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Attention is growing over monkeypox (Mpox). On Wednesday, the WHO declared a global health emergency after reporting 14,000 cases and 524 deaths in the Democratic Republic of Congo. Yesterday, the Swedish Public Health Agency announced that it had recorded the first case outside of Africa of the most dangerous variant, Clade 1. And news of a first case of Mpox came today from Pakistan, although it is yet to be ascertained which variant it is. The European Centre for Disease Prevention and Control (ECDC) said it was very likely that European Union countries would see more imported cases of smallpox caused by the Clade I virus currently circulating in Africa. However, the likelihood of sustained transmission in Europe is very low provided that imported cases are diagnosed quickly and control measures are implemented.
«In Italy the situation is under control»
“The epidemiological situation in Italy is currently under control as no cases of the new strain (clade I) of Mpox have been confirmed. Our offices are in constant contact with international organizations to develop shared measures,” said Mara Campitiello, head of the Prevention Department of the Ministry of Health. “The Ministry of Health – she adds – has activated operational channels with Aifa and ISS to plan risk containment strategies in the event of a change in the current scenario; at the same time, we are proceeding with the strengthening of the diagnostic surveillance network throughout the national territory.” Campitiello also notes that “the national stock of vaccines is currently sufficient to guarantee the need and we are developing a new information circular to the Regions with indications for the population and operators involved in border sites. Furthermore – she concludes – the establishment of an inter-ministerial table in conjunction with the Ministry of Foreign Affairs, Economy and Finance, Interior and Transport is being evaluated to agree on operational plans to combat the spread of the pathogen with an organized strategic approach.”
Andrea Antinori, Director of the Clinical Department at the Lazzaro Spallanzani Institute in Rome, also confirmed that the situation is under control: “In Italy there is currently no emergency from mpox, the situation is under control and the Ministry of Health is also alerted along with all other European organizations. Surveillance measures must rightly be strengthened. We know the disease and how it manifests itself but we also have a very effective vaccine indicated for subjects at risk. In 2022-23, 14,000 people in Italy were vaccinated against monkeypox, 3,500 of these at the Spallanzani Institute alone. But I repeat, the probability of contracting the virus is higher for those who travel to countries on the African continent, including the Democratic Republic of the Congo, Burundi, Uganda, Kenya, Rwanda, the Central African Republic and the Republic of the Congo, all affected by the Clade 1b variant. At greater risk – continues Antinori – are those who have close contact, especially sexual, with potentially infected people. For the general Italian population there is no danger, the situation is constantly monitored. However, this does not exclude the circulation of mpox in our country in the near future. But I repeat, the situation is under control: we know the disease, how it manifests itself and we have a very effective vaccine. Of course, the numbers of the vaccination against mpox are not those of the anti-Covid but because it is aimed at people at risk of contracting the virus through sexual intercourse, a vaccination that is always open. In short, the answer is there and we are ready”, he concludes.
The likelihood of Mpox infection from the new Mpxv strain (clade I) for European citizens travelling to or living in affected areas and having close contact with affected communities is high, says the European Centre for Disease Prevention and Control (ECDC), while the likelihood of infection is low when avoiding contact with affected communities.
ECDC recommendations
“The severity of the disease is expected to be low,” the ECDC specifies. “Overall, the risk for these populations is moderate and low, respectively.” As for the EU and the European Economic Area, “the overall risk for the general population” is “currently assessed as low, based on a very low probability and a low impact,” the ECDC reports. “The probability of infection with Mpox clade I for close contacts of possible or confirmed imported cases is high, but the severity of the disease is expected to be low. However, in this same group, the severity of the disease is considered moderate among those with underlying conditions, particularly immunocompromised individuals. Overall, the risk for these populations is moderate and high, respectively.”
