Hundreds of deaths from mpox have been recorded in the Democratic Republic of Congo
Swedish health officials have confirmed the country’s first case of a highly infectious form of mpox, which was initially identified in eastern Congo. This announcement came just one day after the World Health Organization (WHO) declared the outbreaks in Congo and other African regions a global emergency.
The Swedish public health agency reported that the patient sought medical care in Stockholm after returning from Africa. According to the agency, the individual contracted the infection during their stay in the region of Africa experiencing a significant outbreak of this more contagious strain of mpox.
Magnus Gisslén a state epidemiologist with the Swedish health agency stated that the individual has been treated and provided with “rules of conduct” for managing their condition. Officials emphasized that while mpox is present in Sweden it does not pose a significant risk to the general population with the estimated risk considered “very low.” However they noted that occasional imported cases might still occur.
Earlier this year, scientists identified a new more dangerous form of mpox in a Congolese mining town. This strain which can be fatal for up to 10% of those infected is feared to spread more easily. Mpox mainly spreads through close contact with infected individuals including sexual contact.
The WHO reported over 14,000 cases and 524 deaths across more than a dozen African countries this year exceeding last year’s figures Notably over 96% of these cases and deaths have occurred in Congo.
Given the advanced healthcare resources available in Sweden and other affluent nations scientists believe that if new outbreaks linked to the Congo strain are detected transmission could be contained relatively quickly.
Mpox, which typically spreads through close contact, is usually mild but can be fatal in rare cases. It typically presents with flu-like symptoms and pus-filled lesions on the skin.
The outbreak in Congo initially involved an endemic strain known as clade I, but a new variant, clade Ib, has now emerged. This new variant appears to spread more easily through routine close contact, including sexual contact.
The new variant has spread beyond Congo to countries such as Burundi, Kenya, Rwanda, and Uganda, prompting the WHO to take emergency action.
The detection and rapid spread of a new clade of mpox in eastern DRC its spread to neighboring countries that had not previously reported mpox, and the potential for further transmission are deeply concerning,” said WHO Director-General Tedros Adhanom Ghebreyesus. within Africa and beyond is deeply concerning ” WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday.
In response, the WHO has released USD 1.5 million in contingency funds and plans to provide additional funding in the coming days. The organization’s initial response plan requires USD 15 million and will seek additional funding from donors.
Mpox, formerly known as monkeypox, is transmitted through close contact, such as sexual activity, skin-to-skin contact, and breathing or talking near another person. It causes flu-like symptoms, skin lesions, and can be fatal, with about 4% of cases leading to death. Mpox is most common in the tropical rainforests of West and Central Africa, with thousands of infections occurring each year.
Currently, multiple outbreaks are occurring simultaneously, partly driven by the newer and more severe Clade 1b, identified in September last year. There are two types of Clade 1, and the Swedish case has been identified as Clade 1b. Since the emergence of Clade 1b in the Democratic Republic of Congo, there have been confirmed cases in Burundi, Kenya, and Rwanda, with the recent case in Sweden marking the first instance outside Africa.
Although Clade 2 caused a public health emergency in 2022, it was relatively mild, with about 300 cases reported in Sweden. WHO/Europe is actively working with Swedish health authorities on managing the first confirmed case of mpox Clade 1b and urges other countries to respond quickly and transparently. There are likely to be more imported cases of Clade 1 in Europe in the coming days and weeks.
The Swedish public health agency indicated that the more dangerous outbreak is associated with a higher risk of severe disease and increased mortality. Dr. Jonas Albarnaz, a pox virus specialist at the Pirbright Institute, noted that the first case outside Africa is concerning, suggesting a potentially larger spread than previously known. Dr. Brian Ferguson, Associate Professor of Immunology at the University of Cambridge, also expressed concern but found the development unsurprising given the outbreak’s severity in Africa.
The WHO hopes its declaration of mpox as a public health emergency of international concern will prompt greater support for the affected areas. Although vaccines are available for those at high risk or in close contact with infected individuals, there are concerns about insufficient doses and funding to reach those who need them most.
The mortality rate for the Clade 1b variant in Sweden is expected to be lower than in Africa due to Europe’s high-quality healthcare. However, Dr. Ferguson anticipates more cases in Europe and elsewhere, as there are currently no mechanisms to prevent imported cases. According to the European Centre for Disease Prevention and Control, symptoms typically appear 6-13 days after infection and include fever, headache, rash, sores, and muscle ache. Most people experience mild to moderate symptoms and recover fully, though immunocompromised individuals are at higher risk.
While the news of the first case outside Africa may be alarming, it was expected. As previous outbreaks have shown, swift international action can help prevent further spread of the disease.