The World Health Organization declared an international health emergency on Wednesday over a large and rapidly growing outbreak of mpox spreading from the Democratic Republic of Congo.
It is the second time in about two years that the spread of mpox has prompted the WHO to declare a public health emergency of international concern (PHEIC), the highest level of alert for the United Nations health agency. In July 2022, the WHO declared a PHEIC after mpox cases spread across the world, with the epicentre of the outbreak in Europe, primarily in men who have sex with men. The outbreak was caused by clade II mpoxviruses, which, of the two clades of mpox, is the relatively mild one, causing far fewer deaths. As awareness, precautions and vaccination increased, the outbreak subsided and was declared over in May 2023.
Unlike the 2022-2023 outbreak, the current MPOX outbreak is caused by the clade I virus, the more dangerous version that causes more severe disease and more deaths. Also, in the previous outbreak, the clade II virus unexpectedly spread through sexual contact among adults, but this clade I outbreak is spreading through more classic contact patterns, mainly skin-to-skin contact between household members and healthcare workers. A large proportion of those infected are children.
To date, the Democratic Republic of Congo (DRC), where the virus is endemic, has reported more than 22,000 suspected MPOX cases and more than 1,200 deaths since early January 2023. In recent months, the outbreak has spread to several neighboring countries, including Burundi, the Central African Republic, the Republic of Congo, Rwanda, Kenya and Uganda.
Earlier on Wednesday, WHO convened an emergency committee to assess the situation, with experts from affected countries presenting data to independent international experts. The committee concluded that the outbreak constituted a PHEIC, and WHO Director-General Dr. Tedros Adhanom Ghebreyesus followed their recommendation.
“The emergence of a new clade of mpox, its rapid spread in eastern DRC and the reporting of cases in several neighbouring countries are very worrying,” Tedros said in a statement announcing the PHEIC. “In addition to outbreaks of other mpox clades in DRC and other countries in Africa, it is clear that a coordinated international response is needed to stop these outbreaks and save lives.”
On Tuesday, the Africa Centers for Disease Control and Prevention declared a similar emergency. Africa CDC Director-General Dr. Jean Kaseya said the declaration “will mobilize our institutions, our collective will and our resources to act quickly and decisively. This will allow us to forge new partnerships, strengthen our health systems, educate our communities and deliver life-saving interventions where they are needed most.”
For now, the U.S. Centers for Disease Control and Prevention rates the risk to the American public as “very low,” as there is limited and no direct travel between the U.S. and the outbreak’s epicenter. So far, no clade I cases have been detected outside of Central and East Africa.
