The World Health Organization has declared the latest outbreak of monkeypox in Africa a “public health emergency of international concern,” a category used in the past for Ebola, COVID-19 and a spike in monkeypox cases in Europe in 2022.
In her report published by the British newspaper “The Guardian”, writer Kat Lay said that many countries in Africa are witnessing more cases of monkeypox, as the deadly virus crosses national borders, with fears that it may cause a major global outbreak.
Here’s what we know so far.
What is monkeypox?
The writer mentioned that monkeypox is an infectious disease caused by a virus, and its symptoms are usually similar to the flu, such as fever, chills, muscle aches, and a rash that begins in the form of spots that turn into fluid-filled blisters, and these blisters eventually form crusts.
There are two widely different types, known as “branches,” the first group was once known as the Congo Basin branch, and the second as the West African branch, both of which can be deadly although the first group has historically had a higher mortality rate.
What does a WHO emergency declaration mean?
According to the writer, the WHO’s declaration of a state of emergency aims to urge donor agencies and countries to act, and medical experts urged the declaration to accelerate access to tests, vaccines and therapeutic drugs in affected areas, and to launch campaigns to reduce the stigma surrounding the virus, but the global response to previous declarations has been mixed.
The agency’s declaration of a public health emergency was intended to “mobilize our institutions, our collective will and our resources to act quickly and decisively,” said Gen. Dr. Jean Cassia, director of the Africa CDC, who appealed to Africa’s international partners for help, saying the surge in cases in Africa had been largely ignored.
“It is clear that current control strategies are not working and there is a clear need for more resources,” said Michael Marks, professor of medicine at the London School of Hygiene & Tropical Medicine. “If a global emergency declaration is the mechanism to open these things up, it is justified.”
Where does infection occur?
The writer reported that according to a media briefing by the Africa Centers for Disease Control and Prevention, 34 countries in Africa are either reporting cases or are considered “at high risk.”
The Democratic Republic of the Congo is experiencing a severe outbreak, with more than 14,000 cases and 524 deaths recorded since the beginning of 2024. Outbreaks in the Democratic Republic of the Congo are not unusual, but this year’s figure already matches the total for the whole of 2023, and includes cases in provinces that were not previously affected.
Infections are also being reported in Burundi, Kenya, Rwanda and Uganda, countries neighbouring the DRC where no cases have been recorded previously.
Why are infections rising now?
The writer noted that a new branch of the first lineage, lineage 1B, has been discovered in eastern Democratic Republic of the Congo and has been confirmed in Kenya, Rwanda and Uganda. Scientists believe this variant is playing a role in the spread.
In the past, strain 1 was usually spread by people eating infected bushmeat, and strain 1B is spread from person to person, mostly through sexual contact, but also through face-to-face physical contact, or through contaminated bedding or towels.
“We don’t know if it’s more transmissible, but it’s being transmitted in an efficient way,” said WHO Director-General Dr Rosamund Lewis.
Other forms of the virus are still circulating, with the Democratic Republic of the Congo also recording cases of the first strain A, as well as the Central African Republic, and the second strain has been reported in Cameroon, Ivory Coast, Liberia, Nigeria and South Africa, according to the World Health Organization.
The increase comes amid high levels of insecurity in the region, and the climate crisis that is bringing humans closer to nature, which are also factors according to Dr. Jean Cassia, head of the Africa CDC.
How does it spread and why are children disproportionately affected?
The virus crosses borders with infected people on the move, and Kenyan authorities have diagnosed monkeypox in a long-haul truck driver who had also been to Rwanda, Tanzania and Uganda.
Monkeypox is also spread through sexual contact, and sex workers originally made up a high percentage of those infected.
During the global monkeypox outbreak in 2022, gay and bisexual men made up the vast majority of cases and the virus spread mostly through close contact.
Although some similar patterns have been observed in Africa, children under 15 years of age currently account for more than 70% of monkeypox cases and 85% of deaths in the Congo.
Experts said this may reflect differences in their immune systems, with high rates of malnutrition making children vulnerable to infection. While older people in the region may have received the smallpox vaccine, which provides some protection, that is not the case for younger generations.
Greg Ram, Save the Children’s country director in Congo, said the organization was particularly concerned about the spread of amoxicillin in crowded refugee camps in the east, noting that 345,000 children were “crammed into tents in unsanitary conditions.”
Do we have vaccines?
The writer mentioned that there are vaccines, but there are problems in delivering them; Africa needs 10 million doses, but there are only 200,000 doses available, and thus the lack of treatments and diagnostics is hampering the response.
Vaccination programme plans are still under review but are likely to involve tracing and vaccinating contacts of cases, and targeting groups such as people with HIV who appear to be at higher risk of serious illness.
The World Health Organization has issued an emergency use listing for two vaccines, allowing organizations such as Gavi and UNICEF to purchase them for distribution.
What happened with the last major outbreak?
The author concluded the report by saying that in 2022, a global pandemic spread from Europe, and particularly affected the gay community. In July of that year, the World Health Organization declared a public health emergency, rolled out contact tracing programs and mass vaccination, and lifted the state of emergency in May 2023 after about 90,000 people were infected.