Key Points
- WHO declares global public health emergency as mpox cases surge in Africa.
- Clade 1b spread worrying experts who fear outbreak in Africa is "the tip of the iceberg".
- DRC and neighbours face resource challenges as WHO urges coordinated global response.
The World Health Organization (WHO) has in Africa a global public health emergency, sounding its highest possible alarm over the worsening situation.
Worried by the rise in cases in the Democratic Republic of Congo (DRC) and the spread to nearby countries, the WHO hastily convened a meeting of experts to study the outbreak.
"Today, the emergency committee met and advised me that in its view, the situation constitutes a public health emergency of international concern. I have accepted that advice," WHO chief Tedros Adhanom Ghebreyesus said.
A public health emergency of international concern (PHEIC) is the highest level of alarm under the International Health Regulations, which are legally binding on 196 countries.
"The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying," said Tedros.
"It's clear that a coordinated international response is essential to stop these outbreaks and save lives.
"This is something that should concern us all."
Troubling new subclade 1b
The UN health agency declared a public health emergency a day after the African Union's health watchdog .
Tedros noted that over 14,000 cases and 524 deaths in the DRC this year have already surpassed last year's totals. He highlighted the concerning spread of clade 1b, particularly through sexual networks in the DRC and into neighbouring countries like Burundi, Kenya, Rwanda, and Uganda.
Dimie Ogoina, who led the emergency committee, said all 15 members agreed the mpox surge is an extraordinary event. He said many members feared the known situation in Africa was "actually the tip of the iceberg", because without more robust surveillance, "we don't have the full picture".
What is mpox and what are the symptoms?
Mpox (formerly monkeypox) is that is closely related to the virus that caused smallpox, variola. Smallpox only infected humans, but mpox is an animal virus that occasionally infects humans after they are bitten or scratched by a monkey or other animal.
It is a respiratory virus and can also spread to humans without contact, probably through aerosols. However, it does not usually spread easily between humans, and typically only in close contacts. Studies have found about 3 per cent of contacts of a mpox case will be infected.
A week or two after exposure, infection starts with fever, headache, swelling of the lymph nodes and muscle ache. Skin eruptions usually appear within one to three days of the fever commencing, and in most cases affect the face, hands and feet.
Mpox virus has been spreading at an unprecedented rate across Africa since January. Source: Getty / Mehmet Yaren Bozgun
Since September 2023, the clade 1b subclade has been spreading in the DRC, causing more severe disease with a higher fatality rate.
What does PHEIC status mean?
A PHEIC has only been declared seven times previously since 2009: over H1N1 swine flu, poliovirus, Ebola, Zika virus, Ebola again, Covid-19 and mpox.
Marion Koopmans, director of the Pandemic and Disaster Management Centre at Erasmus University Rotterdam, said
But "the same priorities remain: investing in diagnostic capacity, public health response, treatment support and vaccination", she said, warning that this would be a challenge as the DRC and its neighbours are lacking resources.
