The World Health Organization has said that more imported clade 1 mpox cases were likely to be confirmed in Europe soon, after Sweden announced the first such case outside Africa in an outbreak that has killed hundreds in the DR Congo.
The case recorded in a traveller in Sweden was announced the day after the WHO declared the mpox surge in Africa a public health emergency of international concern – the highest alarm it can sound.
The UN health agency was concerned by the rise in cases and fatalities in the Democratic Republic of Congo, and the spread to Burundi, Kenya, Rwanda and Uganda.
Sweden’s Public Health Agency told AFP that it had registered a case of the clade 1b subclade – the same new strain of the virus that has surged in the DRC since September 2023.
“A person who sought care” in Stockholm “has been diagnosed with mpox caused by the clade 1 variant. It is the first case caused by clade I to be diagnosed outside the African continent,” the agency said in a separate statement.
The person was infected during a visit to “the part of Africa where there is a major outbreak of mpox clade 1”, state epidemiologist Magnus Gisslen said in the statement.
The patient “has received care,” Mr Gisslen said. The agency added that Sweden “has a preparedness to diagnose, isolate and treat people with mpox safely”.
“The fact that a patient with mpox is treated in the country does not affect the risk to the general population, a risk that the European Centre for Disease Prevention and Control currently considers very low,” it said.
Further European cases ‘likely’
The WHO said that more imported cases are likely to be confirmed in Europe soon.
“The confirmation of mpox clade 1 in Sweden is a clear reflection of the interconnectedness of our world … there are likely to be further imported cases of clade 1 in the European region over the coming days and weeks,” the agency’s European regional office said in a statement.
“There are likely to be further imported cases of clade 1 in the European region over the coming days and weeks, and it is imperative that we don’t stigmatise travellers or countries/regions.”
“Travel restrictions and border closures don’t work and should be avoided,” it added.
The WHO yesterday declared the mpox surge in Africa as a global public health emergency, sounding its highest possible alarm over the worsening situation.
Declaring public health emergency status is the WHO’s highest level of alert, and can accelerate research, funding and international public health measures and cooperation to contain a disease.
No cases of clade Ib strain in Ireland
The Health Protection Surveillance Centre has said no cases of clade Ib mpox have been detected in Ireland.
While there have been six mpox cases in Ireland so far this year, the HPSC has said they have been caused by clade II mpox – the type that caused the global outbreak mainly affecting gay, bisexual and other men who have sex with men which began in 2022.
The type of mpox that is causing concern in Africa is caused by a different clade, clade Ib.
There were 13 cases of mpox confirmed in Ireland in 2023, and 227 cases in 2022.
The clade Ib variant appears to spread more easily through routine close contact, including sexual contact.
It has spread from DR Congo to neighbouring countries, including Burundi, Kenya, Rwanda and Uganda, triggering the action from the WHO.
WHO chief Tedros Adhanom Ghebreyesus said the more than 14,000 cases and 524 deaths reported so far this year in DR Congo has already exceeded last year’s total.
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Why is mpox an emergency again, and how worried should I be?
WHO declares mpox a global public health emergency
Danish drugmaker Bavarian Nordic said it is ready to produce up to ten million doses of its vaccine targeting mpox by next year.
“We have additional manufacturing capacity of two million doses for 2024 and (a total of) ten million doses by 2025,” the company’s Vice-President Rolf Sass Sorensen said.
Bavarian Nordic is awaiting orders from the countries concerned before starting manufacturing.
“We need to see the contracts,” Mr Sorensen said.
The firm, whose vaccine against mpox has been licensed since 2019, said it has 500,000 doses in stock.
The US Department of Health said yesterday it would be “donating 50,000 doses of the Food and Drug Administration (FDA)-approved JYNNEOS vaccine to DRC”.
“Vaccination will be a critical element of the response to this outbreak,” it said in a statement.
Previous outbreaks
In May 2022, mpox infections surged worldwide, mostly affecting gay and bisexual men, due to the clade 2b subclade.
The WHO declared a public health emergency which lasted from July 2022 to May 2023.
That outbreak, which has now largely subsided, caused some 140 deaths out of around 90,000 cases.
The clade 1b subclade causes more severe disease than clade 2b, with a higher fatality rate.
Formerly called monkeypox, the virus was discovered in 1958 in Denmark, in monkeys kept for research.
It was first discovered in humans in 1970 in what is now the DRC.
Mpox is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.
The disease causes fever, muscular aches and large boil-like skin lesions.