There has been a global outbreak of mpox since 2022; this outbreak has been caused by the strain of mpox virus called Clade 2 and has affected around 116 countries worldwide. The current surge in cases is being driven by the rapid spread of a different strain – Clade 1b – which is predominantly ...affecting countries across the African region, particularly DRC, Burundi, Kenya, Uganda and Rwanda [1]. The guidance in this document applies to both Clades of mpox. WHO publishes a dashboard of updated cases globally here. Different Clades and Sub-Clades of mpox behave slightly differently to each other; WHO is monitoring for any significant differences between the Clades, including transmission routes. This guidance will be updated as more information becomes available on this issue.
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interim guidance, 25 November 2024
La variole du singe est une maladie infectieuse émergente causée par un virus transmis par des animaux infectés, le plus souvent des rongeurs. Elle peut ensuite se propager d’une personne à l’autre, mais la transmission de personne à personne ne peut à elle seule entretenir une éclosion. ...La présentation clinique est semblable à celle observée chez les patients atteints autrefois de la variole, mais moins grave. La variole a été éradiquée dans le monde entier en 1980. Cependant, la variole du singe est encore présente sporadiquement dans des régions d'Afrique centrale et occidentale, près des forêts tropicales humides. De manière générale, le taux de létalité dans les épidémies de variole du singe est de 1 à 10 %, mais avec des soins appropriés, la plupart des patients se rétablissent.
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Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated eff...icacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies.
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Bas Uele, Equateur, Haut Uele, Ituri, Kasai, Kasai Central, Kasai Oriental, Kinshasa, Kongo Central, Kwango, Kwilu, Lomami, Lualaba,
Maindombe, Maniema, Mongala, Nord-Ubangi, Nord-Kivu, Sankuru, Sud-Kivu, Sud-Ubangi, Tshopo et Tshuapa
Monkeypox is a rare viral zoonotic disease caused by a double stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family.
On August 13, 2024, the Africa CDC declared the mpox outbreak a Public Health Emergency of Continental Security (PHECS). The following day, the WHO declared it a Public Health Emergency of International Concern (PHEIC). A coordinated, continent-wide response is essential, co-led by the African Union... (AU) through the Africa CDC and the World Health Organization (WHO), in close collaboration with global partners working under a unified plan, budget, and monitoring framework.
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The rapid assessment tool (RAT) is meant to assess health facilities within mpox-affected areas that have at least one inpatient bed. Depending on time and resources available, certain facilities may be prioritized during an mpox outbreak. The RAT evaluates 16 infection prevention and control (IPC) ...and water, sanitation and hygiene (WASH) criteria identified as the minimum essential elements required for safe patient care and prevention of transmission within the health facility during readiness or response activities for outbreaks of mpox.
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L’orthopoxvirus simien ou virus de la variole du singe (MPXV), est un virus à ADN double brin qui appartient au genre Orthopoxvirus de la famille
des Poxviridés. Les poxvirus causent des maladies chez l’espèce humaine et beaucoup d’autres animaux ; l’infection se manifeste généralement... par la formation de lésions, de nodules cutanés ou d’une éruption cutanée disséminée. Les autres espèces d’orthopoxvirus (OPXV) pathogènes pour l’être humain comprennent le virus de la variole bovine et le virus variolique (responsable de la variole, qui a été éradiquée). Le virus de la vaccine est également un OPXV qui a été utilisé pour la vaccination humaine, et a été un outil essentiel pour l’éradication de la variole, obtenue en 1980. Le MPXV doit son nom au fait qu’il a été identifié pour la première fois chez le singe. Le MPXV se retrouve principalement chez les rongeurs, mais son réservoir reste indéterminé. Il existe deux clades connus du MPXV, l’un endémique en Afrique de l’Ouest, et l’autre dans la région du bassin du Congo.
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Monkeypox virus is an orthopoxvirus that causes human monkeypox, a viral disease with symptoms similar to smallpox, including fever and rash. Following the worldwide eradication of smallpox in 1980, monkeypox emerged as the most significant orthopoxvirus infection in humans. Cases are most often rep...orted from rural areas of Central and West African countries, particularly in regions close to tropical rainforest where people may have contact with infected animals. Someone can become infected through direct contact with respiratory droplets of another person who has monkeypox in the home or in a health facility, or with contaminated materials such as bedding. Although these are the main modes of person-to-person transmission, monkeypox outbreaks tend to occur in small clusters of a few cases without leading to widespread community transmission. For this reason, outbreaks can be easily controlled when responded to rapidly. On several occasions, monkeypox has been reported in other regions due to importation by travelers or infected animals. This course provides a general introduction to the disease through a video and accompanying downloadable presentation that can be reviewed at your own pace. It is intended for health personnel responsible for prevention and control of monkeypox, and for the general public.
The content and scope of this course on monkeypox have been tailored for outbreaks in African countries where the disease is endemic. The course material was last updated in 2020 and may not reflect most recent WHO guidance issued for the multi-country outbreak in 2022.
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This document provides information and recommendations for action, based on the current available knowledge around monkeypox. It is a first draft which will be updated in light of evolving evidence and additional information as they become available.
Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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