Mpox explained: How to protect yourself and what to watch out for

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OPINION

By Dominic Kizza

On August 14, 2024, the World Health Organization (WHO) declared the Mpox formerly known   as Monkeypox as a Public Health Emergency of International Concern (PHEIC).

This followed an International Health Regulations (IHR) Emergency Committee meeting, where affected member states, including Uganda, presented their data. The global trends indicate that all regions under the World Health Organization (WHO), except the Eastern Mediterranean, are currently reporting Mpox patients.  

A new form of the virus is at the heart of concerns, but many unanswered questions remain. Is it more spreadable? How deadly is it? Is this going to be a pandemic? Despite the uncertainty, we need to realize this is not one Mpox outbreak, but three to assess the threat. They are all happening at the same time, but affecting different groups of people and behaving differently.

They are labeled by their “clade” (branch of the Mpox virus family tree they come from).

• Clade 1a is causing most of the infections in the west and north of the Democratic Republic of Congo (DRC). This is the outbreak that has been ongoing for more than a decade. It is spread mostly by eating meat of infected wildlife known as bushmeat. Those who get sick can pass the virus to people they come into close contact with, and children have been particularly affected.
• Clade 1b is the new branch of the Mpox family and is causing the outbreaks in the east of the DRC and neighboring countries including Uganda. This is being spread along trucking routes with truck drivers having heterosexual sex with sex workers, and with infected people also passing it onto others through close contact.
• Clade 2 caused the Mpox outbreak of 2022 that spread in some parts of Africa and Europe. It had a connection with sex, predominantly affecting homosexual, and bisexual communities. Currently, Mpox outbreaks caused by clade 2 have become less prominent but it remains endemic in some parts of Central and West Africa.

How does Mpox spread?

In the past, people typically caught Mpox by coming into close contact with infected animals through an animal bite, scratch, bodily fluids, feces or by consuming meat that wasn’t cooked enough.

The first human case of monkeypox was detected in 1970 in the DRC. Since then, the virus periodically caused small outbreaks, though most were limited to a few hundred cases.  A handful of cases made it to other continents in the past, brought by travelers or the import of exotic animals that passed the virus to house pets and then to their owners.

The virus may have evolved to become more spreadable resulting in several outbreaks worldwide. Recent outbreaks spread by touching or sharing items like clothing and beddings with infected persons, or by the respiratory droplets produced by sneezing or coughing. Other routes of Mpox transmission include: from mother to fetus via the placenta, contact during and after birth, and through sexual intercourse.

What are the symptoms and how bad can a monkeypox infection get?

Mpox is typically a mild and self-limiting condition; you can recover without medication. On average, symptoms appear within six to thirteen days after exposure but can take up to three weeks.

People who get sick commonly experience a fever, headache, back and muscle aches, swollen lymph nodes, and general exhaustion. About one to three days after getting a fever, most people develop a painful rash that is characteristic of poxviruses. It starts with flat red marks on a patient’s face, hands, feet, mouth or genitals that become raised and filled with pus over the next five to seven days.

Many recent cases have only involved a single lesion or a few pustules on the genitals that do not spread to the rest of the body. Individuals with Mpox are deemed infectious until their blisters have completely crusted over, scabs have fallen off, and new skin has formed underneath. All lesions, including those on the eyes and body, must also have healed. This process usually takes between two to four weeks.

Children and people with underlying immune deficiencies may have more severe cases, but Mpox is rarely fatal. While one strain found in Central Africa can kill up to 10 percent of infected individuals, there have been no confirmed deaths reported outside Africa during the current outbreak.

How do you protect yourself from Mpox infection?

You can prevent yourself from getting infected with Mpox by avoiding close (face-to-face, skin-to-skin, mouth-to-skin, and mouth-to-mouth) contact with people who have been confirmed to have Mpox, or who have signs and symptoms of Mpox. Avoid touching or sharing personal items like bedding, eating utensils, clothes, phones, or other belongings of a person who has the signs and symptoms of Mpox.

Also avoid contact with all wild animals (alive or dead), especially those known to carry the virus, such as rodents or monkeys, and those that appear sick or have been found dead, and avoid eating wild animals (squirrels, rats, mice and monkeys).

In case you think you have Mpox or present with the signs and symptoms, stay at home and immediately inform your community health worker (CHW). You can also call the Ministry of Health toll-free line 0800 100 066 or send an SMS to U-Report at 8500. In addition, avoid physical contact with others and report all suspected cases in your community to the CHW or through the toll-free line.

Measures in place by the Uganda Ministry of Health

In response to the escalating Mpox outbreak, the Ministry of Health, the World Health Organization, and other partners have convened several briefing sessions with partners, heads of diplomatic missions, and agencies to provide an overview of the growing threat of Mpox in the region and Uganda. Cross-border surveillance at different points of entry has been strengthened, and sensitization of health workers and the general public has been done.

Combating the Mpox epidemic requires a robust and coordinated partnership among communities, national health authorities and international organizations. By pooling resources and expertise, these collaborations can enhance surveillance, strengthen preventive measures, and ensure effective response strategies.

The writer is a field epidemiology fellow at the Uganda Public Health Fellowship Program, Ministry of Health