
Washington DC, August 9, 2024 (PAHO/WHO) – In an epidemiological alert published on August 8, the Pan American Health Organization (PAHO) has called on countries in the Americas to strengthen surveillance, including laboratory detection and genomic sequencing of confirmed cases, following the identification of a new mpox virus variant, Clade I (Clade Ib), in the Sub-Saharan African Region. While the new variant has not been reported in the Americas, countries should remain alert for possible imported cases.
The new variant is associated with sustained transmission, as well as the occurrence of cases in a wider range of age groups than during previous outbreaks, including children. It is estimated to have emerged in the Democratic Republic of the Congo in September 2023 and is associated with a significant increase in cases in the country.
Mpox is a viral disease caused by the monkeypox virus, a species of the Orthopoxvirus genus. There are two different clades: clade I and clade II. Symptoms include fever, severe headache, muscle aches, back pain, lack of energy, swollen lymph nodes, and skin rash or lesions on mucous membranes. The rash tends to be concentrated on the face, palms, and soles, but may also be found in the mouth, anogenital area, and eyes. Symptoms usually last 2 to 4 weeks and resolve on their own without treatment.
Since the beginning of 2024 (as of 26 July 2024), the Ministry of Health in the Democratic Republic of the Congo has reported 14,479 cases of mpox and 455 deaths. According to the report, “the number of cases reported in the first six months of this year is consistent with the number reported in all of last year.” Children under 15 years of age accounted for 66% of cases and 82% of deaths. Cases of the new variant have also been reported in Rwanda, Uganda and Kenya. Testing is also underway in Burundi to determine whether the cases reported there are also due to the new variant.
As a result of the surge in cases, on August 7, World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus announced that he will convene a panel of experts to advise him on whether the expanding outbreak constitutes a global health emergency.
Although no cases of the new variant have been reported in the Americas, PAHO recommends that countries in the Americas remain alert to the possibility of its introduction into the region.
In the Americas, 31 countries and territories reported 62,752 cases of mpox between 2022 and July 1, 2024, including 141 deaths. To date, only clade II has been detected in the region. Most cases were identified through HIV care services, sexual health services, or primary health care centers and affected mainly, but not exclusively, men who have sex with men. The epidemiological alert urges health authorities in countries to “continue surveillance based on laboratory testing and timely reporting of confirmed and probable cases.” Genomic surveillance is also key to determining circulating clades and their evolution.
Suspected cases of mpox should avoid contact with others and seek testing to confirm the diagnosis, followed by clinical management of symptoms.
In the alert, PAHO reminds Member States that efforts should focus on “early detection and diagnosis, isolation, and contact tracing.” While vaccination can help prevent infection in people at risk, “mass vaccination against human immunodeficiency virus (MPOX) is neither mandatory nor recommended.”
PAHO also recommends the dissemination of public health messages to inform and educate target populations, including health personnel and populations with a higher prevalence of HIV and other sexually transmitted infections (STIs), primarily, but not exclusively, men who have sex with men, to improve early recognition of signs and symptoms.
On 23 July 2022, the WHO Director-General determined that the multi-country mpox outbreak constituted a public health emergency of international concern (PHEIC). The number of reported cases globally peaked in August 2022 and began to steadily decline through April 2023. On 11 May 2023, following a significant reduction in global spread, the Director-General determined that the event no longer constituted a PHEIC.
Mpox remains a global public health concern, with cases and outbreaks still being reported worldwide. As of June 2024, 26 countries have reported more than 930 cases and 4 deaths globally.