Geneva, Switzerland:

The WHO said Friday it had for the first time prequalified a mpox vaccine — a move expected to speed up access to the jabs to fight an epidemic raging in Africa.

The announcement came on the heels of the arrival of the first MVA-BN vaccines to the Democratic Republic of Congo (DRC), the epicentre of the epidemic.

“This first prequalification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa and in future,” WHO chief Tedros Adhanom Ghebreyesus said in a statement.

“We now need urgent scale up in procurement, donations and rollout to ensure equitable access to vaccines where they are needed most… to prevent infections, stop transmission and save lives.”

WHO’s prequalification listing is used to evaluate the quality, safety and efficacy of medical products like vaccines, paving the way for the United Nations and other international agencies to procure them.

The list is also used by lower-income countries without the means to carry out their evaluations to fast-track procurement approvals.

“The WHO prequalification of the MVA-BN vaccine will help accelerate ongoing procurement of the mpox vaccines by governments and international agencies… on the frontlines of the ongoing emergency in Africa and beyond,” said Yukiko Nakatani, WHO’s assistant chief in charge of access to medicines and health products.

Mpox, previously known as monkeypox, is caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact. 

It causes fever, muscular aches and large boil-like skin lesions, and can in some cases be deadly.

The WHO declared an international emergency over mpox last month, concerned by the surge in cases of the new Clade 1b strain in the DRC that spread to nearby countries.

DRC has recorded nearly 22,000 cases and 716 deaths linked to the virus since January.

So far, some 200,000 vaccine doses have been delivered to the DRC by the European Union, along with about 50,000 from the United States.

Safe and effective 

WHO said it had based its prequalification assessment on information submitted by the manufacturer of the MVA-BN vaccine, Bavarian Nordic A/S, and a review by the European Medicines Agency.

“Good safety profile and vaccine performance has been consistently demonstrated in clinical studies, as well as in real-world use,” it said.

According to the prequalification, the vaccine can be administered to people over the age of 18 as a two-dose injection given four weeks apart.

With a majority of mpox cases and deaths in the DRC in children, WHO stressed that the vaccine could be used “off-label” in infants, children and adolescents, as well as in pregnant and immunocompromised people.

“This means vaccine use is recommended in outbreak settings where the benefits of vaccination outweigh the potential risks,” WHO said.

The agency also recommends single-dose use in outbreak settings where the supply of the vaccine is constrained, although it stressed that more data was needed on vaccine safety and effectiveness in such circumstances.

The currently available data, it said, shows that a single dose of the MVA-BN vaccine given before exposure has an estimated 76 per cent effectiveness in protecting against mpox, while two doses are estimated to be 82 per cent effective.  

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

The World Health Organization headquarters in Geneva, Switzerland. File
| Photo Credit: AP

The United Nations health agency said on Friday (October 4, 2024) that it had approved the use of the first diagnostic test for mpox, a key tool in countries battling outbreaks.

More than 800 people have died across Africa from mpox, where the disease has been officially detected in 16 countries, according to the African Union’s disease control centre.

“The approval for emergency use” of the test “will be pivotal in expanding diagnostic capacity in countries facing mpox outbreaks, where the need for quick and accurate testing has risen sharply”, the World Health Organization said in a statement.

The test, called the Alinity m MPXV assay and manufactured by Abbott Molecular Inc., enables the detection of the mpox virus from swabs taken from human lesions.

“By detecting DNA from pustular or vesicular rash samples, laboratory and health workers can confirm suspected mpox cases efficiently and effectively”, the WHO said.

“Limited testing capacity and delays in confirming mpox cases persist in Africa, contributing to the continued spread of the virus”, it said.

The approval of the test “represents a significant milestone in expanding testing availability in affected countries,” the statement quoted Yukiko Nakatani, an assistant director-general of WHO, as saying.

“Increasing access to quality-assured medical products is central to our efforts in assisting countries to contain the spread of the virus and protect their people, especially in underserved regions”, Ms. Nakatani said.

Mpox, previously known as monkeypox, is caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.

It causes fever, muscular aches and large boil-like skin lesions, and can be deadly.

The World Health Organization headquarters in Geneva, Switzerland. File
| Photo Credit: AP

In an important move to improve global access to Mpox testing, the World Health Organization (WHO) has listed the first Mpox in vitro diagnostic under its Emergency Use Listing procedure.

“The approval for emergency use of the Alinity m MPXV assay, manufactured by Abbott Molecular Inc, will be pivotal in expanding diagnostic capacity in countries facing Mpox outbreaks, where the need for quick and accurate testing has risen sharply. Early diagnosis of Mpox enables timely treatment and care, and control of the virus,’’ WHO said in a statement on Thursday (October 3, 2024).

Currently, 35 laboratories across India are equipped to test suspected cases of Mpox. In mid-August 2024, the WHO declared the surge of Mpox cases in several parts of Africa as a public health emergency of international concern. In India, 30 Mpox cases have been reported since the WHO’s declaration.

Limited testing capacity

The latest WHO statement added that limited testing capacity and delays in confirming Mpox cases persist in Africa, contributing to the continued spread of the virus. In 2024, over 30,000 suspected cases were reported across the region.

The presence of the monkeypox virus is confirmed by nucleic acid amplification testing, such as a real-time or conventional polymerase chain reaction (PCR), according to the WHO’s interim guidance on diagnostic testing for the monkeypox virus (MPXV). The recommended specimen type for diagnostic confirmation of an MPXV infection in suspected cases is lesion material.

The Alinity m MPXV assay is a real-time PCR test that enables detection of monkeypox virus (clade I/II) DNA from human skin lesion swabs. It is specifically designed for use by trained clinical laboratory personnel who are proficient in PCR techniques and in vitro diagnostic procedures. By detecting DNA from pustular or vesicular rash samples, laboratory and health workers can confirm suspected Mpox cases efficiently and effectively.

Expanding availability

“This first Mpox diagnostic test listed under the Emergency Use Listing (EUL) procedure represents a significant milestone in expanding testing availability in affected countries,” said Yukiko Nakatani, WHO’s assistant director-general for access to medicines and health products. “Increasing access to quality-assured medical products is central to our efforts in assisting countries to contain the spread of the virus and protect their people, especially in underserved regions,” Dr. Nakatani added.

The EUL process accelerates the availability of life-saving medical products, such as vaccines, tests and treatments, in the context of a public health emergency of international concern.

New Delhi:

The World Health Organization (WHO) said today that droplets were a “minor” route of transmission for mpox compared to physical contact, adding that more research is required to understand how the virus spreads.

The UN health agency declared mpox a public health emergency of international concern on August 14 amid a surge of cases across the Democratic Republic of Congo (DRC) and its neighbouring countries.

Mainly, two distinct clades of the virus, Ia and Ib, are causing significant concern in the DRC. A third variant, Clade II, originated in Nigeria and has been responsible for the global outbreak that began in 2022.

What is Mpox?

The mpox virus is an orthopoxvirus that causes mpox (monkeypox), a disease with symptoms similar to smallpox, although less severe, according to the WHO website. 

What are the symptoms of Mpox?

1. Fever
2. Extensive characteristic rash 
3. Swollen lymph nodes
4. Headache
5. Back pain and muscle ache
6. Lack of energy

The incubation period of mpox can range from 5 to 21 days. The febrile stage of illness (when fever persists) usually lasts 1 to 3 days, according to WHO. This is followed by the skin eruption stage, which can last for 2 to 4 weeks.

How does Mpox spread?

WHO has said that mpox spreads between people mainly through close physical contact with someone who has the virus. “Close contact includes skin-to-skin (such as touching or sex) and mouth-to-mouth, or mouth-to-skin contact (such as kissing),” it said.

However, WHO spokeswoman Margaret Harris said today that if a person with the virus had lesions, “if you’re talking closely to someone, breathing on them, physically close, face-to-face, there is a possibility” of viral spread, “but this is a minor source”.

“When you’re talking to somebody, you’re spitting out droplets,” but “it’s not a very major form of transmission — and it’s not a… through-the-air, long-distance sort of transmission,” she added.

The WHO recommends the use of facemasks for those with mpox, their close contacts and health workers treating them.

Does mpox have a vaccine?

Yes, there are vaccines recommended by WHO for use against mpox. However, only people who are at risk should get the vaccine. WHO has not recommended mass vaccination against mpox.

How has India prepared for a possible mpox outbreak?

India currently has no active mpox cases. The government had ordered the authorities in airports, ports and borders with Bangladesh and Pakistan to remain alert about incoming international passengers who show mpox symptoms.

The All India Institute for Medical Sciences (AIIMS) had issued protocols for handling suspected mpox cases in India. Various government hospitals were directed to set up isolation rooms for suspected and confirmed cases of mpox.

The institute has recommended setting up a screening process in the triage area wherein, upon arrival, patients with fever, rash, or a history of contact with confirmed mpox cases should be flagged for immediate assessment.

According to an assessment, the risk of a large outbreak with sustained transmission is low, officials had said.
 

(With inputs from AFP)

This file picture shows doses of Imvanex, a vaccine to protect against Monkeypox virus.
| Photo Credit: AFP

Thailand on Wednesday (August 21, 2024) reported a suspected first case of the new more dangerous strain of mpox, which the World Health Organization has declared a global public health emergency.

Also read:Risk of large outbreak of mpox low in India for now, says Health Ministry official

The patient is a European who travelled to Thailand from an African country, Thongchai Keeratihattayakorn, head of the kingdom’s Department of Disease Control told AFP.

Laboratory tests are under way to confirm the strain, but officials believe it to be from Clade 1. The infected person has been quarantined in hospital.

“We have done a test and they definitely have mpox and it’s definitely not Clade 2,” Mr. Thongchai said..

“We are convinced the person has the Clade 1 variant, but we have to wait to see the final result in the lab for two more days.”

Mpox cases and deaths are surging in Africa, where outbreaks have been reported in the Democratic Republic of Congo, Burundi, Kenya, Rwanda and Uganda since July.

The disease, caused by a virus transmitted by infected animals but passed from human to human through close physical contact, causes fever, muscular aches and large boil-like skin lesions.

While mpox has been known for decades, a new more deadly and more transmissible strain — known as Clade 1b — has driven the recent surge in cases.

Clade 1b causes death in about 3.6 percent of cases, with children more at risk, according to the WHO.

Formerly called monkeypox, the virus was discovered in 1958 in Denmark, in monkeys kept for research.

DR Congo has reported more than 16,000 cases and 500 deaths this year.

On August 15 Sweden reported the first confirmed Clade 1 case outside Africa.

A health worker speaks to women about mpox prevention at a clinic in Munigi, eastern Congo.
| Photo Credit: AP

Congo will receive the first vaccine doses to address its mpox outbreak next week from the United States, the country’s health minister said Monday, days after the World Health Organization declared mpox outbreaks in Africa a global emergency.

Mpox cases have been confirmed among children and adults in more than a dozen African countries, and a new form of the virus is spreading. Few vaccine doses are available on the continent.

Congo has the vast majority of the mpox cases and currently needs 3 million vaccine doses. The U.S. and Japan have offered to donate vaccines, Health Minister Roger Kamba told journalists. He did not say how many doses would be sent or when the ones from Japan would arrive.

The WHO has reported over 17,000 mpox cases and over 500 deaths worldwide this year. More than 96% of all cases and deaths have been in Congo, whose health system has long struggled to contain disease outbreaks over the country’s vast area and poor infrastructure. Children under 15 account for more than 70% of the cases and 85% of deaths in Congo.

Scientists are also concerned by a new version of mpox in Congo that might be more easily transmitted. Last week, Sweden reported its first case of the new version. Officials said the risk to the general public was considered “very low” and that they expected sporadic imported cases to continue.

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form causes milder symptoms and lesions on the genitals. That makes it harder to detect, meaning people might sicken others without knowing they’re infected. Mpox is not airborne and typically requires close, skin-to-skin contact to spread.

The WHO has said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks were linked to the epidemic in Congo.

The mpox outbreak in Africa is yet another example of how infectious diseases perceived to be “someone else’s problem”, and affecting mainly poor, developing countries, may suddenly pose unexpected global threats.

Mpox was discovered in 1958 (in captive monkeys, hence the original misnomer “monkeypox”) and the first human case was identified in 1970. Then for decades it was largely neglected by the scientific and public health communities, regarded as an uncommon infection in remote rural areas in tropical Africa without relevance for the rest of the world.

When a massive mpox outbreak hit developed countries in 2022, increased research funding led to a surge in scientific studies. On just one medical search engine, there’s been more research produced since April 2022 than in the preceding 60 years.

The 2022-23 global mpox outbreak happened despite repeated calls from African researchers for increased global investment in diagnostic, therapeutic and infection prevention tools for mpox.

The WHO has now declared the current upsurge of mpox in central Africa a public health emergency of international concern.

This is the highest alert level for events that constitute a public health risk to other countries and requires a coordinated international response.

We are infectious disease researchers who have worked on HIV, SARS-CoV-2 and other viral infections.

Mpox’s recent history is yet another reminder that an infectious disease in one corner of the world should not be regarded as someone else’s problem, as it can suddenly start to spread fast and far.

It also highlights global inequities in resource allocation and access to vaccines, diagnostics and treatments. These were made available in many industrialised countries and helped curb the global outbreak, but are still largely lacking in most of Africa.

The 2022 outbreak: a total surprise

The disease has been renamed “mpox” but the name of the virus, for now, remains “monkeypox” (MPXV). It is closely related to the smallpox virus.

MPXV was considered a zoonotic disease endemic in parts of central and west Africa. It was acquired mainly through close contact with wild mammals, especially handling bush meat, but there was no sustained human-to-human transmission.

Only very occasionally were cases seen outside the endemic areas, due to infected travellers or import of infected small mammals.

This changed abruptly in 2022 when a massive, rapidly evolving global outbreak caused over 99,000 laboratory-confirmed cases in 116 countries. At its peak in August 2022, over 6,000 cases were reported each week.

This outbreak came as a total surprise as most cases were reported from non-endemic countries, mostly in men who have sex with men who had become infected during recent sexual encounters.

Even though most cases were clinically not particularly severe and the death toll stands at just over 200, the global outbreak was declared a public health emergency of international concern by the World Health Organization on 23 July 2022.

Fortunately, case numbers soon plummeted due to a combination of behavioural changes and vaccination in at-risk groups.

Modern vaccines and antiviral drugs with activity against mpox were made available in many affected high-income countries.

These had been developed and stockpiled in the U.S. and Europe, mostly in preparation for a potential bioweapon attack using a poxvirus.

The global outbreak in 2022 was caused by clade II of MPXV, which is endemic in west Africa and not as virulent as clade I MPXV, which so far has only been seen in the Congo Basin. That first mpox public health emergency of international concern was declared in May 2023.

Upsurge in Africa

The African region is experiencing an upsurge in mpox cases which started in 2023.

As the continent which includes the areas where mpox has been endemic for a long time, Africa now presents a complex mosaic, cases arising from the endemic, largely zoonotic, pattern that used to be predominant in the past cases linked to the 2022 global outbreak, for example in South Africa. Most worryingly, ever increasing numbers of MPXV clade Ib infections reported from the Democratic Republic of Congo.

New, more dangerous strain The current clade I MPXV (formerly called Congo Basin strain) is more virulent than the clade II (west African) strain, resulting in a higher case fatality rate.

The ongoing outbreak has its epicentre in South Kivu province, eastern DRC, and has the potential to fuel a large pandemic.

It has a distinct epidemiological pattern with sustained chains of human-to-human transmission, often via the sexual route.

The virus which causes it is the newly defined clade Ib lineage. It displays mutations that are the hallmark of human-to-human spread that is estimated to have been happening since September 2023.

Case numbers are rising rapidly, even though many suspected cases are likely not tested and thus not counted as confirmed. Complicating matters, a commonly used test was found to miss infections with this lineage of the virus. It affects mostly adults. The case fatality rate is higher than it was in the 2022 global outbreak.

Already, this outbreak has resulted in mpox cases occurring in several neighbouring countries, including some (like Kenya) with no previous record of mpox.

The challenge is enormous. The eastern DRC is an area beset by multiple problems. This includes natural disasters, violence and infectious diseases including measles, cholera and poliomyelitis for the DRC.

In recent years the second-largest Ebola outbreak ever took place in the wider area and, despite the availability of vaccines and treatments, posed considerable challenges.

Stockholm:

The World Health Organization said more imported Clade 1 mpox cases were likely to be confirmed in Europe soon, after Sweden on Thursday announced the first such case outside Africa.

“The confirmation of mpox Clade 1 in Sweden is a clear reflection of the interconnectedness of our world… there are likely to be further imported cases of Clade 1 in the European region over the coming days and weeks,” the WHO’s European regional office said in a statement.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

The World Health Organization declared mpox a global public health emergency
| Photo Credit: AP

Sweden said on Thursday (August 15, 2024) it had confirmed a first case of mpox, a viral infection that spreads through close contact.

Earlier on Thursday (August 15, 2024), the World Health Organization declared mpox a global public health emergency for the second time in two years, following an outbreak in the Democratic Republic of the Congo that has spread to other countries.

Also Read: Explained | Global mpox infections: Symptoms, treatment, and status of outbreak

“We have now also, during the afternoon, had confirmation that we have one case in Sweden of the more grave type of mpox, the one called Clade I,” Health and Social Affairs Minister Jakob Forssmed told a news conference.

DR Congo:

An mpox outbreak in the Democratic Republic of Congo has killed 548 people since the start of the year, with all provinces affected by the virus, the health minister said on Thursday in a statement.

The World Health Organization (WHO) on Wednesday declared the mpox surge in Africa a global public health emergency, worried by the rise in cases in DRC and the spread to nearby countries.

“According to the latest epidemiological report, our country has recorded 15,664 potential cases and 548 deaths since the beginning of the year,” Health Minister Samuel-Roger Kamba said in a separate video message seen by AFP on Thursday.

The DRC is made up of 26 provinces and has a population of around 100 million.

The most affected provinces are South Kivu, North Kivu, Tshopo, Equateur, North Ubangi, Tshuapa, Mongala and Sankuru, Kamba said.

The UN health agency’s decision came the day after the African Union’s health watchdog declared its own public health emergency over the growing outbreak.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)