The first case of Mpox clade 1b strain was officially reported in India on Monday in a man hailing from Kerala who recently visited United Arab Emirates. This is the first case of this strain as earlier a man in Haryana had tested positive for clade 2 strain making it the first case in the country since World Health Organisation had called this disease a public health emergency.
In its warning for the health emergency, WHO mentioned the spread of clade 1b strain as it is considered far more virulent than the clade 2 strain of the Mpox.
The clade 1 strain was previously known as the Congo Basin strain has a higher mortality rate of up to 10 per cent compared to the clade 2 strain, as per reports.
The ongoing outbreak is centered in South Kivu province, eastern Democratic Republic of the Congo (DRC), and poses a risk for a pandemic.
This outbreak has exhibited the pattern of spreading through human contact, sexual contact and even though it mostly affects adults, there are several children who have been affected by the virus as well.
Accoridng to a report in Nature, "Clade Ib seems to be different, and is spreading largely through contact between humans, including through sex. Around 18,000 suspected cases of mpox, many of them among children, and at least 600 deaths potentially attributable to the disease have been reported this year in the DRC alone."
A major part of the African population face secondary health conditions including HIV and malnitrition which further increases the death rates.
Untreated HIV can lead to faster deaths and compromised immunity of the individuals and children under the age of 5 suffering from malnutrition may also find it difficult to survive the virus.
The virus belongs to the newly defined clade Ib lineage, which shows mutations indicating human-to-human spread that may have begun in September 2023.
Case numbers are rising rapidly, but many suspected cases likely go untested and uncounted due to a testing method that misses infections with this lineage.
Most affected individuals are adults, and the case fatality rate has increased compared to the 2022 global outbreak.
What Is Mpox?
Mpox is a viral infection caused by the monkeypox virus, which belongs to the Orthopoxvirus genus. There are two distinct variants of mpox, each affecting the severity of the disease and its impact on the populations affected.
What Are The Strains?
These strains are: clade 1b (The Central African (Congo Basin) strain) and clade 2 ( West African strain).
Mpox Symptoms:
Skin rash that develops into pus-filled blisters
High fever
Headaches
Muscle aches
Back pain
Low energy
Swollen lymph nodes
Sore throat
The blisters can appear on the palms of the hand and soles of the feet, face, mouth, throat, groin and genital areas, and anus.
How Does Mpox Spread?
Mpox is transmitted through skin-to-skin contact and can spread by being face-to-face with an infected person, as close interactions can release infectious respiratory particles.
The World Health Organization (WHO) states that individuals with multiple sexual partners are at a higher risk of contracting mpox.
Additionally, the virus can be transmitted through contaminated objects like clothing and linen, needle injuries in healthcare settings, or in community places such as tattoo parlors.
Infected individuals can spread the disease until all sores have healed and a new layer of skin has formed.
Children, pregnant women, and those with weakened immune systems are particularly vulnerable to mpox.
What needs to happen
A recent article we co-authored in The Lancet Global Health outlines what needs to be done to contain this outbreak and prevent it from turning into an epidemic, possibly even a pandemic.
Equitable access to diagnostic tests, vaccines and antiviral treatments requires political commitment and financial investments.
Scientific investigations are needed to learn more about exposure settings, transmission routes and clinical presentations.
It’s important to find the best ways to make these interventions.
We have proposed the establishment of an African-led, multidisciplinary, multi-country Mpox Research Consortium (MpoxReC) in Africa.
It should conduct research towards the elimination of mpox as a public health problem.
There is no doubt that a disease in one corner of the world can suddenly become a global heath threat. It’s time the global health system woke up to this reality.
