There was a global outbreak of mpox in 2022. How is the current situation different?
The resurgence of mpox in the Democratic Republic of the Congo started in 2023, and it’s a different clade than the one that was circulating in the United States in 2022. Clade I is currently circulating in the DRC, and now it’s spilling over into neighboring countries like Burundi, Rwanda, and Uganda.
The outbreak in 2022 was spread primarily by sexual contact, and we were seeing it spread along LGBTQ social networks. But what we’re seeing now in Central Africa is a lot of families and children with mpox. You can get mpox by sharing blankets, towels, utensils or cups with someone who’s infected, and we are seeing more transmission that way. It seems to be spreading among families and households that are taking care of people who might be sick. There are also reports of it spreading through sexual contact as well.
Are the symptoms different now than they were in 2022?
Classically, mpox starts with a fever, chills, and muscle ache, then you get a pustular rash everywhere. With the last outbreak in 2022, we were seeing some people not getting that fever or flu-like illness. Sometimes they might just have had a couple of those pustular lesions that were isolated to their anal or genital regions. What we’re seeing this time is more of the classic presentation with a fever, flu-like illness, and widespread pustular rash, though a more limited pustular rash has also been reported.
How dangerous is the current clade?
The last report I saw with this current outbreak, the mortality rate for clade I is about 3%, which is higher than the less than 1% we see with clade II. Public health and medical systems are very strained in that area, so it’s hard to directly compare, but we do think that this clade I is more virulent and capable of causing more severe disease than the previous clade II.
How is mpox prevented and/or treated?
Fortunately, we have a vaccine that protects against all clades of mpox (and other pox viruses) called Jynneos. The WHO, Centers for Disease Control and Prevention, and local Ministries of Health are stepping up public health response efforts in Africa as we speak. In terms of treatment, we have something called tecovirimat, or TPOXX, which is an oral antiviral treatment that works well for mpox.
How does the current mpox outbreak compare to COVID-19 in its early days?
They transmit differently. COVID is more respiratory-driven and partially airborne. There may be some mpox transmission with very close respiratory droplets, but we do not think it is airborne over long distances. Most mpox cases are transmitted through skin to skin or direct physical contact.
What is the current danger of mpox in the U.S.?
There are no travel-imported cases currently in the United States, but it’s important for health care providers and public health officials in the United States to be aware that there’s a current outbreak, and any travelers who may be sick with an mpox-like syndrome and have been in an area that has an mpox outbreak should isolate and be treated as appropriate.
Prior to this current outbreak, we said that people who have had close contact or sexual contact with people who may be infected with mpox are probably at higher risk, and there’s no new recommendation beyond that at this time. If you have any questions, you can ask your health care provider about possible vaccination.
