Last week, the World Health Organisation (WHO) declared mpox a global health emergency for the second time in just over two years. This decision was prompted by a surge in mpox cases in the Democratic Republic of the Congo (DRC) and other African countries, which the WHO has identified as a public health emergency of international concern (PHEIC).

The new strain of mpox (clade 1b) is particularly worrying due to its increased ability to spread through close contact and its disproportionate impact on children, according to a report by Reuters.

In response, Dr Jeremy McAnulty, NSW Health Executive Director of Health Protection, noted that over 15,000 mpox cases have been reported in central Africa this year, with many linked to this new strain. However, it has not yet been detected in Australia.

“With the recent increase in cases, NSW Health is urging people who may be at risk of mpox to stay vigilant for symptoms,” McAnulty said.

“Mpox spreads through close skin-to-skin contact, including sexual contact, and often starts with small pimple-like skin lesions, particularly in areas that are hard to see, such as the genitals, anus, or buttocks.”

Some people may also experience mild fever, headache, fatigue, swollen lymph nodes, or symptoms like mouth ulcers or rectal pain. Mpox can spread to others until the lesions heal.

“Anyone with symptoms of mpox, even if they’ve been vaccinated or their symptoms are mild, should immediately contact their GP or sexual health service for an appointment,” McAnulty said.

Since 2022, there has been a global outbreak of mpox, with over 97,000 reported cases in many countries outside Africa, including Australia.

Professor Oyelola Adegboye of James Cook University explained that the disease was endemic to Central and West Africa and was believed to have spread through contact with infected animals or their bodily fluids before 2022. Recent evidence suggests that its primary mode of transmission outside these regions is through unprotected sex, with a lower chance of it spreading through respiratory droplets.

“The 2022 global outbreak showed that almost 97 percent of cases occurred in males, primarily adults,” Adegboye said.

“There is relatively low human-to-human transmissibility of the virus, with most people experiencing mild illness and recovering within a few weeks, but it can be severe in immunocompromised individuals,” Adegboye said.

In August, the U.S. Centres for Disease Control and Prevention (CDC) issued a health alert, urging healthcare professionals to be vigilant for mpox in patients who have recently travelled to affected countries. Soon afterwards, the European Centre for Disease Prevention and Control raised its risk level for mpox after a case of the new virus strain was confirmed in Sweden—the first case outside Africa. Pakistan’s health ministry also confirmed at least one case of mpox in a patient returning from a Gulf country and the Philippines has reported a case of the milder clade 2 variant.

The current outbreak has spread more widely than previous ones, with transmission extending to neighbouring countries. So far this year, more than 17,000 suspected cases and 517 deaths have been reported across 12 central and eastern African nations, according to the Africa Centres for Disease Control and Prevention.

What does this mean for Australia?

While the immediate risk to Australians remains low, the global nature of the mpox outbreaks highlights the need for vigilance and preparedness. Australia’s health authorities are likely to monitor the situation closely, and it remains crucial for anyone at risk to consider vaccination, especially if travelling to or returning from affected regions.

Given the interconnectedness of global health, Australia must remain proactive in supporting international efforts to contain mpox, recognising that early intervention and resource allocation to affected regions are vital strategies to prevent further spread.

Keeping clean

The CDC has issued guidance on cleaning and hygiene protocols to prevent the spread of mpox:

• If cleaning and disinfection are performed by someone other than the person with mpox (e.g., an uninfected family member or friend), they should protect themselves by wearing disposable gloves, a well-fitting mask or respirator (such as an N95), and clothing that fully covers their arms and legs.
• Do not share items that may have the virus on them, such as bed linens, clothing, towels, washcloths, drinking glasses, or eating utensils, until they have been disinfected according to the guidelines in “How to Clean and Disinfect Types of Surfaces.”
• Cover upholstered furniture and porous materials that cannot be washed with sheets, blankets, tarps, or other covers.
• People who have recovered from mpox and are ending their isolation should clean and disinfect their entire living space, including frequently touched surfaces, shared items, or any objects or fabrics used during isolation.

ISSA has also provided guidelines for worker protection and appropriate disinfectants.

Photo by National Institute of Allergy and Infectious Diseases on Unsplash.