WHO urges govt, communities to intensify efforts in mpox fight

The World Health Organization has urged the Ugandan government and the general public to escalate efforts in the fight against mpox.

Mpox cases are now increasing at a higher rate, and Uganda has recorded a total of 262 confirmed cases in 28 districts, with 98 new confirmed cases reported in the last one week.

This is according to the Mpox Outbreak in Uganda Situation update of October 29, 2024.

One death has been recorded, translating into a case fatality rate of 0.38%. 

The latest situation report says that students make up the majority of the confirmed mpox cases in Uganda.

These are followed by fishermen, bar attendants, commercial sex workers, roadside vendors, and others. 

Additionally, males are more affected than females.

Mpox is an infectious disease caused by the monkeypox virus. It is a zoonotic disease transmitted from animals to human beings through handling or consuming infected animals, such as squirrels, rats, mice or monkeys.

It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick.

'Labour intensive'

Dr Elizabeth Mgamb, the team lead for emergency preparedness and response at WHO Uganda, said there is a need to bolster efforts so that mpox does not spread.

“The more it spreads the more likely that the vulnerable or most at risk will acquire the disease. And for those who are at most risk, the chances of them developing severe disease will be high,” she said.

Not forgetting, as the cases keep increasing, they will overwhelm the healthcare system just as the case was with the COVID-19 pandemic.

Mgamb was speaking during a media orientation on the mpox outbreak in Uganda at Fairway Hotel in Kampala on Thursday.

“As long as you have mpox patients, they have to be taken care of, and in the process, you still have the same workforce, same infrastructure. However much you mobilize, if the cases are many, it becomes recourse and labour intensive, and we really do not want to get there,” she said.

When an individual gets infected with mpox, they have to be isolated. The worry for some isolated cases is that if they are under the category of people who earn their living daily, it means they will not be able to fend for their families.

Mgamb said when learners are affected, it will in turn affect the education sector and others.

She said such outbreaks will end only when the communities are meaningfully engaged and are actively part of the response they lead.

“Risk communication and community engagement is a very big role because we need communities and everyone on board to curb the spread of the infection."

Besides the capital Kampala, mpox cases have also been confirmed in Nakasongola, Wakiso, Mayuge, Kasese, Mukono, Buliisa, Masindi, Nakaseke, Mityana, Mbarara, Adjumani, Amuru, Isingiro, Kanungu, Lira City, Lwengo, Luuka, Kagadi, Dokolo, Namayingo, Hoima City, Mubende, Kabale, Tororo, Gulu, Kalungu and Nebbi.

Treatment units with active admissions are in the districts of Nakaseke, Nakasongola, Kasese, Wakiso, Adjumani, Kabale, Isingiro, Buliisa Kanungu, Dokolo and Mbarara.

Mpox can be spread from an infected human being to another through direct physical contact such as kissing, or sexual contact with an infected person.

You can also catch the disease if you inhale droplets from an infected individual or if you get in contact with contaminated materials such as bedding, clothing or needles that have been used by an infected person.

Immaculate Atuhaire, the WHO Country Emergency Readiness Officer, said that infected pregnant women and breastfeeding mothers can pass the virus on to their unborn babies or newborn babies by close contact during and after birth.

Individuals can get infected by getting in contact with contaminated materials such as bedding, clothing or needles that have been used by an infected person, she added.

Signs and symptoms

It takes five to 21 days for the person infected with mpox to develop signs and symptoms, also termed as the incubation period.

Atuhaire said the signs and symptoms start from the entry point of the virus or the point of exposure. For instance, if your left hand rubs on the body of an infected person, then the rash will start from there.

Additionally, if you have had a sexual encounter with an infected person, then the rash will start to develop around the private parts, and later spread to the entire body.

The mpox signs and symptoms develop in two phases. 

The first phase is characterized by fever, body ache and runny nose, which lasts a few days. 

In the second phase, an individual will develop a skin rash, swollen glands (lymph nodes) in the neck, armpits, and groin. 

Other signs and symptoms may include mouth and sore throat, headache, back pain, and general body weakness.

Treatment and prevention

Being a viral disease, mpox does not have specific treatment, but health workers treat signs and symptoms as they appear. For example, they may treat a skin rash, a fever and manage pain.

“It is very important to seek treatment and supportive care early to avoid getting into a complicated phase,” said Atuhaire, adding that people will recover within two to four weeks based on the severity of the infection.

Tabley Bakyaita is the social behavioural change technical officer for risk communication and community engagement at Uganda's health ministry.

He said there is a need to raise awareness without scaring people but rather encouraging them to seek medical care.

He discourages the public from eating infected animals, such as squirrels, rats, mice or monkeys, given that mpox is transmitted from animals to human beings.

It is also important that you observe the standard operating procedures (SOPs), for example, washing hands regularly using soap and water, using an alcohol-based hand rub, and regularly cleaning contaminated surfaces.

Additionally, you should avoid shaking hands, hugging, kissing and pecking.

When infected with mpox, you should avoid physical or intimate contact with others, including sexual activity until the skin rash clears. 

If you are recovering from mpox, it is advisable to practice safer sex by using condoms for 12 weeks (three months), according to WHO recommendations.

You should not share linen, towels, or personal care items with anyone.

Background

On August 14, 2024, the UN's health agency WHO declared mpox a public health emergency of international concern. 

It was the second time in two years that the agency reclassified mpox to this highest level of response.

The global alert was preceded by a declaration by the African CDC recognizing mpox as a public health emergency of continental security.

These declarations underline the seriousness of the situation and the need for concerted efforts to curb the spread of the disease.