More than four years after the WHO (World Health Organization) declared COVID-19 a pandemic in March 2020, fears of another massive outbreak persist. On August 14, the WHO declared the current surge of ampox or monkeypox in Central Africa a global emergency requiring urgent action. Global concern for the virus grew further when it spread to other African countries, and in a short time a deadly strain of ampox – clade 1b – crossed the African continent to reach Sweden, Pakistan and other countries.
The virus has killed more than 500 people so far, mostly in the Democratic Republic of Congo, where the disease has been spreading since last year. The country has seen more than 96% of the nearly 17,000 recorded cases of ampox worldwide this year.
Though no cases have been reported in India yet, the central government is keeping a close watch on the situation. Our healthcare infrastructure faced severe challenges during the COVID-19 pandemic, resulting in thousands of deaths. No one would want to be caught off guard this time.
Is Mpox as dangerous as COVID-19 or swine flu?
Ampox is a zoonotic infection that causes flu-like symptoms and skin lesions. Being fatal in some cases, WHO first declared it a global emergency in 2022.
The ampox virus can be classified into two clades: clade 1 and clade 2. The first, found mainly in central African countries, is more severe and has a higher mortality rate. Clade 2 has milder symptoms and is found in western Africa. The latter caused a public health emergency in 2022, with about 300 cases – albeit mild – reported from Sweden. This time, it is the new and more serious clade 1b, identified in September last year, that is causing the current outbreak.
Though experts are concerned that MPox could be as dangerous as Covid-19 or swine flu, there is a difference in the nature of transmission. Both Covid-19 and swine flu were highly contagious because they spread through the air. In contrast, MPox spreads through close skin-to-skin contact, talking or breathing close to an infected person or using their dirty clothes or bed sheets. Rakesh K Mishra, former director of the Centre for Cellular and Molecular Biology, says, “MPox is unlikely to become a pandemic like Covid-19, primarily because of its mode of spread. It requires very close and physical contact, unlike SARS-CoV-2 which spreads through the air. Also, symptoms like blisters on the skin are more visible indicators and hence, it is easier to identify the disease and isolate the person to prevent the spread.”
The first case of ampox in India was reported in Kerala in 2022, from a traveller who arrived from the UAE. Soon, the virus spread within the country, with cases also being reported in Delhi among people who had not recently travelled internationally. According to the WHO, India recorded 27 confirmed cases and one death that year. The last case in the country was reported in Kerala in March this year, and no new cases have been reported since then.
How to stay safe?
In response to the WHO warning, both the central and state governments have swung into action. Monkeypox advisories have been issued and public health measures are being taken. Both the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) are closely monitoring the situation and reviewing international trends.
In Tamil Nadu, the Directorate of Public Health and Preventive Medicine (DPH) has already issued an alert. According to reports, passengers arriving from the Democratic Republic of Congo and Central African countries are being monitored by airport health officials and port health workers. Hyderabad and New Delhi – cities popular among African students pursuing higher education – have also been put on high alert.
The need for vaccines
In 2022, ICMR researchers isolated the first mpox strain. Pharmaceutical companies and drug manufacturers are being asked to develop vaccines and testing kits for the virus. Existing vaccines for smallpox and chickenpox can also provide protection in India.
Regarding other prevention strategies, Mishra says, “It is important to closely monitor the spread of the disease in different countries and be prepared for screening with already available methods of DNA-based diagnosis. An effective vaccine is already available, but ensuring its supply may not be easy.”
“Simple habits like avoiding close physical contact with a suspected/potentially infected person, maintaining distance from people with symptoms, and wearing a mask should be effective in preventing the spread of the infection,” says Mishra.
Developed countries, especially those in Europe, already have vaccines available for people at higher risk of monkeypox. And given the high quality of healthcare there, preventing the disease will be less challenging. It is underdeveloped African countries, which have neither vaccines nor the resources to purchase them, that are most at risk and need the most help.
(Bharti Mishra Nath is an associate editor at NDTV)
Disclaimer: These are the personal views of the author
