Dr. Tresor Wakilongo confirms the development of skin lesions on the ear of Innocent, an infectious disease caused by the monkeypox virus, at Munigi’s treatment center following monkeypox cases in the Nyiragongo region near Goma, North Kivu province, Democratic Republic of Congo, July 19, 2024. | Photo credit: Reuters
The World Health Organization has announced that Ampox outbreaks in Congo and elsewhere in Africa A global emergency, with cases reported in children and adults in more than a dozen countries and a new variant of the virus spreading. Few vaccine doses are available on the continent.
Earlier this week, the Africa Centres for Disease Control and Prevention declared the ampox outbreak a public health emergency, with more than 500 deaths, and called for international help to stop the spread of the virus.
Explained | Global ampox infection: symptoms, treatment and outbreak status
“This is something that should worry all of us… The potential for it to spread to Africa and beyond is very worrying,” WHO Director-General Tedros Adhanom Ghebreyesus said.
The Africa CDC previously said that ampox, also known as monkeypox, has been detected in 13 countries this year and more than 96% of all cases and deaths are in Congo. Cases have increased by 160% and deaths by 19% compared to the same period last year. So far, more than 14,000 cases have been reported and 524 people have died.
“We are now in a situation where (ampox) is posing a threat to Central Africa and many more of its neighbours,” said South African infectious disease expert Salim Abdool Karim, who chairs the Africa CDC emergency group. He said the new variant of ampox spreading from Congo has a case fatality rate of about 3-4%.
During the global 2022 ampox outbreak, which affected over 70 countries, less than 1% of people died.
Michael Marks, a professor of medicine at the London School of Hygiene & Tropical Medicine, said it was justified to declare the ampox outbreaks in Africa as emergencies if that could help free up more aid to contain them.
“It is a failure of the global community to release the necessary resources to allow the situation to become so bad,” he said.
Africa CDC officials say about 70% of cases in Congo are in children under 15 years of age, and 85% of deaths are also in children.
Jacques Alonda, an epidemiologist working with international charities in Congo, said he and other experts were particularly concerned about the spread of ampox in refugee camps in the conflict-torn east of the country.
“The worst case I have seen is that of a six-week-old baby who was just two weeks old when he contracted ampox,” Mr Alonda said, adding that the child had been in their care for a month. “He got the infection because due to overcrowding in the hospital, he and his mother had to share a room with someone who had the virus but had not been diagnosed.”
Save the Children said Congo’s health system was already “collapsed” by malnutrition, measles and cholera.
WHO Director-General Tedros Adhanom Ghebreyesus said authorities were facing multiple outbreaks of ampox in different countries, with “different modes of infection and different levels of risk”.
The UN health agency said that ampox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of these outbreaks are linked to the outbreak in Congo. In Ivory Coast and South Africa, health officials have reported outbreaks of a different and less dangerous version of ampox that spread around the world in 2022.
Earlier this year, scientists reported the emergence of a new form of the deadly form of ampox in a mining town in Congo that could kill up to 10% of people, leading them to fear it could spread more easily. ampox is mostly spread through close contact with infected people, including sex.
Unlike previous ampox outbreaks, where lesions were mostly seen on the chest, arms and legs, the new variant has mild symptoms and lesions only on the genitals. This makes it difficult to identify, which means people can make others sick without knowing they are infected.
In 2022, the WHO declared MPOx a global emergency as it had spread to more than 70 countries where MPOx had not been previously reported, and affected mostly gay and bisexual men. Prior to that outbreak, the disease had been seen mostly in sporadic outbreaks in central and western Africa when people came into close contact with infected wild animals.
Western countries have halted the spread of ampox with vaccines and treatments, but few of these are available in Africa.
Marks, of the London School of Hygiene & Tropical Medicine, said that in the absence of licensed ampox vaccines in the West, officials could consider vaccinating people against smallpox, a related disease. “We need large supplies of vaccine so that we can vaccinate the most at-risk populations,” he said, meaning sex workers, children and adults living in outbreak areas.
Congolese officials said they have requested 4 million doses of the Monkeypox vaccine, said Chris Kasita Osako, coordinator of Congo’s Monkeypox Response Committee. APMr Osako said these would be used mainly for children under 18 years of age.
“The United States and Japan are two countries that are willing to provide vaccines to our country,” Mr. Osako said.
Although the World Health Organization’s emergency declaration is intended to spur donor agencies and countries into action, the global response to previous emergency declarations has been mixed.
The World Health Organization’s previous emergency declaration for ampox “did very little” in getting things like diagnostic tests, medicines and vaccines to Africa, said Dr. Boguma Titanji, an infectious disease specialist at Emory University.
“The world has a real opportunity to act decisively and not repeat past mistakes, (but) this will require more than an (emergency) declaration,” Dr Titanzi said.