Now that the World Health Organization (WHO) Director-General has declared mpox as a public health emergency of international concern (PHEIC) in the Democratic Republic of the Congo (DRC) and other countries in Africa, we are closely monitoring the situation and released our mpox SPOTREP #1 with a situation overview and key updates. PHEIC is the highest public health declaration that can be issued by the WHO. The emergence of mpox and rapid spread of a new strain was a main reason for declaring mpox as a PHEIC. It better positions and elevates the attention that it should be receiving in the world’s capitals.

The Centers for Disease Control and Prevention (CDC) has also stated that the risk of mpox spreading to the public in the U.S. is very low, due to the limited number of travelers and direct flights from the DRC or neighboring countries, where the WHO Secretariat’s risk assessment was “high.”

However, the outbreak is not “the new COVID,” says the WHO Regional Director for Europe, as the first known infection of the strain clade 1a outside of Africa appearing Aug. 15 in Sweden.

When evaluating the risks of the latest mpox outbreak, we can concentrate on the lessons learned and challenges encountered during the most recent outbreak.

• Vaccine Distribution Challenges: Addressing and ensuring equitable access to vaccines during the outbreak, particularly among marginalized and high-risk communities. Previous efforts were slow to get resources, such as vaccines, to the community most at risk, including the LGBTQIA community. As a result of this lack of protection, the disease spread rapidly. Education about who should be prioritized for vaccines is necessary for providers.
• Public Health Communication Strategies with a Focus on Community Engagement and Equity: Evaluating how public health messaging was received during the last outbreak, with an emphasis on combating misinformation and fostering trust. Discussing the importance of involving local communities and ensuring resources reach populations that are often left out, such as LGBTQ+ communities and those with access and functional needs. This understanding of the community at risk allows healthcare providers to meet people where they are, including LGBTQIA events, with the education and resources to protect them.
• Surveillance and Data Collection: Identifying cases and improving early detection and contact tracing for future outbreaks.
• Healthcare System Preparedness: Reflecting on the ability of healthcare systems to manage outbreaks amid other public health crises, and the need for integrated response strategies.
• Funding and Resource Allocation: Examining how funding limitations impacted outbreak response and the need for sustained investment in public health infrastructure.
• Global Coordination and Response: Exploring the role of international collaboration in managing the outbreak and sharing best practices across borders.

The public:

• Seek medical care immediately and avoid contact with others if you have been in the DRC or its neighboring countries in the last 21 days and develop a new, unexplained skin rash (lesions on any part of the body), with or without fever and chills.
• Consider getting vaccinated against mpox if you have risk factors and are eligible for vaccination. CDC continues to recommend that people who are eligible for vaccination receive two doses of the JYNNEOS vaccine for the best protection. People at risk for mpox who have only received one dose more than 28 days prior should receive a second dose as soon as possible. JYNNEOS vaccine is believed to protect against both mpox clades.
• Review CDC Travel Health Notices for the DRC and neighboring countries before traveling. People with risk factors for MPXV infection who are not able to be vaccinated or (e.g., pregnant people, infants less than 1 year, people with eczema or active skin conditions, and people who are immunocompromised) should avoid situations that might increase their risk for mpox.
• All travelers to areas with mpox cases should protect themselves by avoiding close contact with people who have skin or genital lesions; avoiding contact with dead or live wild animals; avoiding contact with materials used by sick people like clothing, bedding, or in health care; avoiding materials that came into contact with wild animals; and avoiding eating or preparing meat from wild animals (bushmeat), or using products made from wild animals in countries where mpox occurs in animals.
• Visit https://www.cdc.gov/poxvirus/mpox/collections/index.html for more community resources.

Mpox shares the same family as the variola virus, the virus that causes smallpox. Symptoms of the virus are similar to smallpox, but usually milder and rarely fatal. Mpox can affect anyone regardless of gender or sexual orientation. This outbreak of mpox includes two sub-clades (or groups) — clade 1a and clade 1b — both spread through human-to-human contact and known to cause more severe disease than clade 2, which caused the global outbreak of mpox in 2022.

There are two vaccines currently recommended by WHO’s Strategic Advisory Group of Experts on Immunization – While there are no current treatments specifically for mpox infections, supportive care and pain control (ibuprofen, naproxen, acetaminophen) can help patients recover without medical treatment. Tecovirimat is the recommended therapeutic for the treatment of patients with mpox. Brincidofovir, Vaccinia Immune Globulin, and Cidofovir are all additional therapeutics that can be administered as an alternative to tecovirimat.

For more information visit: https://healthcareready.org/mpox/ once the information is updated (now has 2022 info)