Declared a public health emergency of international concern¹ in August 2024 by the World Health Organisation (WHO), Mpox, formerly known as monkeypox, is a rare but highly contagious disease that is endemic in parts of Central and West Africa². With the potential to spread to other countries in Africa and beyond, Mpox is garnering renewed interest as nations buckle down on efforts to monitor and manage cases. As of 5 September 2024, Singapore has detected 15 cases of the milder clade II and no cases of clade I³.
This article explains what you need to know about Mpox in 2024.
Understanding Mpox
Mpox is a viral illness caused by the monkeypox virus (MPXV), with two main types: clade I and clade II. The virus itself is closely related to smallpox but has lower fatality, reduced transmissibility and causes milder symptoms. It is a zoonotic disease that can be acquired from contact with or exposure to infected animals and humans.
- Clade I: Clade I originates from Central Africa and is more infectious and deadly, especially for individuals who are immunocompromised. It is responsible for the recent outbreak in the Democratic Republic of Congo (DRC) and spreads primarily through direct contact⁴.
- Clade II: Clade II originates from West Africa and causes less severe illness than clade I. The mortality rate for clade II is about 2.2%, according to a research study published by the CDC⁵.
Current Mpox Situation
The resurgence of Mpox sees an uptick in cases of both clade I and II infections exceeding 102,900, with up to 219 deaths reported across 121 countries since monitoring began in 2022³. The DRC has been the most affected, with over 5,000 confirmed cases and 700 deaths⁶ recorded in the first three quarters of this year. This spike is driven by the highly aggressive clade I variant, following the clade II outbreak that occurred in 2022.
In Singapore, all documented Mpox infections have been of the milder clade II. So far in 2024, a total of 14 cases have been reported in the country.
Countries at Risk of Mpox
The Ministry of Health⁷ identifies ten countries at risk of Mpox transmission. These include regions in Central Africa (Burundi, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Republic of Congo, and Rwanda), East Africa (Kenya and Uganda), and South Asia (India, specifically Kerala).
While these countries are primarily those where Mpox is endemic or neighbouring countries, this does not mean that other regions are entirely free from the threat of the disease. Spread can still occur due to international travel or animal trade⁸.
Mode of Transmission
Mpox is transmitted from one person to another through direct physical contact with an infected individual. It can also be spread through skin lesions and bodily fluids, as well as by coming into contact with contaminated surfaces and environments. The virus can also be passed from infected animals to humans through bites, scratches, and other bodily secretions.
Signs and Symptoms
Symptoms of Mpox typically appear within 21 days after exposure and can easily be mistaken for the flu. However, these symptoms are usually followed by skin rashes that manifest on the face, hands and feet, gradually spreading to other parts of the body. The rashes can last up to four weeks and tend to progress from flat sores to blisters before scabbing and falling off.
The most common symptoms include:
- Fever
- Headache
- Muscle aches and back aches
- Fatigue
- Swollen lymph glands
Vulnerable Populations
People who have had close contact with infected individuals are at risk of contracting the virus. Healthcare workers and those living in the same household are also vulnerable. Close contact includes skin-to-skin, mouth-to-mouth and mouth-to-skin interactions. Touching surfaces contaminated by respiratory droplets from Mpox-infected individuals can also increase susceptibility to transmission.
These other groups face an elevated risk of contracting Mpox:
- Immunocompromised Individuals: Individuals with weakened immune systems are at a greater risk of experiencing severe or prolonged illness because their bodies’ ability to fight off infections is reduced. Additionally, those with existing chronic conditions may be more prone to complications.
- Young Children and Pregnant Women: Children’s immune systems are still developing⁹, and their difficulty in maintaining careful contact can make them more vulnerable to infection. Infants under one year old and pregnant women are particularly at higher risk of developing severe cases of Mpox.
- Travellers From Countries with Mpox: Travellers who may have had close contact with individuals infected with Mpox in endemic areas, or have been in places where community transmission can occur, may deal with greater Mpox risk.
Treatment and Prevention of Mpox
Most treatment for Mpox is symptomatic, focusing on alleviating symptoms such as fever and pain. Moreover, some products used to treat smallpox, like the antiviral tecovirimat¹⁰, may also be used to address Mpox. It is essential to manage the symptoms of Mpox as soon as possible to prevent complications.
To curb the spread of Mpox, several measures can be taken to avoid transmission. This includes receiving the MVA-BN (JYNNEOS) vaccine if it is recommended for you⁷, the LC16, or the ACAM2000 vaccine if the others are unavailable¹⁰. It is important to consistently minimise close interactions with individuals infected with Mpox and those exhibiting rashes, reduce contact with their belongings, and practise good personal hygiene. You can also protect yourself by refraining from travelling to areas where Mpox is prevalent.
Find out about travel-related illnesses here. For more information, contact ID Specialists directly.
References
- WHO Director-General declares Mpox outbreak a public health emergency of international concern. World Health Organization. https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern. Accessed October 8, 2024.
- Clade I Mpox in Central and Eastern Africa. CDC. https://wwwnc.cdc.gov/travel/notices/level2/clade-1-mpox-central-eastern-africa. Accessed October 8, 2024.
- Public health preparedness measures to handle Mpox. Ministry of Health. https://www.moh.gov.sg/newsroom/public-health-preparedness-measures-to-handle-mpox. Accessed October 8, 2024.
- Mpox Outbreak Clade I vs Clade II. Johns Hopkins Bloomberg School of Public Health. https://publichealth.jhu.edu/sites/default/files/2024-06/mpox-clad-i-vs-ii.pdf. Accessed October 8, 2024.
- Djuicy DD, Sadeuh-Mba SA, Bilounga CN, et al. Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979–2022. Emerging Infectious Diseases. 2024;30(3):432-443. doi:10.3201/eid3003.230861. Accessed October 8, 2024.
- UNICEF scales up efforts to protect children from Mpox outbreak in the Democratic Republic of the Congo. Unicef. https://www.unicef.org/press-releases/unicef-scales-efforts-protect-children-mpox-outbreak-democratic-republic-congo. Accessed October 8, 2024.
- Mpox. Ministry of Health Singapore. https://www.moh.gov.sg/diseases-updates/mpox. Accessed October 8, 2024.
- Tosh P. Monkeypox: What is it and how can it be prevented? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/infectious-diseases/expert-answers/monkeypox-faq/faq-20533608. Accessed October 8, 2024.
- What is Mpox and how is it spread? BBC. https://www.bbc.com/news/articles/cxww2dxr3mko. Accessed October 8, 2024.
- Mpox. World Health Organization. https://www.who.int/news-room/questions-and-answers/item/mpox. Accessed October 8, 2024.