On Wednesday, the World Health Organization announced that mpox has been declared a global public health emergency for the second time in two years, as health officials in the U.S. continue to express concerns about its potential spread.

This declaration was made in response to an outbreak of the viral infection in the Democratic Republic of Congo, which has now spread to nearby countries.

A WHO emergency committee convened in Geneva on Wednesday to advise Director-General Tedros Adhanom Ghebreyesus on whether the situation qualifies as a “public health emergency of international concern” (PHEIC).

PHEIC is the highest alert level from the WHO, aimed at speeding up research, funding, and collaboration on public health efforts to control the disease.

“We need a coordinated international response to halt these outbreaks and protect lives,” Tedros emphasized.

Mpox spreads through close physical contact. While it typically causes mild symptoms, it can be deadly in rare instances. Symptoms include flu-like signs and pus-filled lesions.

The outbreak in Congo started from an endemic strain known as clade I. However, a new variant, clade Ib, seems to spread more easily during close contact, including sexual encounters.

This variant has made its way from Congo into neighboring nations such as Burundi, Kenya, Rwanda, and Uganda, prompting the WHO’s recent action.

“The emergence and quick spread of a new mpox clade in eastern DRC, its detection in neighboring countries that hadn’t reported any cases before, and the risk of further spread in Africa and beyond is quite concerning,” Tedros noted.

On Wednesday, Tedros announced that the WHO had allocated $1.5 million in contingency funds and plans to release additional funds in the upcoming days. The WHO’s response requires an initial investment of $15 million, and the agency seeks funding from donors.

This week, Africa’s leading public health organization also declared an mpox emergency for the continent, citing an alarming increase in cases with over 17,000 suspected cases and more than 500 fatalities reported this year, primarily among children in Congo.

Professor Dimie Ogoina, who chairs WHO’s mpox emergency committee, stated that all committee members unanimously recognized the current surge in cases as an “extraordinary event,” with a record high in Congo.

Vaccinations and behavior modifications were effective in curbing the spread during a previous global outbreak of a different mpox strain, which primarily affected men who have sex with men, leading to the WHO’s emergency declaration in 2022.

In Congo, the transmission pathways are still under investigation, and no vaccines are currently available, although efforts to change that are underway. The WHO is also appealing to countries with vaccine stockpiles to donate doses.

Continued vigilance as U.S. monitors cases of different variant

The worldwide mpox outbreak in 2022 was caused by another strain, clade II, which is still present in the U.S. and other locations.

The latest caution regarding mpox emphasizes clade I and its variant, believed to be more transmissible and potentially causing more serious illnesses. According to the Centers for Disease Control and Prevention (CDC), no clade I cases have been reported outside of central or eastern Africa, and the current risk for spread in the U.S. is considered “very low.”

Last week, the CDC issued its second alert regarding clade I since December, prompted by the worsening situation in and around Congo, which has reported the highest annual number of suspected clade I mpox cases since January 2023.

This virus is endemic and has expanded beyond Congo. Thus far in 2024, the WHO reports over 14,000 cases and 524 deaths in the region, marking a significant rise compared to 2023.

Due to the spread risk, the CDC has advised healthcare providers to “maintain a heightened suspicion” for patients who have traveled recently to Congo or neighboring countries and exhibit symptoms associated with mpox. However, the CDC also noted that the limited travel to and from Congo reduces the likelihood of the disease spreading.

In an official statement, the U.S. Department of Health and Human Services noted that while clade I mpox has resulted in more severe illness and fatalities in Congo, officials expect lower sickness and death rates in the U.S.

Recognizing symptoms and vaccine availability

• Rash on hands, feet, chest, face, mouth, or near the genitals;
• Fever;
• Chills;
• Swollen lymph nodes;
• Fatigue;
• Muscle or back aches;
• Headache;
• Respiratory symptoms like sore throat, nasal congestion, and cough.

The CDC recommends the JYNNEOS vaccine for individuals who may have been exposed to mpox. This two-dose vaccine protects against all types of the mpox virus; however, it is not generally available in Congo, where it is most critical. On Wednesday, the HHS announced that the U.S. is donating 50,000 doses of the JYNNEOS vaccine to Congo.