More Contagious Mpox Variant Spreads Outside Africa, U.S. Acts

Last week, the World Health Organization (WHO) declared mpox a global health emergency for the second time in about two years. At that time, WHO determined the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of African countries constituted a public health emergency of international concern (PHEIC) under the International Health Regulations. The new form of mpox (clade 1b) has concerning global implications because it has been shown to spread more easily through routine close contact and has spread disproportionately among children, Reuters reported.

In response, the New York City Department of Health and Mental Hygiene (NYC Health Department) issued a statement considering the fact the city was the epicenter of the mpox outbreak in the United States two years ago.

“While the current risk to New Yorkers and Americans is low, we must not only plan ahead but act now,” said Dr. Ashwin Vasan, NYC Health Department commissioner.

In 2022, New York City introduced a range of interventions that were adopted nationwide. Still, the NYC Health Department cautioned outbreaks are difficult to control and to predict exactly who will be affected.

“We must also advocate for resources to flow to the parts of the world most affected because we know stopping outbreaks at their source is the smartest way to respond,” Vasan said. “As we learn time and again, we are connected, and we cannot stand by and hope that another country’s suffering will not reach us. Prevention means we must be as invested in each other as we are in ourselves. It is not only moral and ethical, but also strategic.”

NYC Health Department emphasized the importance of vaccination and encouraged anyone at risk who still needs to do so to get vaccinated now. Two doses are needed for maximum protection.

Last week, the U.S. Department of Health and Human Services said the U.S. is donating 50,000 vaccine doses to the DRC. During the previous few months, the U.S. also has provided US$17 million to support clade 1 mpox response efforts in central and eastern Africa.

Earlier this month, the U.S. Centers for Disease Control and Prevention CDC) issued a health alert for healthcare professionals to maintain a heightened index of suspicion for mpox in patients who have recently visited infected countries. Additionally, on Friday, the  European Centre for Disease Prevention and Control raised its risk level for mpox, a day after global health officials confirmed one case of infection with a new strain of the virus in Sweden—the first outside Africa. Pakistan’s health ministry also confirmed on Friday at least one case of the mpox virus in a patient who had returned from a Gulf country. Today, the Philippines has detected a new case of the mpox virus, but it is waiting test results to know the virus strain.

Since January 2023, the DRC has reported the largest number of yearly suspected clade I mpox cases on record. While clade I MPXV is endemic, or naturally occurring, in the DRC, the current outbreak is more widespread than any previous DRC outbreak. It has resulted in clade I mpox transmission to neighboring countries. This year, at least 12 central and eastern African countries have had over 17,000 suspected cases, and 517 people have died from mpox, according to Africa Centres for Disease Control and Prevention. 

In 2022, the world experienced a global clade II mpox outbreak, which led to more than 95,000 cases across 115 non-endemic countries. Since 2022, the U.S. has had outbreaks of clade II mpox, according to recent CDC data. Overall, mpox has infected more than 32,000 people in the U.S., and 58 have died of mpox.