks typically take off when humans infect each other.

In 2005, additional mpox cases in humans were recorded in the DRC, and thousands of suspected cases have been reported every year since then. Since 2017, mpox has also caused frequent infections in Nigeria.

Although mpox has been around for a long time, there are still many unknowns about how the virus spreads and why it suddenly spread around the world in 2022. What researchers do know is that the virus has been rapidly mutating in recent years.

Interestingly and maybe worryingly, while most genetic mutations have no effect at all, some can cause viruses to become deadlier or more effective at spreading. When geneticists compared the 2022 mpox genome to a sample collected in 2017, they found some 40 genetic mutations had occurred. Some researchers have suggested that these mutations have improved how easily the virus can spread from person to person, but it seems that there is no firm consensus yet.

In September 2023, an entirely new mpox clade I variant, tentatively called clade IB, was discovered in the DRC. The World Health Organization has not confirmed if the new variant causes more severe disease or can be spread more easily.

Rosamund Lewis, the mpox technical lead at the World Health Organization, posits that genetic mutations are not behind the sudden global surge of mpox. Instead, she suggests that the virus happened to start infecting new populations sex workers and men who have sex with men and that has in turn fueled wider transmission. Mpox is reminiscent of the origins of HIV, when chimpanzees infected humans in southwestern Cameroon before taking firm root in the booming urban center and among the large sex worker population of Kinshasa, the capital of the DRC.

Sexual transmission among adults may only be one of the main drivers of mpox transmission. In the DRC, some 70 percent of mpox cases recorded this year were among children who were likely exposed through close contact with infected animals or household members who were infected.

One of the biggest risk factors for severe mpox infection and death is preexisting HIV infection. Unfortunately, about 25.6 million people in Africa have HIV, more than any other region in the world, meaning many African nations may experience deadlier outbreaks than other parts of the world. The dual burden of mpox and HIV was also a major factor that prompted the Africa CDC to declare the mpox outbreaks a continental emergency, Kaseya explained.

There are at least two vaccines Jynneos, also called Imvanex in Europe, which is made by Danish company Bavarian Nordic, and LC16, which is manufactured by Japanese company KM Biologics that are effective against mpox. The US Food and Drug Administration approved the Jynneos vaccine for use against smallpox and mpox in 2019. LC16 was developed for smallpox but is also effective against mpox.

When the US and Europe started recording mpox cases in 2022, health officials quickly disseminated millions of doses of existing vaccines. For the first two years of the pandemic, however, no vaccines were available in the DRC.

The DRC, like most countries in Africa, does not have the infrastructure to produce its own vaccines nor can it afford to pay for millions of doses. (The mpox vaccine costs just under $100 per dose, according to Kaseya; GDP per capita in the DRC is just $649.) Thus, these countries must rely on donations from the US, Europe, and other countries. Following the Covid-19 pandemic, the Africa CDC started leading efforts to fill this crucial gap, but progress has been slow.

In the void, officials in the Democratic Republic of the Congo and other African countries have been carrying on their outbreak responses without vaccines. It wasnt until last month that the first shipments of mpox vaccines started arriving in the DRC. But the country received only 200,000 doses, according to Lewis, forcing personnel to cobble together a plan outlining how they will utilize such finite resources. Kaseya did not elaborate on how Africa CDC will aid in this process.

Donor governments have been providing technical and financial support for mpox outbreak responses in Africa. Last week, the US Agency for International Development, or USAID, announced that it will surge $10 million in funds to support the mpox response in DRC.

It remains unclear if the new emergency designations will have any impact on mpox vaccine availability. Still, the Africa CDC and World Health Organization are increasing financial resources for the mpox response. Earlier this month, the African Union released $10.4 million in funds for the mpox response. The World Health Organization has promised $1.45 million in emergency funds, according to WHO Director-General Tedros Adhanom Ghebreyesus, with more to follow in the coming days.

This is a fight for all Africans and we will fight it together, Kaseya said.

Update, August 15, 1:35 pm ET: This story was originally published on August 13 and has been updated multiple times, most recently to include a statement from the USs CDC about the risk of mpox to Americans as well as the news of the first case outside of Africa in Sweden.

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Mpox never stopped spreading in Africa. Now its an international public health emergency. Again. - Vox.com