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Mpox
Context:
The Democratic Republic of Congo (DRC), the epicentre of a rapidly spreading Mpox outbreak, has received its first shipment of Mpox vaccines.
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- Since January 1, 2022, Mpox cases have been reported in 121 countries, including 20 WHO member states across Africa.
- As of September 5, 2024, a total of 103,048 laboratory-confirmed cases and 229 deaths have been recorded globally since the beginning of 2022.
- On Monday, India also reported its first Mpox case, linked to international travel.
- Despite rising cases, Africa faces a severe vaccine shortage, with only the DRC and Nigeria receiving Mpox vaccines, contributing to the virus’s rapid spread and the WHO’s recent global health emergency declaration.
What is Mpox?
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- Mpox is an infectious disease that can cause a painful rash, swollen lymph nodes, fever, headache, muscle aches, back pain, and fatigue.
- Mpox is caused by the monkeypox virus (MPXV), a double-stranded DNA virus from the Orthopoxvirus genus in the Poxviridae family, which also includes viruses like variola, cowpox, and vaccinia.
- There are two distinct clades of the virus: clade I (with subclades Ia and Ib) and clade II (with subclades IIa and IIb).
- Although the virus’s natural reservoir remains unknown, small mammals such as squirrels and monkeys are known to be susceptible to MPXV.
Transmission:
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- The virus spreads from person to person through direct contact with infectious sores, scabs, or body fluids.
- Mpox can be transmitted through close contact with someone who has Mpox, with contaminated materials, or with infected animals.
- During pregnancy, the virus may be passed to the foetus, or to the newborn during or after birth.
Vaccines used
- Currently, three vaccines are available for Mpox, all based on weakened versions of vaccinia, the live virus used in the smallpox vaccine.
- The most widely used vaccine is Modified Vaccinia Ankara (MVA), made by Denmark’s Bavarian Nordic, and approved for Mpox by both the US FDA and the European Medicines Agency (EMA). The DRC has received this vaccine.
- Another vaccine, LC16m8, is produced by Japan’s KM Biologics and is approved for Mpox only by Japan’s regulatory authority.
- The third, ACAM2000, made by US-based Emergent BioSolutions, was approved for Mpox by the FDA last month.
Why did Africa not get Mpox vaccines sooner?
- Africa did not receive Mpox vaccines sooner primarily due to their high cost, ranging from $50 to $75 per dose, according to the WHO.
- As a result, African countries rely on donations from developed nations and vaccine producers, as well as purchases through organisations like Gavi (the Vaccine Alliance) and UNICEF.
- However, Gavi and UNICEF can only procure vaccines after the WHO issues an Emergency Use Listing or full approval, which requires companies to submit efficacy and safety data.
Mpox and Smallpox are different diseases, though both are caused by Orthopoxviruses. Smallpox was more severe and had a higher mortality rate, whereas Mpox typically leads to a milder illness. Mpox can affect anyone through close contact with infected individuals or contaminated materials and is not limited to any particular group or geographic area. Mpox is less easily spread than viruses such as the flu. It generally requires close, prolonged contact for transmission.
