The World Health Organization (WHO) on August 14, 2024, declared mpox as a global health emergency calling for a concerted effort across continents to contain the latest outbreak, which at the time, was largely localised to some African countries.

The global health outfit declared the disease as a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR). 

The IHR Emergency Committee of independent experts arrived at their decision after considering the upsurge of mpox and its potential of spreading further across Africa and possibly outside the continent.

At the time of the declaration, the bulk of confirmed cases were in the Democratic Republic of Congo (DRC) from where it is believed to have spread to neighbouring Uganda, Rwanda, Kenya and Burundi.

Beyond East Africa, Ivory Coast (West Africa) and South Africa (Southern Africa) have also reported cases.

Mpox has been on WHO alert since 2022 when the global health body issued a similar alert following a major outbreak in the Americas and Europe. Ghana was among the countries in the global south that recorded cases.

The Director-General of the WHO, Tedros Adhanom Ghebreyesus, said while declaring the emergency: “The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”

GHS issues three working definitions of mpox

In preparedness, the Ghana Health Service (GHS) on August 15, 2024, issued a statement signed by Dr Patrick Kuma Aboagye, GHS Director-General, highlighting three working definitions of how to detect mpox.

  1. Suspected case: An acute illness with fever > 38°C, intense headache, lymphadenopathy, back pain, myalgia, and intense asthenia followed one to three days later by a progressively developing rash often beginning on the face and then spreading elsewhere on the body, including soles of feet and palms of the hand.

  2. Probable case: A case that meets the clinical case definition, is not laboratory confirmed, but has an epidemiological link to a confirmed or probable case.

  3. Confirmed case: A clinically compatible case that is laboratory-confirmed. All suspected cases of Monkeypox should be investigated. Management is supportive and may include antipyretic treatment for fluid and electrolyte imbalance and oxygen when needed. Give empirical antibiotic therapy if secondary bacteria infection is suspected and then Acyclovir if Varicella zoster infection is suspected.

Here is a fact sheet to help to know what mpox is about, and how it can be contracted and prevented.

What is Mpox?

According to the CDC, it is “a disease caused by infection with a virus, known as Monkeypox virus. This virus is part of the same family as the virus that causes smallpox.” 

Being a zoonotic disease, means it can be spread between animals and people. It is endemic, or found regularly, in parts of Central and West Africa. The virus that causes mpox has been found in small rodents, monkeys, and other mammals that live in these areas. Mpox is not related to chickenpox.

Infection and key symptoms 

The incubation period (interval from infection to onset of symptoms) of mpox is usually from 6 to 13 days but can range from 5 to 21 days.

The infection is divided into two periods

The invasion period (which lasts between 0–5 days) is characterised by fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches) and intense asthenia (lack of energy). Lymphadenopathy is a distinctive feature of monkeypox compared to other diseases that may initially appear similar (chickenpox, measles, smallpox)

The skin eruption usually begins within 1–3 days of the appearance of fever. The rash tends to be more concentrated on the face and extremities rather than on the trunk. It affects the face (in 95% of cases), palms of the hands and soles of the feet (in 75% of cases).

Also affected are oral mucous membranes (in 70% of cases), genitalia (30%), conjunctivae (20%), as well as, the cornea.

The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off.

The number of lesions varies from a few to several thousand. In severe cases, lesions can coalesce until large sections of skin slough off.

Virus Types

There are two types of Monkeypox virus: clade I and clade II.

Clade I causes more severe illness and death. Some outbreaks have killed up to 10% of the people who get sick, although more recent outbreaks have had lower death rates. Clade I is endemic to Central Africa.

Clade II is the type that caused the global outbreak that began in 2022. Infections from clade II mpox are less severe. More than 99.9% of people survive. Clade II is endemic to West Africa.

Both types of the virus can spread through:

  1. Direct contact with infected animals
  2. Close contact (including intimate contact) with a person with mpox
  3. Direct contact with contaminated materials
  4. Risk of Severe Disease

Although cases of mpox are not life-threatening, some people may be more likely to get severely ill, including

  1. People with severely weakened immune systems
  2. Children younger than 1
  3. People with a history of eczema
  4. People who are pregnant

Preventing Mpox

There are several ways you can protect yourself and others from mpox, including:

  1. Avoid close, skin-to-skin contact with people who have a rash that looks like mpox and animals that carry the mpox virus.

  2. Learning steps you can take to lower your risk of mpox during sex or at a social gathering.

  3. Get vaccinated. Check with your healthcare provider to find out if the mpox vaccine is recommended for you. 

Some key facts about Mpox

  1. The Mpox virus was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox” originally, the source of the disease remains unknown. Scientists suspect African rodents and non-human primates (like monkeys) might harbour the virus and infect people.

  2. The first human case of mpox was recorded in 1970, in what is now the Democratic Republic of the Congo. 

  3. In 2022, mpox spread around the world. Before that, cases of mpox in other places were rare and usually linked to travel or to animals being imported from regions where Mpox is endemic.

  4. WHO renamed the disease in 2022 to follow modern guidelines for naming illnesses. Those guidelines recommend that disease names avoid offending cultural, social, national, regional, professional or ethnic groups and minimize unnecessary negative effects on trade, travel, tourism or animal welfare. The virus that causes it still has its historic name, however.

  5. It is a zoonotic disease, meaning it can be spread between animals and people. It is endemic, or found regularly, in parts of Central and West Africa. The virus that causes mpox has been found in small rodents, monkeys, and other mammals that live in these areas. Mpox is not related to chickenpox.

By: Alfa Shaban