Mpox: what we know

You might have heard that, in 2022, a disease called mpox spread in parts of the world where it typically does not. The disease was first known as monkeypox but was renamed by the WHO and is now called mpox to avoid stigmatizing and racist language. Both names will still be used for a transition period until the end of 2023, but mpox is already the preferred term. 1

If you want to learn more about the viral outbreak and mpox, this article is for you. 

Between early May 2022 and July 2023, health authorities were on alert because scientists had identified an unusually high number of mpox cases in Europe, the Americas, and Australia. 2 There were also a few cases reported in Asia. This was especially concerning because mpox is rare outside Central and West African countries. 2

On 23 July 2022, the World Health Organization (WHO) declared the 2022 mpox outbreak a Public Health Emergency of International Concern. After the number of international cases dropped, this so-called PHEIC ended on 10 May 2023. 4

The 2022-2023 outbreak has caused more than 88,000 cases of mpox in 112 countries, resulting in 149 deaths reported to the WHO. 5 The peak of the outbreak was in August 2022. The weekly cases in December 2022 were already about 90% down compared to August and continued declining afterward. 6

In the first half of 2023, only about 1,500 cases had been reported from 13 countries, with the majority stemming from Nigeria and the Democratic Republic of the Congo, where mpox is endemic. Cases are still monitored in other countries, like China and Thailand. Because of the lower case numbers, the WHO decided to end the Public Health Emergency of International Concern and now pledges to support the countries with the most cases in establishing effective countermeasures to prevent a new global outbreak. 4

Although everyone can be affected by mpox, some populations tend to be at higher risk. Most affected populations in this outbreak were men who have sex with men. 7

Mpox is a disease that scientists first discovered in monkeys in 1958, which is where it got its old name, monkeypox. It was first seen in humans in 1970. 2 Mpox is caused by the mpox virus, which is from the same virus family as smallpox, but it causes a less severe illness than smallpox. 2

There are 2 types of mpox: clade I (formerly the Congo Basin strain) and clade II (formerly the West African strain). 2

PCR analysis indicates that the recent outbreak has been caused by clade II, which tends to have less severe symptoms than clade I. 2

For most people, mpox is not life-threatening. But it can cause painful symptoms, disrupt day-to-day life, and may be linked to social stigma. 8

Mpox usually causes fever and a distinctive rash, but other symptoms include: 2

• Headaches
• Back pain
• Aching muscles
• Swollen lymph nodes

The mpox rash usually appears on the face, hands, and feet, although it can also affect other parts of the body. Eventually, the rash turns into a scab and falls off. 2

Pregnant women, children, and immunocompromised people may be at increased risk of serious disease. 2

The smallpox vaccine may be up to 85% effective in preventing mpox. 9 There are also existing antiviral drugs that may be effective against mpox. 9

But for most people with an infection, treatment is not necessary as the disease will run its course in a couple of weeks. 10

Mpox infections can occur due to contact with infected animals or people. The virus spreads through skin-to-skin contact, exchange of bodily fluids, and respiratory droplets. 2 This could be during sex, parties, dance events, or other social gatherings.

Even though the recent outbreak mostly affected men who have sex with men, mpox is not considered a sexually transmitted disease. 8

The rise in cases may have been due to the drop-off of smallpox vaccinations around the globe in the 1980s. 11 This means most people under 45 have poor immunity to mpox and other similar viruses.

As of July 2023, the WHO has ended the Public Health Emergency of International Concern because the global number of new mpox cases dropped. If you live in West, Central, or East Africa, where the virus is endemic, or plan to travel to countries with higher case numbers, you should be aware of the situation and protect yourself against infection. 

Mpox is not a new virus. The distinctive rash means it's easy to know if you're infected and need to stay away from others. What's more, there are already effective vaccines and treatments against it.

If case numbers increase again globally, diligence will be necessary. But that doesn't mean you need to panic. 

Anyone can get infected with mpox and pass it on. The best ways to protect yourself and others are: 7

• Staying at home and calling to your doctor if you have symptoms 
• Avoiding skin-to-skin contact with anyone who has symptoms 
• Wearing a mask if you are in close contact with someone with symptoms 
• Washing your hands regularly
• Cleaning objects and surfaces that are regularly touched