Mpox, formerly known as Monkey Pox: What to look out for

This was due to fears it could spread quickly to previously-unaffected countries and regions.

Thirty-four countries in Africa are either reporting infections or considered at high risk.

So far this year there have been over 17,000 suspected cases of mpox and at least 571 deaths worldwide.

Those at highest risk of more severe mpox disease and death include new-born babies, children, people who are pregnant and people with weakened immune systems, such as those with cancer or with HIV infection.

Children aged under 15 years now account for more than 70 per cent of the mpox cases and 85 per cent of deaths in the Democratic Republic of Congo.

Mpox, formerly called monkeypox, is a virus that can infect humans causing flu-like symptoms, including fever, chills and muscle aches which is followed by a rash that starts as raised spots that turn into blisters filled with fluid.

These eventually form scabs. Most cases are mild but it can be fatal.

There are two main types of mpox known as ‘clades’.

Clade 1a is causing most of the infections in the west and north of the Democratic Republic of Congo.

It is initially contracted by eating infected bushmeat.

Those infected pass the mpox virus on to people they come into close contact with. Clade 1b is the new subtype of the mpox virus and is causing the outbreaks in the east of the Democratic Republic of Congo and Burundi, Kenya, Rwanda and Uganda.

This is being spread along trucking routes with drivers having sex with prostitutes in mining cities.

Due to the mass movement of people along these routes, infected people then pass it on to children through close contact or via contaminated bedding or towels.

Clade 1b outbreak is the main reason for the WHO declaring mpox a public health emergency of international concern and cases outside of Africa have been detected in Sweden, Thailand, the Philippines and Pakistan. Clade 2 is the mpox outbreak that went around the world in 2022.

It is more common in LGBT communities with 98.6 per cent of those affected in the UK being men who have sex with men.

Both clades can be fatal although clade I has a higher morbidity and mortality rate.

In previous outbreaks up to 10 per cent of people infected with Clade 1 mpox died.

Mpox is not expected to be a Covid-level event.

The most likely scenario in the UK is imported infection where somebody flies back who is infected with the virus.

This has happened multiple times with mpox in the past in the UK and the UK continues to report cases of mpox linked to the 2022 Clade 2 outbreak, predominantly amongst homosexual men.

These imported cases could be the end of it or there may be limited spread within households through close physical contact, however, a more concerning event would be an infected child taking it to school and infecting others through play and close contact.

This is the limit of what is being considered likely in the UK and care would be honed on contact tracing, isolating infected patients, vaccinating those at risk and treating them accordingly with antiviral medication.

There are no mpox-specific vaccines but the JYNNEOS jab is a two-dose smallpox vaccine that also works against mpox.

Smallpox and the monkeypox viruses are members of the same viral family and immunity to one leads to protection from the other.

For most patients with mpox infection who don’t have a weakened immune system, supportive care and pain control will help them recover without medical treatment.

People with severe mpox may require hospital treatment, supportive care and antiviral medicines to reduce the severity of disease and shorten the recovery time.

An antiviral medication called tecovirimat was approved by the European Medicines Agency for the treatment of mpox under exceptional circumstances in 2022, however, so far its use for it has been limited.

Anyone concerned about mpox infection should seek medical advice.

Our columnist Dr Jason Seewoodhary is a former Worcester GP.