The World Health Organization issued a warning yesterday about monkeypox, officially classifying it as a “public health emergency of international concern,” the highest level of international health law alarm. They also identified a few features of the new mutant strain that make it more worrying than previous iterations.
The strain that circulated in 2022 got a lot of hype as the COVID-19 pandemic was still front and center in many people’s minds, but it ended up being far less threatening as it was spread largely through sexual contact among gay and bisexual men and was not particularly fatal.
However, the new strain has a much higher death rate, with the Centers for Disease Control and Prevention reporting that the new clade 1 strain can kill as many as 10% of individuals who contract it, while the previously circulating clade 2 strain had a 99% survival rate.
In some cases, the virus is being passed among people who are not believed to have had any sexual contact whatsoever, and most of the cases and deaths reported in the current outbreak in Congo have involved children. Authorities are not sure why this is the case. One infectious diseases expert said that it may be that children are more vulnerable, and that social factors such as exposure to parents with the disease and overcrowding may also be contributing factors.
Although this new strain can be passed through sexual contact like the previous one and is being transmitted through local sex work, it also appears to be spreading within households and from mothers to their children. Some cases have even been reported of person-to-person spread outside of homes and without any sexual contact, which means it has more opportunities to spread.
While it is currently confined to central Africa, there are concerns it could spread to other areas given its easier transmissibility. All confirmed cases of the stronger “Clade 1b” strain were initially limited to the Democratic Republic of the Congo, but authorities now claim that more than 100 confirmed cases have already been reported in nearby countries such as Uganda, Rwanda, Burundi and Kenya.
The chair of the WHO emergency committee, Dimie Ogoina, said: “It was unanimous that the current outbreak of mpox, upsurge of mpox, is an extraordinary event. What we have in Africa is the tip of the iceberg. … We are not recognizing, or we don’t have the full picture of, this burden of mpox.”
More hype or a genuine emergency?
If all of this turns out to be true, it is indeed quite worrying. However, there is also a possibility that this is being overblown, and some people believe the intention is to drive demand for vaccines given how profitable they proved to be during the COVID-19 pandemic.
Last week, World Health Organization officials said the virus can be contained “quite straightforwardly, if we do the right things at the right time” and WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday: “It’s clear that a coordinated international response is essential to stop these outbreaks and save lives.”
They have signed off on an Emergency Use Listing process for the two existing monkeypox vaccines. There are currently half a million doses of the vaccines in stock, and they predict that another 2.4 million could be made by the end of the year.
Not surprisingly, shares of monkeypox vaccine makers such as Bavarian Nordic skyrocketed following the WHO’s public health emergency declaration, jumping as much as 17% in early trading, while Emergent BioSolutions’ shares soared 12%.
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