The World Health Organization’s (WHO) emergency committee is to meet to discuss the ongoing ampox outbreak, which has affected 116 countries so far. In a recent report, the health agency has classified it as an “acute” grade 3 emergency, the highest level of classification, indicating a need for urgent and immediate attention.

Since its onset in 2022, the outbreak has been ongoing, with a recent surge in cases globally. It is spreading in western, central and eastern African countries, with cases also being reported in the US and Europe.

In 2022, the first confirmed case of ampox in India was reported in a 35-year-old patient in Kerala.

What is Mpox?

Ampox, formerly known as monkeypox, is a viral disease caused by the ampoxvirus, which belongs to the Orthopoxvirus genus.

The disease was first identified in monkeys in Denmark in 1958, hence its original name, but it mainly affects rodents and other small mammals.

This rare zoonotic disease (transferred from animals to humans) originates from the Poxviridae family, whose viruses also cause other diseases like smallpox, cowpox, vaccinia, etc.

Currently, there are two clades, or genetic groups, of ampox: Clade I, which is found primarily in Central and Eastern Africa, and Clade II, which is associated with more cases in Western Africa.

The first human case of ampox was reported in 1970 in a nine-year-old boy in the Democratic Republic of the Congo.

In the year 2022, the World Health Organisation changed its name from monkeypox to ampox to address racist insinuations against a particular community following the outbreak that year.

what are the symptoms?

Ampox has symptoms similar to smallpox, including fever, headache, muscle aches, and a distinctive rash that often starts on the face and spreads to other parts of the body.

The virus spreads to humans through direct contact with infected animals, bodily fluids, or contaminated substances, and can also spread from person to person through respiratory droplets or close contact.

The symptoms last for 2 to 4 weeks.

Most people experience mild symptoms, but some people can develop more severe illness that requires medical care. Children, pregnant women, and people with weakened immune systems are generally at higher risk of contracting the virus.

What is it tested on?

According to the World Health Organization, the preferred laboratory test for ampox is detection of viral DNA using polymerase chain reaction (PCR).

The most accurate diagnostic samples are those obtained directly from the rash, such as skin, fluid, or scabs, collected through vigorous cleaning.

If there are no skin lesions, testing may be done using an oropharyngeal, anal, or rectal swab. Blood tests are not recommended.

Antibody detection methods are generally not useful, as they do not distinguish between the different orthopoxviruses.

What is the treatment?

Currently, there is no cure or treatment for ampox. WHO recommends supportive care to manage symptoms.

Patients are advised to drink plenty of water, eat nutritious foods, get enough sleep, and avoid scratching their skin.

General hygiene tips are also provided, such as washing hands frequently and after touching a wound.

If infected individuals cannot avoid sharing space with others, they should keep their wounds covered with a cloth or bandage until they can be isolated again.

Is there a vaccine available?

In January 2022, the European Medicines Agency approved tecovirimat, an antiviral originally developed to treat smallpox, for the treatment of ampox in exceptional circumstances.

However, experience with this therapeutic modality is limited, and it is usually used in conjunction with participation in a clinical trial or expanded access protocol to collect information for future reference.

Three vaccines developed for smallpox, MVA-BN, LC16, and OrthopoxVac, have been approved for the prevention of smallpox.

However, vaccination is only recommended for at-risk individuals, and the World Health Organization does not support mass vaccination against ampox.

Some time ago, the World Health Organisation had issued an invitation to manufacturers of the Mpox vaccine to submit expressions of interest for Emergency Use Listing (EUL), given the worrying trend of spread of the disease.