Mpox has been declared a global public health emergency. Although immunologists indicate that further research is required to assess its prevalence, cases are being reported in various communities, affecting both adults and children.
The MPOX group 1b strain has spread throughout much of Africa since its initial identification in the Kamituga region of the Democratic Republic of the Congo.
Last week, a case was reported in Sweden involving an individual who had traveled to an affected African nation, marking it as the first diagnosis outside the continent.
The group 2b strain was responsible for the public health emergency in 2022, with concerns at that time suggesting a link to the gay community, primarily affecting gay, bisexual, and other men who have sex with men (MSM) aged 18 to 49.
David Kelvin, a professor in the Department of Microbiology and Immunology at Dalhousie University and one of the lead researchers studying the Kamituga mpox strain, stated that initial research indicated some of the first cases resulted from heterosexual contact; however, since its discovery last year, several cases have also been identified in children.
How contagious is it?
According to the Public Health Agency of Canada, evidence suggests that group 1, of which group 1b is a variant, is more transmissible and may lead to more severe illness than group 2b.
The U.S. Centers for Disease Control and Prevention (CDC) reports that some outbreaks have resulted in mortality rates of up to 10 percent among those infected, though recent outbreaks have shown lower rates.
Earlier this year, the city of Bukavu, located near Kamituga, reported approximately six cases, a number that has now surged to about 4,000.
The virus primarily spreads through close contact, usually skin-to-skin, with an infected person and the resulting rash or scabies.
This transmission can occur through sexual activities, along with kissing and other social interactions that involve close contact.
Kelvin noted that one reported case involved a hairdresser who contracted the virus and disseminated it during close contact with clients while cutting their hair.
This close contact is also a concern for children, particularly since schools can be quite crowded, including in African regions where the virus is spreading.
“Children in close proximity may touch one another and spread saliva, among other things,” he said.
Contact with saliva, respiratory secretions such as mucus, bodily fluids, or lesions in the genital area can also facilitate virus transmission.
The Centers for Disease Control and Prevention indicates that prolonged face-to-face interactions, such as talking or breathing closely together, can spread mpox; however, this is attributed to respiratory droplets rather than airborne transmission.
While sexual contact may be one route of transmission, Dr. Don Vinh, an infectious disease specialist at McGill University Health, noted that the virus can also spread among household contacts. Additionally, there may be instances of animal-to-human transmission, as the CDC categorizes mpox as a zoonotic disease.
“Therefore, the combination of potential sexual networks, non-sexual close contact networks, and possibly even interactions with animals compels us to consider the primary drivers of transmission carefully,” he added.
Dr. Don Shepherd, deputy chief of infectious diseases and immunization programs at the Public Health Agency of Canada, explained that the 1b strain likely originates from such animal transmission and may contribute to some community spread.
“Children often bear the brunt of infection within families, but the demographics in Congo differ markedly from those in Canada, where there are more young people than older individuals, making children susceptible,” he said.
He further remarked that similar to the variants observed during the Covid-19 pandemic, the spread of the 1b variant to multiple countries in Africa and now to Sweden may suggest it is “more adept at spreading,” potentially indicating higher contagion levels.
Vinh emphasized that individuals should exercise caution regarding indirect contact, as surfaces recently touched by an infected person that have not been properly disinfected can pose infection risks.
How can Canadians avoid getting infected with mpox?
The Clade 1 and Clade 1b variants were not identified in Canada until August 19; however, there are still precautions individuals can take.
- Firstly, if you plan to travel to one of the affected areas in Africa where mpox is endemic, avoid crowded locations and practice effective public health measures, such as frequent hand washing.
- If you do not intend to travel, the risk of infection remains low, but individuals eligible for the mpox vaccine should consider getting vaccinated.
Those at higher risk, including those with immunodeficiency or comorbidities, should be prioritized for vaccination.
Kelvin clarified that although indications suggest this strain and its mpox variant are more transmissible and potentially more infectious, further research is needed.
“We still require numerous studies to address this disease, and considering the remarkable speed at which it can spread in specific geographical areas and subsequently move to others, we must remain vigilant regarding the emergence of new cases,” he stated.
Understanding Mpox: Global Health Emergency and Transmission Insights
Mpox has been declared a global public health emergency, and while immunologists say more research is needed to determine how widespread it is, cases are being reported across communities and the virus affects not only adults but also children.
Known as MPOX group 1b, the strain has spread across much of Africa since it was first discovered in the Kamituga region of the Democratic Republic of the Congo.
Last week, a case was reported in Sweden in a person who had travelled to an affected African country, marking the first case diagnosed outside the continent.
Group 2b was the strain that caused a public health emergency in 2022, with concerns emerging at the time that it was linked to the gay community, affecting gay, bisexual and other men who have sex with men (MSM) aged 18 to 49 disproportionately.
David Kelvin, a professor in Dalhousie University’s Department of Microbiology and Immunology and one of the lead researchers studying the Kamituga mpox strain, reported that initial research showed some of the first cases were from heterosexual contact. However, since its discovery last year, several cases have also been found in children.
How Contagious Is Mpox?
According to the Public Health Agency of Canada, evidence suggests that group 1 — of which group 1b is a variant — is more transmissible and may cause more severe illness than group 2b.
The U.S. Centers for Disease Control and Prevention states that some outbreaks have resulted in deaths in up to 10 percent of those infected, although recent outbreaks have exhibited lower mortality rates.
Earlier this year, the city of Bukavu, near Kamituga, recorded about six cases, and that number has now risen to about 4,000.
The primary way the virus spreads is through close contact, usually skin-to-skin, with an infected person and the resulting rash or scabies.
This includes sexual activities, and kissing and other social activities that involve close contact can also transmit the virus. One reported case involved a hairdresser who became infected while in close contact with clients during haircuts.
This close contact is particularly concerning for children, as schools can become crowded, especially in areas of Africa where the virus is spreading. Kelvin noted, “Kids who are in close contact may touch each other, spread saliva, things like that.”
Contact with saliva, respiratory secretions such as mucus, bodily fluids, or lesions around the genital area can also facilitate the spread of mpox.
The Centers for Disease Control and Prevention emphasizes that prolonged face-to-face interactions, such as talking or breathing in close proximity, can also spread mpox due to respiratory droplets, even though it is not airborne transmission.
While sexual contact may be a part of the spread, it can also occur between household contacts. Dr. Don Vinh, an infectious disease specialist at McGill University Health, suggested that animal-to-human transmission might play a role, as the Centers for Disease Control and Prevention classifies mpox as a zoonotic disease.
“So the combination of potential sexual networks, non-sexual close contact networks, and perhaps even exposure to animals, makes us think hard about the main drivers of transmission,” Dr. Vinh added.
Dr. Don Shepherd, deputy chief of infectious diseases and immunization programs at the Public Health Agency of Canada, noted that the group 1b strain likely originated from animal transmission and could lead to community spread.
“Children are often the most affected within families, but the demographics in Congo are very different from those in Canada, where there are more young people than older people, so children tend to be involved,” he explained.
He elucidated that the spread of the 1b variant across several countries in Africa, including its recent emergence in Sweden, may suggest that it is “better at spreading,” indicating potentially higher contagiousness.
Vinh cautioned about the risk of indirect contact, as surfaces touched by an infected person that have not been adequately disinfected can lead to transmission.
How Can Canadians Avoid Getting Infected with Mpox?
The Clade 1 and Clade 1b variants were not detected in Canada until August 19, which makes preventive measures crucial. Here are some practical tips:
- If you decide to travel to affected areas in Africa where mpox is endemic, avoid crowded spaces and practice good public health measures, such as frequent hand washing.
- If you’re not planning to travel, remember that the risk of infection is low, but eligible individuals should consider getting the mpox vaccine.
Those at higher risk, including individuals with immunodeficiency or comorbidities, should prioritize vaccination. Kelvin emphasized the need for further studies to address the severity and transmissibility of this strain, explaining, “We may have to be vigilant about the emergence of new cases.”
Current State of Mpox: Statistics and Updates
| Location | Reported Cases of Mpox | Transmission Type |
|---|---|---|
| Bukavu, Democratic Republic of Congo | ~4,000 | Close Contact |
| Sweden | 1 | Travel-Related |
| Canada | Not Detected Until August 19 | N/A |
Benefits of Vaccination and Community Awareness
Vaccination against mpox is crucial in controlling the outbreak, especially for high-risk groups. Here are a few benefits:
- Reduces the risk of severe illness.
- Decreases the spread of the virus within the community.
- Protects vulnerable populations, including immunocompromised individuals and children.
Community awareness efforts are essential to inform the public about transmission routes and preventive measures, making it easier to identify and manage potential outbreaks.
First-Hand Experiences and Case Studies
Individuals affected by mpox have shared experiences highlighting the urgency of awareness and action. One case involved a family in Bukavu that reported symptoms swiftly, leading them to seek immediate medical attention. This highlights the importance of recognizing symptoms early and acting quickly.
Public health authorities have been conducting outreach programs to educate citizens about the transmission and prevention of mpox. Sharing knowledge can significantly reduce the spread of misinformation and increase community vigilance.
As research continues, it will be imperative for communities worldwide to stay informed and proactive in the fight against mpox.
