The Centers for Disease Control and Prevention (CDC) has issued an urgent alert to healthcare providers to be vigilant for signs of a severe strain of mpox, previously known as monkeypox, that is spreading rapidly in parts of Africa. The warning comes as the World Health Organization (WHO) considers declaring the outbreak a public health emergency of international concern.
The strain, known as clade 1, is currently confined to central and eastern Africa. However, the CDC cautioned that due to the potential for international spread, clinicians in the United States should consider mpox in patients who have recently traveled to the Democratic Republic of Congo (DRC) or its neighboring countries-Angola, Burundi, Central African Republic, Republic of Congo, Rwanda, South Sudan, Uganda, or Zambia-and who exhibit symptoms of mpox.
Mpox is a viral disease that causes fever, headaches, muscle aches, and painful skin lesions. It is transmitted through close, skin-to-skin contact and can be fatal. The latest strain, clade 1, is particularly concerning due to its severity, with a mortality rate of nearly 4%, compared to less than 1% for the 2022 global outbreak strain, clade 2.
"Most reported cases in known endemic provinces continue to be among children under 15 years of age," the WHO noted on its website. "Infants and children under five years of age are at highest risk of severe disease and death." The CDC's alert also highlighted that outbreaks in some provinces of the DRC have been linked to sexual contact, while other cases have been attributed to contact with infected animals, household transmission, or patient care.
In response to the outbreak, U.S. officials have committed $424 million in aid to the DRC, including 50,000 doses of the Jynneos mpox vaccine and $10 million in health assistance. This assistance is part of a broader package that includes over $170 million in agricultural commodities. The health aid aims to support critical public health interventions in the region, which has struggled with mpox outbreaks for decades but lacks the infrastructure for widespread vaccine distribution.
The WHO's Director-General Dr. Tedros Adhanom Ghebreyesus announced that he will convene an emergency committee to assess whether the mpox outbreak should be declared a global public health emergency. This move underscores the urgency and potential global impact of the outbreak.
Despite the rise in cases, the CDC has indicated that the risk of clade 1 mpox being imported to the U.S. remains low due to the limited number of travelers and the lack of direct commercial flights from the DRC. However, the agency stressed the importance of vigilance among healthcare providers.
Epidemiologists and health officials are particularly concerned about the rapid spread and high mortality rate of clade 1 mpox. The DRC has seen a 160% increase in mpox cases this year compared to 2023, with outbreaks reported in 15 African countries. The virus causes fever, chills, swollen lymph nodes, fatigue, and muscle aches, and can be deadly, especially for young children, pregnant women, and individuals with weakened immune systems.
The Jynneos vaccine, produced by Bavarian Nordic, is effective against both clade 1 and clade 2 mpox strains. Alongside Jynneos, the Japanese-made LC16 vaccine from KM Biologics has been authorized for emergency use
