The escalating mpox outbreaks, marked by new and potentially more severe strains, are sparking concerns among health experts about the adequacy of current containment measures. The World Health Organization (WHO) recently declared mpox a global public health emergency after the outbreak, initially concentrated in the Democratic Republic of Congo (DRC), spread to non-endemic countries like Sweden, Pakistan, and Thailand.

This new outbreak is characterized by a recently identified clade 1b subvariant, which may present increased transmissibility and severity compared to previous strains. “Clade 1b has recently emerged and there are many unknowns that need to be addressed,” noted Trudie Lang, professor of global health research at the University of Oxford. “There is emerging evidence of differences in transmission and symptoms; such as more commonly passed person to person and from mothers to their babies in pregnancy,” she added.

The outbreak has been observed to affect young people disproportionately and appears to spread through sexual networks, as reported by Jonas Albarnaz, a research fellow at The Pirbright Institute. However, he emphasized the need for further data to fully understand its transmission dynamics and to develop effective control strategies.

The outbreak is particularly alarming in regions with high rates of immunocompromised individuals, including those with HIV, where the disease’s severity is amplified. “As mpox disease is more severe in immunocompromised individuals, it is also a concern that the current outbreak is taking place in a region where HIV prevalence is relatively high but access to antiretroviral drugs is poor,” said Brian Ferguson, associate professor of immunology at the University of Cambridge.

The DRC, struggling with ongoing conflicts and high numbers of displaced people in refugee camps, has exacerbated the outbreak’s spread due to deteriorating sanitation conditions. According to the WHO, over 15,000 cases and at least 537 deaths have been reported this year alone.

Ferguson criticized the global response, noting that lessons from the previous outbreak, which was declared a public health emergency in July 2022 and later removed in May 2023, have not been adequately applied. “The lack of activity in the intervening period has resulted in what could now become a new global outbreak. There should have been a greater effort to produce and distribute vaccines to the affected areas, but this has not happened,” he said.

In response, Danish biotech firm Bavarian Nordic is considering ramping up production of its approved mpox vaccine. The company recently submitted data to the European Union’s drug regulator for extending vaccine use to adolescents. “More than 70% of the cases in Africa currently are in people younger than 18, so it’s going to be critical that our vaccine can be used in this younger age group,” said CEO Paul Chaplin. The decision to increase production will be crucial in addressing the growing global threat of mpox.

The situation underscores the urgent need for improved international cooperation and vaccine availability to manage and contain the spread of mpox effectively.

(Adapted from CNBC.com)

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