On Wednesday, independent experts convened virtually to provide advice to WHO Director-General Tedros Adhanom Ghebreyesus regarding the severity of the mpox outbreak. Following their consultation, Ghebreyesus declared a Public Health Emergency of International Concern (PHEIC), the highest alert level under international health regulations.
Ghebreyesus highlighted the alarming spread of a new strain of mpox, clade Ib, which has emerged in eastern Democratic Republic of Congo (DRC) and has now affected four neighboring countries previously unreported for the virus. He stressed the seriousness of this development and the potential for further spread across Africa and beyond.
The emergency committee reached a unanimous consensus that the outbreak constitutes an extraordinary event. Committee Chair Dimie Ogoina commented that the situation in Africa represents just the “tip of the iceberg,” indicating a need for a more comprehensive understanding of the outbreak’s full scale.
In addition, the Africa Centres for Disease Control and Prevention (Africa CDC) declared the outbreak a public health emergency of continental security on Tuesday, marking its first such declaration since its inception in 2017.
Since the start of the year, over 17,000 mpox cases and more than 500 deaths have been reported in 13 African countries, with the DRC experiencing the majority of cases—over 14,000, or 96% of this month’s confirmed cases. Mpox, previously known as monkeypox, is a viral disease transmitted through close contact and contaminated materials. Its symptoms include fever, a painful rash, headache, muscle and back pain, low energy, and swollen lymph nodes.
Historically, mpox was confined to Central and West Africa but began spreading to Europe and North America in 2022. The WHO had previously declared the mpox outbreak a global health emergency in July 2022, lifting the declaration in May 2023.
Mpox is categorized into two genetic clades, I and II. The 2022 outbreak was associated with clade II, but clade Ib, which is linked to more severe disease, is now causing concern.
Tedros noted, “We are not dealing with a single outbreak of one clade but several outbreaks involving different clades, each with distinct transmission modes and risks.”
The US Centers for Disease Control and Prevention (CDC) has not reported any cases of clade I mpox in the United States but continues to monitor the situation. The US government has provided funding, support, and vaccines to the WHO and the DRC to aid efforts in Africa. The CDC has recommended vaccination for those exposed to or at high risk of mpox.
WHO officials have stated that the virus could be contained effectively with timely and appropriate actions. They are calling for international cooperation to finance and coordinate efforts to combat the outbreak and to fund research on clade Ib and its transmission.
Tedros emphasized the necessity of a coordinated international response to halt the outbreaks and save lives. The WHO has approved the Emergency Use Listing process for mpox vaccines and developed a regional response plan requiring $15 million, with $1.5 million already allocated from the WHO Contingency Fund for Emergencies.
