The first case of clade 1B of ampox in India was reported in Kerala in a 38-year-old man who had arrived from the United Arab Emirates. Clade 1B is a rapidly spreading type of ampox, leading the World Health Organization to declare it a public health emergency of international concern (PHEIC).

The first case of ampox in India was reported from Delhi. A 26-year-old man from Hisar, Haryana tested positive for the Clade 2 strain of ampox.

Clade 1b vs. Clade 2

Ampox is a viral infection caused by the monkeypox virus, a species of the Orthopoxvirus genus. There are two types of ampox that differ in nature in terms of the severity of the disease and its impact on the affected population.

These strains are: Clade 1b (Central African (Congo Basin) strains) and Clade 2 (West African strains).

This species causes symptoms such as red skin rashes followed by pus-filled blisters, high fever, headache, muscle aches, back pain, lack of energy, swollen lymph nodes and sore throat.

These blisters can appear on the palms of the hands, soles of the feet, face, mouth, throat, groin, genital areas and anus.

The ampox strain is spread through skin-to-skin contact. This can also include being face-to-face with a person with ampox (such as talking or breathing in close proximity to each other, which may produce infectious respiratory particles).

According to the WHO, people who have multiple sexual partners have a higher risk of getting ampox. In addition, people can also become infected with ampox from contaminated items such as clothing or linens, from needlestick injuries in healthcare, or in community settings such as tattoo parlors.

People with ampox can spread the disease to others until all lesions have healed and a new layer of skin has formed.

Children, pregnant women, and people with weakened immune systems are at higher risk of getting ampox.

Why is Clade 1B deadly?

The Clade 1B strain is known for its higher virulence, causing more severe symptoms and complications. Patients infected with the Central African strain are at a higher risk of experiencing serious health problems, including a high mortality rate of up to 10%.

According to a report published in Nature, “Clade Ib appears to be distinct, and is transmitted primarily through contact between humans, including sexual contact. In the DRC alone there have been nearly 18,000 suspected cases of ampox this year, most of them children, and at least 600 deaths are likely attributable to the disease.”

Secondary health conditions can also distort mortality rates. For example, people living with HIV, who make up a significant portion of the population in many African countries, have a mortality rate from ampox that is twice as high as that of the general population, especially when their HIV is untreated.

According to Laurens Lissenborghs, an infectious disease researcher at the Institute of Tropical Medicine in Antwerp, Belgium, the high mortality rate among children under 5 may be partly due to malnutrition, a common problem among children in rural areas of the DRC.