Mpox is not just an African problem

Mpox, once called Monkey Pox, is now officially a global public health emergency (again) according to the World Health Organization.

(Incidentally, "mpox" is the new name for what was known for decades as "monkeypox". It was decided that the "monkey" label plays into "racist and stigmatizing language", although this is never clearly explained. Plus, monkeys are not the main spreaders of the virus; rodents are. Presumably "rodentpox" was considered and rejected.)

The viral infection started in the Democratic Republic of the Congo (DRC), and the general perception is that it is very much an African disease and an African problem. But a map of the worldwide incidence of the disease tells a very different tale:

Yes, the majority of cases are in the USA and Brazil, followed by Canada, the rest of South America, China, and Western Europe. Only then do you get to the Democratic Republic of the Congo and, still less affected, some of the neighbouring African countries.

So, what gives? Well, I guess the main point is that the USA and Canada is well-positioned to deal with an outbreak, including access to plentiful vaccines; DRC and neighbouring countries not so much. 

The USA is donating 50,000 doses of the vaccine to Africa, which is something but much less than needed, as well as nearly half a billion dollars in humanitarian aid. Europe is donating some 215,000 doses. Canada has yet to announce any such donation, despite having a stockpile of millions of doses.

The other thing is that a new variant of the virus, known as Clade 1b, is starting to take hold in DRC, triggering more severe illness and an increased fatality rate (around 3-4%), and WHO really does not want this new variant spread across the globe. This new, Clade 1b-dominant outbreak can almost be considered an entirely new outbreak. Currently, WHO is reporting 17,000 cases and 500 deaths worldwide, but over 96% of them have been in DRC.

Is mpox the new COVID-19, then? Probably not. It does not spread as easily as COVID, and it is easier to prevent and contain. It is, in the main, not airborne, and typically requires close, skin-to-skin contact to spread. Plus, we already have effective vaccines. 

Should we be wary of it, then? Oh, yes. It is especially transmissible through skin cuts and mucus membranes, which is why so may cases are occurring through sexual contact, particularly among men whom have sex with men, raising some raw memories of the HIV/AIDS epidemic of the 1980s.

UPDATE

The proverbial cat is probably already out of the proverbial bag, as a case of the Clade 1b mpox virus has now reported in Sweden, in a person recently returned from Africa. In practice, this probably means that there are more cases already in Sweden, and possibly elsewhere in the world outside of West Africa.