Episode #124 - Mpox: what you need to know

VGS We're in the Emergency Operations Centre (EOC) in WHO’s headquarters in Geneva and today we are talking about mpox. Doctor Tedros, WHO’s Director-General has declared this outbreak of mpox a public health emergency of international concern. Doctor Salam is joining us from WHO’s office in Brazzaville in the Republic of Congo. Welcome, Doctor Salam. Doctor Salam, mpox as a viral disease has been around for decades, what is different about this outbreak to trigger this declaration a public health emergency of international concern?

ASG Thank you, Vismita. Mpox has traditionally been reported from some countries in central and west Africa. In 2022, an outbreak erupted and became global, when the disease spread to many countries that had never seen the virus before. What is happening in 2024 is a large number of cases in the Democratic Republic of Congo including the appearance of a new virus strand clade Ib, which is spreading fast from person to person. Unlike the outbreak in 2022, where it was affecting mostly men who have sex with men, this time it is affecting everybody, women, men and children.

VGS When WHO declares an outbreak a public health emergency of international concern, what does that mean for countries and what does that mean for the public?

ASG The public health emergency of international concern (PHEIC) is the International Health Regulation tool that is given to the WHO Director-General as the highest alert system in public health. It means that the international community should support the countries that need it. The companies that can make vaccines, diagnostic or therapeutic, should work with the partners that are able to fund it. The researchers should also look for solutions for the benefit of humankind.

VGS Could you please talk to us about how mpox is transmitted?

ASG Mpox can be transmitted in different ways. The first way is close contact, skin-to-skin, mouth-to-mouth or sexual encounters. When a sick person is speaking very close to another person who is not sick, they may have some micro particles that are infectious. Another transmission way is from animal to human, during the hunting, skinning or cooking of the animal. The third transmission way is through contaminated objects, such as sheets, towels and needles. Finally, the transmission may be vertical through a pregnant woman to the fetus or the baby.

VGS Dr Salam, who is at risk of getting infected with mpox?

ASG Everybody who is in contact with a sick person is at risk, particularly people at the household level or sexual partners. Mpox is also affecting healthcare workers that are advised to use the infection prevention and control tools, but also to use personal protective equipment, particularly when they are taking care of patients that are sick or suspected to have mpox or when they are taking a swab for diagnostic, or when they are taking care of a dead body.

VGS We are hearing a lot of lies and misinformation on social media that WHO is going to impose or force mega-lockdowns for mpox. Could you please clarify?

ASG Let's make it very clear, Vismita, WHO does not have the authority to impose lockdowns and has not recommended lockdowns. In this outbreak, lockdowns are not needed. We can control it by ensuring surveillance, good clinical care and access to other countermeasures, more research and supporting communities. For this international coordination and commitment, both political and financial are crucial.

VGS Let's talk about vaccines. Who should be getting vaccinated at this time?

ASG The vaccine should be for people at risk. People who are planning to travel should approach their caregiver to have more information. The quantity of vaccines that are available now are very limited, so we should use it [in a] very smart way. Evidence-based, focused and targeted. Those vaccines, if well used, can help to stop the chain of transmission. But they are not the only way to stop the chain of transmission. If we do an appropriate surveillance with early detection of cases and we make a monitoring of the contacts of those cases, when they get sick, we isolate them very quickly and we give them appropriate treatment and also when we make sure that those who do not have any symptoms are taking very simple measures, like washing hands.

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