A NEW strain of mpox described as “the most dangerous yet” is spreading rapidly, experts warn.
Countries in central Africa are most at risk, but the virus now also poses a threat to other parts of the world, including Europe, they said.
“There is a critical need to address the recent surge in mpox cases,” Rosamund Lewis, the World Health Organization‘s (WHO) technical lead for mpox, said.
Mpox is a viral infection that causes flu-like symptoms and pus-filled lesions.
Most cases are mild but it can be deadly, killing about one in 10 of those infected.
Initially, it spread through sexual contact, but experts say the mutant variant, clade 1lb, is increasingly being passed on through everyday touch.
“It is undoubtedly the most dangerous strain of mpox yet,” Professor Trudie Lang, the director of Global Health Network at Oxford University, said.
It is said to be behaving “extremely differently” to clades 1 and 2, the latter of which spread internationally to 110 countries, including the UK, in 2022, mostly among gay and bisexual men.
This prompted the WHO to declare a public health emergency.
Although that has ended, experts say the disease remains a threat.
Around 8,600 mpox cases and 410 deaths have been reported in the Democratic Republic of the Congo alone so far this year, Cris Kacita, the doctor in charge of operations in the country’s mpox control programme, told Reuters last week.
In South Africa, three people have died, with at least 16 laboratory-confirmed cases, the country’s health ministry said.
The third person who died was a 40-year-old man from the KwaZulu-Natal province who had mpox-like symptoms, including a rash all over his body.
“He passed away at home and the results came back positive for mpox on June 23, 2024,” it added in a statement.
It is unclear exactly how many cases and deaths the new strain accounts for, but scientists say overall, it’s “just the tip of the iceberg”.
Vaccines and treatments were previously used to combat the global outbreak, but they are not available in many countries, including Congo.
The WHO said efforts were ongoing to address that.
Leandre Murhula Masirika, research coordinator in the health department in Congo’s South Kivu province, said 20 cases were arriving at a hospital in the mining town of Kamituga every week, and the numbers were rising.
“At the rate things are going, we risk becoming a source of cases for other countries,” said Kacita.
South Kivu borders Rwanda and Burundi.
He said 24 of 26 provinces in Congo were affected and the outbreak was the worst mpox epidemic yet.
Clade 1 mpox has a fatality rate of around five per cent in adults and 10 per cent in children, compared to three per cent for clade 2.
Less is known about clade 1lb, but researchers say it is spreading via sexual contact among men and women, particularly among sex workers, and close touch.
Jean Claude Udahemuka, from the University of Rwanda, who has been studying the outbreak, said there is also evidence of transmission in schools and from mums or carers to children.
The disease appears to be causing miscarriages among pregnant women, as well as “horrendous whole body rashes” and other lingering symptoms.
Previously, it caused lesions more limited to the genital area.
These significant differences from previous mpox strains are “incredibly worrying,” Prof Lang said.
She added: “There is definitely the opportunity for this to get on a plane,” so countries around the world – including those in Europe – could be at risk through travel.
“We need to be really vigilant now and try to move to contain it.”
All countries should be preparing for this new strain “before it spreads to other places, before it is too late,” Udahemuka added.
In April, researchers warned: “Without intervention, localised outbreaks harbour the potential to spread nationally and internationally.
“Given the recent history of mpox outbreaks in Congo, we advocate for swift action by endemic countries and the international community to avert another global mpox outbreak.”
The most obvious mpox symptom is the hallmark spots.
According to the NHS, these lesions go through four stages, from flat spots to raised spots, to blisters to scabs.
But people are also likely to experience flu-like symptoms, which will begin between five and 21 days after infection.
The symptoms often get better by themselves over two to four weeks.
The NHS says these include:
If you have some of these symptoms and believe you could have monkeypox, you should stay at home, avoid close contact with others and get medical help by phone until you’re assessed.
There are some complications associated with mpox, such as bacterial infection from skin lesions, mpox affecting the brain (encephalitis), heart (myocarditis) or lungs (pneumonia).
