Lethal outbreak of new strain is spreading from central Africa.

GENEVA/ ISLAMABAD   -   The World Health Organisation on Wednesday declared the ongoing mpox outbreak in Africa a global health emergency.

WHO convened its emergency mpox committee amid concerns that a deadlier strain of the virus, clade Ib, had reached four previously unaffected provinces in Africa. This strain had previously been contained to the Democratic Republic of Congo.

Independent experts on the committee met virtually Wednesday to advise WHO Director-General Tedros Adhanom Ghebreyesus on the severity of the outbreak. After that consultation, he announced Wednesday that he had declared a public health emergency of international concern — the highest level of alarm under international health law.

Also known as PHEIC, this is a status given by WHO to “extraordinary events” that pose a public health risk to other countries through the international spread of disease. These outbreaks may require a coordinated international response, according to the organization.

The Africa Centres for Disease Control and Prevention declared the outbreak a public health emergency of continental security the day before — the first such declaration by the agency since its inception in 2017.

Since the beginning of this year, more than 17,000 cases and more than 500 deaths have been reported in 13 countries in Africa, according to the Africa Centers for Disease Control and Prevention, which classifies the outbreak as a “very high risk event.” The highest number of cases — more than 14,000 — is in the DRC, which reported 96% of confirmed cases this month.

Mpox, formerly known as monkeypox, is a viral disease that can spread easily between people and from infected animals. It can spread through close contact such as touching, kissing or sex, as well as through contaminated materials like sheets, clothing and needles, according to WHO. Symptoms include a fever, a painful rash, headache, muscle and back pain, low energy and enlarged lymph nodes.

For decades, the disease had largely been found in Central and West Africa, but it also began spreading in Europe and North America in 2022. WHO previously declared the spread of mpox a global health emergency in July 2022 and ended it in May 2023.

Mpox is characterized by two genetic clades, I and II. A clade is a broad grouping of viruses that has evolved over decades and is a genetic and clinically distinct group. Clade Ib is more transmissible and causes more severe disease.

WHO officials previously said the virus could be contained “quite straightforwardly, if we do the right things at the right time.” They are further calling for international cooperation in financing and organizing efforts to quell the outbreak.

The organisation has already signed off on the Emergency Use Listing process for both mpox vaccines and developed a regional response plan requiring $15 million, with $1.45 million already released from the WHO Contingency Fund for Emergencies.

In response to the rising cases of Mpox globally, particularly in African countries, and the recent outbreak of the Zika virus in Pune, India, the National Command and Operations Center (NCOC) Wednesday issued an alert to the Border Health Services, urging strict vigilance at all points of entry, National Institute of Health (NIH) officials said on Wednesday.

In an emergency meeting, the NCOC urged the Border Health Services to maintain strict vigilance at all points of entry. It also alerted all provincial health departments to remain vigilant and monitor potential outbreaks of vector-borne diseases like Zika, dengue, and chikungunya.

These viruses, carried by mosquitoes present in Pakistan, pose a significant threat, especially during the ongoing monsoon season when accumulated rainwater creates ideal breeding conditions.

“An increase in Mpox cases has been observed in several countries, including those in Africa, while a rise in Zika virus cases has been reported in Pune, India. The NCOC is closely monitoring the situation and has advised the Border Health Services (BHS) to screen international travelers for Mpox and Zika virus at all airports and points of entry,” an NIH official said.

In the past year, Pakistan has confirmed nine cases of Mpox, all among travellers returning from the Middle East and other countries. Tragically, one patient, who was co-infected with HIV and Mpox, later died in Islamabad.

During a special session of the NCOC on Mpox, it was noted that around 15 African countries are currently reporting Mpox cases, with a total of 2,030 confirmed cases. Four countries — Burundi, Kenya, Rwanda, and Uganda — previously unaffected by Mpox, have reported cases since mid-July 2024.

According to NIH officials, the World Health Organisation (WHO) reported that from January 1, 2022, through June 30, 2024, a cumulative total of 99,176 laboratory-confirmed cases of Mpox, including 208 deaths, were reported from 162 countries across all six WHO regions.

In June 2024 alone, 934 new cases were reported, with most cases coming from the African Region (61%), followed by the region of the Americas (19%) and the European region (11%).

Regarding the Zika virus, although no official cases have been detected in Pakistan, researchers at Aga Khan University claim to have identified four cases in Karachi between 2021 and 2022, indicating that Zika virus is circulating in the city, according to NIH officials. In neighboring India, 81 cases, including four deaths, have been reported in Pune as of August 8, 2024. Among these, 32 cases were reported in pregnant women. “We also have the vector — the mosquito that carries the Zika, dengue, and chikungunya viruses. Given the current monsoon rains, conditions are highly conducive to the spread of the Zika virus in the country. In light of this, we have alerted all relevant authorities, provincial health departments, border health services, and others to remain vigilant against outbreaks of vector-borne diseases,” an NIH Islamabad official added.