Episode #96 - mpox update

VGS  WHO has declared that the Public Health Emergency of International Concern for mpox the disease previously known as monkeypox, remains in effect. We are going to get a status update, learn about who is at risk and what we have learned so far from the response from Dr. Rosamund Lewis. Welcome, Rosamund. Let's start with a status update on mpox, please.

RL  Indeed, in this outbreak, we've seen now almost 90,000 cases of mpox occurring in over 110 countries around the world with 97 deaths. This is an unprecedented outbreak, as we know. Countries around the world that are reporting mpox had not previously experienced this at all. Now, at this time, where many countries have effectively curbed their outbreak and cases have really come down. There are still some parts of the world where there is continuing risk. This includes the Americas, particularly Central America.

It includes countries that are still reporting. We still have over 30 countries that have reported in the last month. So, for example, Spain, a few other countries in Europe, mostly Latin America, Central America and of course, Africa. In this outbreak though, we are still seeing cases linked to travel but travel from different parts of the world. And so that means that an outbreak can occur any time through link to travel.

VGS   Rosamund, who is at risk of mpox?

RL   In this global outbreak of mpox, the group primarily affected have been men who have sex with men. This remains the group that is most at risk for new cases of mpox. There have been some women and children affected, but they have been relatively few. So it is very important for people who may be at risk, particularly men who have sex with men, to continue to be mindful of how to reduce their risk by reducing the number of sexual partners, for example, and being aware when they are attending events where sexual activity may occur. The other group that continue to be at risk, of course, are people who are affected in the African setting. In West Africa, there is a mix. There is sexual transmission between men and women. And in Central Africa, there continue to be outbreaks where people may be affected through contact with the forest and animal to human transmission of the monkeypox virus. We all need to be aware that in the coming spring and summer season in the northern hemisphere, of course, this is true around the world, there may be activities linked to gatherings and events where risk may be higher, where there may be sex on premises, where there may be sexual contact with multiple partners. These are the situations where there may be greater risk of mpox even as the outbreak is slowing down worldwide.

VGS   Rosamund, what is new and what have we learned so far from the response?

RL   In this outbreak, we've learned a lot about mpox the disease and monkeypox virus as well. We've learned that this strain of virus that is driving the outbreak is not new, but it has adapted to person to person transmission. This particular strain of the virus has not been found in animals. And so it's really critically important that we continue public health measures to protect people and prevent further transmission of this disease. We have learned, for example, that people who have advanced or untreated HIV infection are much higher risk for severe illness or death. It is important for you to know your HIV status in order to be able to get appropriate treatment, testing and care. While the outbreak appeared to begin primarily in Caucasian men in Europe and North America and has spread around the world, we are now also learning that it is reaching more marginalized and ethnic and racial groups such as black and Latino men who have a much higher rate of acquiring mpox in their communities and a much lower access to prevention measures and face greater stigma and discrimination. So now public health efforts are also going to continue engagement with communities most affected and to reach those who are harder to reach in order to protect them and prevent stigma so that they may also have access to the services that are necessary. As the outbreak is coming under control globally, we can now turn our efforts towards eliminating mpox in countries where that is feasible and supporting countries where mpox control and prevention are essential to prevent such further outbreaks in the future. One of the things that we have seen in this outbreak response that has been most successful has been the engagement with and by the most affected communities themselves. Men who have sex with men have taken charge of their own health in order to seek access to services and reduce their own risk. In this outbreak response, we will continue to work with the most affected and marginalized communities to stop this outbreak.

VGS   Thank you, Rosamund. That was Science in 5 today. Until next time, then stay safe, stay healthy, and stick with science.