DANGER ZONES
Map reveals 15 mpox hotspots as 2 new country report cases and experts warn it’s ‘almost certainly’ in the UK
More than 500 people have died so far in the latest outbreak
MPOX has been declared a public health emergency of international concern by the World Health Organization (WHO).
The latest outbreak has seen cases confirmed in 15 countries - but experts fear this is only the beginning.
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Due to travel, they expect it to cross other borders rapidly.
Since the beginning of the year, mpox has already killed at least 511 people and infected 16,789 in the Democratic Republic of Congo (DRC), Africa Centres for Disease Control and Prevention data shows.
But the highly contagious condition quickly spread to Burundi and the Central African Republic, where there have been 226 and 258 cases respectively.
Mpox is also on the rise in Cameroon (35 cases, two deaths), Nigeria (24 cases), South Africa (24 cases, three deaths), Congo (169 cases, one death), Liberia (five cases), Ghana (four cases) Cote d'Ivoire (two cases), Rwanda (two cases), Uganda (two cases) and Kenya (one case).
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Last week, Sweden recorded the first mpox case outside of Africa, followed by Pakistan, which is monitoring three cases.
No other countries have confirmed cases or deaths, but experts fear it is "almost certainly" already in the UK.
Professor Paul Hunter, professor of medicine at the University of East Anglia, told Times Radio: "We saw with the 2022 pandemic of mpox that once it gets into sexual networks, it can spread very rapidly around the world and it’s actually very difficult to control that spread.
"I think it’s not surprising that we’ve had a first case in Europe, and I think we’re going to see more.
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"I think we will undoubtedly see cases in the UK over the coming weeks.
"The big question is whether or not the high mortality rates that are being reported in African cases will be replicated in Europe, and that I think there’s a degree of uncertainty over [that].
"So hopefully we won’t see the same sorts of levels of mortality that they’re seeing in Africa, but only time will tell."
Mpox is a viral infection that is transmitted through close contact, such as sex, skin-to-skin, touch, and talking or breathing close to another person.
There are two main types - clade 1 and clade 2.
A previous mpox public health emergency, declared in 2022, was caused by the relatively mild clade 2.
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However, this time it is the far more deadly clade 1 variant that is on the rise.
It has a fatality rate of around five per cent in adults and 10 per cent in children, compared to three per cent for its predecessor.
This compares to a 0.7 per cent fatality rate for the Omicron variant of Covid.
The WHO's European regional office said: "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."
Magnus Gisslen, an epidemiologist at Sweden’s public health agency, said the infected person was receiving care.
“We are closely monitoring the outbreak and we are continuously assessing whether new measures are needed,” he added.
There are currently no mechanisms in place to stop imported cases of mpox happening
Brian Ferguson,
A 34-year-old man in Pakistan, who had travelled from a Gulf country, is being treated in Khyber Pakhtunkhwa province.
His strain is yet to be confirmed, according to the country's Ministry of Health.
Provincial health authorities reported they had detected at least three cases in Pakistan.
Both United States and Canadian officials have said they have not identified any cases so far.
Should we be worried?
Dr Jonas Albarnaz, a research fellow specialising in pox viruses at The Pirbright Institute, said:
"This news of a case of clade 1 mpox in Sweden is concerning for two main reasons.
"First, this is the first clade 1 mpox virus case outside Africa. This indicates that the extent of the international spread of clade 1 outbreak in DRC might be larger than we knew yesterday.
"And second, clade 1 mpox virus is associated with a more severe disease and higher mortality rates than the clade 2 virus responsible for the international mpox outbreak in 2022.
"This is hard to predict whether we will see further cases of clade 1 mpox outside of Africa, but this case in Sweden is a warning call for public health authorities to be vigilant and implement robust surveillance and contact-tracing strategies to detect possible new cases early on.
"It’s also critical to determine what is the link between this clade 1 mpox virus detected in Sweden and the ongoing outbreak in DRC."
The outbreak in Africa prompted the WHO to announce a public health emergency of international concern (PHEIC) - the highest level of alert it can sound.
This category of alert has been used for Ebola outbreaks, Covid-19 and a 2022 mpox surge in Europe.
Brian Ferguson, associate professor of immunology at the University Cambridge, said: "It is not surprising, given the severity and spread of the outbreak in Africa, that travel between continents has brought this case to Europe.
"There will likely be more here and in other parts of the world, as there are currently no mechanisms in place to stop imported cases of mpox happening.
"The timing of this case comes less than 24 hours after the WHO’s PHEIC declaration and only 15 months after the WHO ended the previous mpox PHEIC in May 2023.
"The lack of activity in the intervening period has resulted in what could now become a new global outbreak.
"There should have been a greater effort to produce and distribute vaccines to the affected areas, but this has not happened.
"It is possible to address these problems but this requires rapid international co-operation."
Dr Meera Chand, deputy director at the UK Health Security Agency (UKHSA), said that the risk to Brits was low, but added that planning was underway to prepare for cases of clade 1.
"This includes ensuring that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission," she said.
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Pamela Rendi-Wagner, director of the European Centre for Disease Prevention and Control (EDCD), said: "As a result of the rapid spread of this outbreak in Africa, the ECDC has increased the level of risk for the general population in the EU/EEA and travellers to affected areas.
"Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases."
I mistook monkeypox for Covid – I’ve never been in so much pain
A MAN who caught mpox in 2022 first believed he had Covid before experiencing agonising symptoms that made him fear for his life.
Harun Tulunay, a 35-year-old charity worker, experienced extreme symptoms which left him hospitalised for almost two weeks.
Harun, who lives in London, first started to display flu-like symptoms back in early June 2022, such as high fever, chills and muscle aches.
After having recently caught Covid he was “convinced” he had had the virus again, he told The Sun. “But every test I did came back negative.”
A few days later, the charity worker developed a red and white rash on his body that resembled an allergic reaction, which he said was “nothing like the monkeypox pictures you see online”.
It wasn’t until a few days later that he also noticed a painless spot on his nose which he assumed was a mosquito-like bite or pimple.
Harun works in sexual health so is well versed in monkeypox and its symptoms, but he had never seen his rash or spot associated with the disease and so didn’t think he could have it.
A few days later, Harun's health took a turn for the worse as his fever reached 40C. “No amount of painkillers would ease the pain,” he said.
It was at this point that Harun developed swollen tonsils and a very sore throat.
“I couldn’t breathe, swallow or speak,” he said.
“I vividly remember calling up the hospital and crying in pain."
Harun was finally referred to the hospital where he was put into isolation.
His test confirmed he had monkeypox, and only then did lesions often associated with monkeypox begin to appear on his hands, legs, and feet.
"My throat was covered," he said, explaining that the lesion on his nose was bigger and had become infected.
“I was scared I would die alone in my hospital room,” he said. “I’d never been in so much pain in my life.”
“I remember looking at a water bottle and crying because I couldn’t drink it,” he added.
Harun has now made a full recovery.
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