A worrying variant of the monkeys has quickly spread to Central Africa in recent months. The outbreak initiated the African Centers for Disease Control and Prevention (Africa CDC) to explain its first public health emergency on August 13th, and the World Health Organization (WHO) meets on August 14th to have a to check.

The measures reflect the deep care of the scientists that the outbreak of MPOX, which could develop into an epidemic caused by the monkey kit virus, which spreads over the continent. They find that the virus is questionable not only in rural regions, but also in densely populated areas.

In the past few months, the MPOX infections in Central Africa have risen sharply and have affected locations such as Bukavu, a city in the Democratic Republic of Congo (DRC) with more than 1 million inhabitants, and four countries in the region have reported MPOX infections for the first time. These infections are probably related to an outbreak that began at the end of 2023 in the province of South Kivu, a DRC region that was hit by violent conflicts.

Knowledge from earlier outbreaks indicate that the virus type, which is spread in Central Africa, is fatal than the tribe that the Worldwide MPOX outbreak of 2022 has been triggered since then and has more than 95,000 people.

"I hope that we have long been to believe that something that cannot affect us somewhere else," says Anne Rimoin, epidemiologist at the University of California, Los Angeles, which has been working on MPOX outbreaks in the DRC since 2002. "An infection somewhere is potentially an infection everywhere, and we have experienced this many times."

tender years

African countries already reported and suspected MPOX infections in 2024 than in the entire year 2023: 17,500 this year compared to around 15,000 in 2023. Children are particularly susceptible: Around two thirds of the infections in the DRC affect people under the age of 15.

Some of these infections were attributed to a tribe called Clade II, which caused the outbreak of 2022. But in the past few months, an increasing proportion of the reported infections has been attributed to a tribe called Clade I. Clade I has triggered small outbreaks in Central Africa for decades, which are often limited to a few households or municipalities.

In April, researchers who analyzed samples that were collected in South Kivu, analyzed in the end of 2023 and early 2024, revealed a variant of Clade I, called Clade IB, which apparently spreads effectively between people, among other things through sexual contacts. Since then, the virus has spread into densely populated areas, presumably through highly mobile population groups such as sex workers, and to neighboring countries. South Kivu also faces a humanitarian crisis that makes it more difficult to pursue and treat infected people, and the DRC is struggling with the aggressive spread of other diseases such as cholera.

Burundi, Kenya, Rwanda and Uganda all reported their first MPOX infections within the last month, and in a single week in early August the DRC reported almost 2,400 suspected infections and 56 deaths. These developments prompted Jean Kaseya, the general director of the Africa CDC in Addis Ababa, to use the authority to explain a public health emergency in 2023.

The outbreak also caused the WHO to convene a meeting to discuss whether the outbreak of a global emergency needs what countries all over the world signal that coordination and preparation may be necessary to control the virus.

enigmatic virus type

mpox causes skin lesions filled with liquid that can be painful and can lead to death in severe cases. It is still unclear whether the symptoms of the Clade IB virus differ from those of the Clade II virus that caused the outbreak in 2022 and how dangerous and transferable it is. "That is the multi -million dollar question," says Rimoin.

Although the mortality rate at Clade I MPOX is higher than with Clade II MPOX, it is difficult to determine why, says Espoir Bwenge Malembaka, an infectious epidemiologist at the Catholic University of Bukavu. In addition to the intrinsic virus of the virus, many factors could be responsible for the high mortality rate of Clade I: For example, Clade I was historically reported in rural parts of the country with poor access to health care, which it may be fatal, he says.

A rapid intensification of surveillance and the cooperation between affected countries will be crucial to bring the outbreak under control, says Bwenge Malembaka. But treatments and vaccines against MPOX, which many wealthy countries use during the worldwide outbreak of 2022, African nations are almost completely not available.

vaccines required

That could change soon: the Africa CDC is negotiating with Bavarian Nordic, a biotechnology company in Hellerup, Denmark, Denmark, around 200,000 cans of a to obtain two-doses-MPOX vaccines , Kaseya announced on August 8th. But that is far from the 10 million cans that the Africa CDC estimates that are required to contain the current outbreak, added Kaseya.

If and when these negotiations are complete, a lot of work will still be done: it will be difficult to provide these doses in regions with poor public health infrastructure and in stigmatized population groups that have a high risk of getting MPOX like sex workers and men who have sex with men, says Rimoin. In addition, the effectiveness of the vaccines against Clade IB is unclear - but in view of the serious situation in Central Africa, Rimoin says that this should not justify a delay in the plans to obtain cans.

rimoin adds that she hopes that the after-school declaration does not meet the after-school declaration of vaccines and treatments in Wealthy countries follow, as was the case during the Covid-19-Pandemie and the MPOX outbreak of 2022. "It is of crucial importance to remember that our best protection against outbreaks is to provide the countries that are most affected by the origin and spread of the tools to control outbreaks at the origin," she says.