Following Sweden's announcement yesterday of the first novel clade 1 mpox case outside of Africa, the European Centre for Disease Prevention and Control (ECDC) today warned that more imported clade 1 infections are highly likely and urged countries to take preparedness steps.
The identification of the case in Sweden is part of quickly evolving developments with the virus, which included public health declarations this week from the Africa Centre for Disease Control and Prevention (Africa CDC), followed a day later by a similar one from the World Health Organization (WHO).
In its statement and risk assessment today, the ECDC recommended that countries with close travel links to Africa issue travel advice for those visiting or returning from affected countries. It said the risk is high for those who have close contact with affected communities and moderate for those who are close contacts of Europeans with suspected or confirmed clade 1 mpox infections.
For the general public, it assessed the overall risk from the clade 1 virus as low. The mpox situation in Africa is complex, with different countries battling different versions of the virus. The main hot spot is the Democratic Republic of the Congo (DRC), where a novel clade 1 virus emerged in 2023 and is spreading through social networks. Meanwhile, other African countries, such as South Africa, are experiencing spread of the global clade 2 virus.
Earlier infections from clade 1 viruses in endemic parts of Africa mainly involved zoonotic spread, with limited human transmission. However, the DRC outbreak saw the region's first sexual spread of clade 1 mpox, and health officials have reported transmission among social networks, such as through sex workers, and among household contacts. Some spread is also thought to be occurring through respiratory droplets.
Another alarming aspect of Africa's outbreaks is the spread to countries, such as the DRC's neighbors, that have never reported the disease before.
UK asks for vigilance
Meanwhile, the United Kingdom Health Security Agency (UKHSA) yesterday issued guidance on clade 1 mpox, noting that since it is more severe, the agency classifies it as a high-consequence infectious disease.
It urged healthcare providers to be vigilant, including for sexually acquired cases, especially if the clade isn't known and the patient has a history of travel to the DRC or other affected countries or is a contact of a confirmed clade 1 patient within 21 days of symptom onset.
UKHSA said all mpox samples, regardless if they are potential clade 1 cases, should be sent to the agency for clade differentiation tests.
MSF urges vaccine donations and access
In vaccine developments, Doctors Without Borders (MSF) today said it strongly supports the WHO's appeal to donors this week to help with a coordinated response to Africa's mpox outbreak and emphasized that the use of existing vaccine is key for reducing future spread.
Africa CDC has estimated that at least 10 million doses are needed to slow the spread of the virus, but very few doses are available in the region.
MSF urged countries with existing supplies of Bavarian Nordic's MVA-BN vaccine (Jynneos) that aren't experiencing active outbreaks to donate as many doses as possible. It also pressed the company to review its pricing policies and urgently seek partnerships with vaccine manufacturers in Africa.
