Mpox cases are soaring in Africa – What must be done to prevent a global pandemic

Mpox is one species of pox virus, such as smallpox and cowpox, characterised by a rash followed by bumps that appear on the skin. With mpox the bumps then fill with liquid and eventually scab over.

As we’ve come to know through diseases such as COVID-19, viruses change genetically and mutate quite quickly.

Mpox is no different, although pox viruses typically mutate much more slowly compared to other viruses, such as HIV. HIV changes approximately every three times a single virus replicate.

There are two strains of mpox – clade I and clade II. Think of them as two big branches on a tree.

Until about five or six years ago these clades weren’t that diverse.

Something has changed. These branches are growing and the leaves on the branches are becoming more numerous. In fact, we have new subclades for both I and II, so two new offshoot branches have appeared.

Clade II is far less dangerous with a case fatality rate of about 0.1%. In other words, roughly one person in a thousand dies.

Now scientists are seeing thousands of cases of clade I being reported in 16 countries in Africa and a case fatality rate of anything from 3% to 4%. That means three or four people in a hundred die. Many cases are children.

Let’s use COVID-19 again as a comparison. It was declared an international public emergency from 30 January 2020 to 31 December 2021, with an estimated case fatality rate of 1.2%.

Mpox is a relatively understudied virus. Until recently there were a handful of confirmed cases every year. It occurred primarily in tropical rainforest areas of central and west Africa. There was very little opportunity for the virus to adapt to a human host.

We don’t understand if genetic changes are making these viruses spread more easily and if the variants in circulation are more dangerous.

We do know the virus is changing and moving through lots of people. Viruses can only mutate when they’re passing through a host such as a human.

The more people it passes through, the more opportunity it has to change and potentially become more virulent or more transmissible.

Now this virus is moving through lots of people, there are lots of these opportunities.