Mpox remains public health emergency of international concern

The World Health Organisation (WHO) has maintained that Mpox, formerly known as monkeypox, continues to constitute a Public Health Emergency of International Concern (PHEIC).

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WHO Director-General, Tedros Ghebreyesus, made this declaration following the fourth meeting of the International Health Regulations (IHR) Emergency Committee held on 5 June, where global health experts reviewed the situation and advised to uphold the emergency status.

In a statement, Mr Ghebreyesus said that although some countries have made progress in responding to the outbreak, the overall situation remains concerning.

He noted that the decision was influenced by the continuous increase in Mpox cases, including a recent surge in West Africa, and likely undetected transmission in countries beyond the continent.

“Ongoing operational challenges in responding to the event, including concerning surveillance and diagnostics, as well as a lack of funding, make prioritising response interventions challenging and require continued international support,” he said.

Mpox, a viral disease related to smallpox, has seen a resurgence in several regions, especially in Central and West Africa.

PREMIUM TIMES review of WHO global Mpox trends shows that the Democratic Republic of the Congo (DRC) remains the epicentre, consistently reporting between 200 and 600 new weekly cases.

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The chart also reveals a slight increase in countries like Uganda and Burundi, while newer cases have emerged in Nigeria, Sierra Leone, and Liberia, regions that had previously seen minimal cases.

Global spread of Mpox

Mpox continues to spread across multiple regions of the world, with outbreaks involving both Clade I and Clade II of the virus.

According to the CDC’s latest situation report, clade I Mpox is responsible for sustained transmission in countries such as Burundi, the Democratic Republic of the Congo (DRC), Kenya, Malawi, Rwanda, South Sudan, Tanzania, Uganda, and Zambia, with additional reports from the Central African Republic and Republic of the Congo.

Clade I Mpox has also led to localised person-to-person outbreaks in non-endemic countries, facilitated by sexual contact, household exposure, and healthcare-associated spread, particularly in the absence of protective measures.

As of 2 June, travel-related cases of clade I Mpox have been reported in countries beyond Africa, including Australia, Brazil, China, Germany, India, the United Kingdom, the United States, and several others.

Meanwhile, the CDC noted that the global outbreak of clade II Mpox, driven by subclade IIb, has surpassed 100,000 cases across 122 countries, 115 of which had not previously reported Mpox.

CDC data as of 3 June shows Nigeria has recorded 332 cases and three deaths so far.

Revised recommendations

Mr Ghebreyesus also issued the committee’s revised temporary recommendations to member states experiencing Mpox outbreaks to guide efforts to prevent and control spread of the disease.

According to him, the full report of the fourth meeting will be issued in the third week of June.

“The upsurge of Mpox in the Democratic Republic of the Congo and its spread to neighbouring countries was first determined to be PHEIC by Ghebreyesus on 14 August, 2024,” he said.

“Since then, the committee has met on three additional occasions, each time advising the director general that the event continues to constitute a PHEIC.”

Countries are also advised to improve disease surveillance systems to detect and report new cases promptly, enhance diagnostic capabilities, and investigate outbreaks to better understand transmission dynamics.

WHO urged countries to provide comprehensive clinical, nutritional, and psychosocial support to Mpox patients, including those in isolation or receiving home-based care.

READ ALSO: WHO issues temporary recommendations to control Mpox spread

It also highlighted the need to extend these services to vulnerable groups such as children, pregnant women, and people living with HIV, many of whom face a higher risk of complications due to untreated or advanced infections.

The recommendations call for testing and treatment for other sexually transmitted infections (STIs) in cases linked to sexual contact and suggest offering HIV tests where status is unknown.

It added that frontline health workers are to be equipped with personal protective equipment and trained on infection prevention and control to protect themselves and their patients.