Mpox, India, World Health Organization, 2022: An In-Depth Analysis

Between January 2022 and June 2024, India reported 27 laboratory-confirmed cases of Mpox and one death, according to the World Health Organization (WHO). This statistic highlights the presence and impact of Mpox within the country, albeit on a relatively smaller scale compared to other nations. The emergence of Mpox in India has prompted health authorities to enhance surveillance and reporting mechanisms to manage and contain the virus effectively. The WHO’s involvement underscores the global nature of the disease and the necessity for international cooperation in addressing public health threats.

The WHO’s 35th situation report, published in June 2024, revealed that globally, there were 934 new laboratory-confirmed cases of Mpox and four deaths reported from 26 countries. This data indicates a significant spread of the virus across multiple regions, necessitating a coordinated response to mitigate its impact. The distribution of cases varied significantly, with some regions experiencing higher numbers than others. This uneven distribution points to potential differences in healthcare infrastructure, reporting accuracy, and public health measures among different countries and regions.

According to the report, the African region reported the most cases, with 567 new infections. This high number is indicative of the endemic nature of Mpox in parts of Africa, where the virus is primarily found in tropical rainforest areas. The Americas followed with 175 cases, the European region with 100, the Western Pacific region with 81, and the South-East Asia region with 11 cases. These figures highlight the global reach of Mpox and the need for comprehensive surveillance and control strategies across continents. The varying numbers also reflect the differing levels of exposure and vulnerability among populations in these regions.

Interestingly, the Eastern Mediterranean region did not report any cases of Mpox in June 2024. This absence of cases could be attributed to several factors, including effective containment measures, lower exposure risk, or underreporting. It is crucial to consider these variables when interpreting the data, as they can significantly influence the perceived prevalence and spread of the virus. The lack of reported cases in this region does not necessarily imply immunity or absence of the virus but rather highlights the complexities of tracking and reporting infectious diseases.

Within the South-East Asia region, Thailand had the highest number of confirmed cases, with 805 reported infections. This substantial number places Thailand at the forefront of the Mpox outbreak in the region, necessitating robust public health interventions. Indonesia followed with 88 cases, while India reported 27 cases, Sri Lanka 4, and Nepal 1. These numbers underscore the varying degrees of impact within the region and the importance of tailored responses to address the specific needs and challenges of each country. The data also reflects the interconnectedness of regional health dynamics and the potential for cross-border transmission of infectious diseases.

Thailand also reported the highest number of deaths in the region, with 10 fatalities attributed to Mpox. India, on the other hand, reported one death. These mortality figures, while relatively low, highlight the potential severity of Mpox infections and the importance of timely medical intervention. The higher death toll in Thailand may be indicative of factors such as healthcare access, underlying health conditions, and the virulence of the virus strain circulating in the region. Understanding these factors is crucial for developing effective treatment protocols and reducing the fatality rate associated with Mpox.

According to the WHO, the current global data may underestimate the actual number of Mpox cases due to declining reporting by countries. This potential underreporting poses significant challenges for public health authorities in accurately assessing the scope of the outbreak and implementing appropriate control measures. It underscores the need for enhanced surveillance systems and international collaboration to ensure comprehensive and accurate data collection. Reliable data is essential for informing public health policies, resource allocation, and the development of targeted interventions to curb the spread of Mpox.

The WHO has emphasized the importance of surveillance for properly tracking Mpox cases. Effective surveillance systems enable early detection of outbreaks, prompt response measures, and continuous monitoring of the virus’s spread. This proactive approach is critical for preventing widespread transmission and minimizing the public health impact of Mpox. The WHO’s call for improved surveillance highlights the need for investment in healthcare infrastructure, capacity building, and international cooperation to strengthen global health security. Robust surveillance is a cornerstone of effective disease control and prevention strategies.

Four new countries in eastern Africa—Burundi, Kenya, Rwanda, and Uganda—have reported their first cases of Mpox. The emergence of Mpox in these countries signifies the virus’s expanding geographical reach and the need for heightened vigilance and preparedness. The identification of new cases in previously unaffected areas underscores the dynamic nature of infectious disease outbreaks and the importance of continuous monitoring. These new reports also highlight the potential for Mpox to spread to other regions, necessitating a global response to contain and manage the virus effectively.

The WHO identified clade i as the cause of rising Mpox infections in these eastern African countries. Understanding the genetic makeup and characteristics of the virus clade responsible for the outbreak is crucial for developing targeted interventions and treatment strategies. The identification of specific clades helps in tracing the virus’s origin, transmission patterns, and potential mutations. This information is vital for informing public health responses and ensuring that control measures are appropriately tailored to the specific characteristics of the virus strain involved in the outbreak.

The Ivory Coast in West Africa is experiencing an outbreak of Mpox linked to clade ii MPXV. This outbreak highlights the diversity of Mpox virus strains and the varying epidemiological patterns observed in different regions. The presence of multiple clades complicates the efforts to control the virus, as each clade may exhibit distinct transmission dynamics and clinical manifestations. Understanding these differences is essential for developing effective vaccines, treatments, and public health strategies. The situation in the Ivory Coast serves as a reminder of the ongoing challenges posed by Mpox and the need for continuous research and surveillance.

South Africa has reported two more confirmed cases of Mpox, adding to the growing list of countries affected by the virus. The spread of Mpox to South Africa underscores the interconnectedness of global health and the potential for infectious diseases to transcend borders. It also highlights the importance of regional cooperation and information sharing in managing public health threats. The new cases in South Africa emphasize the need for vigilance and preparedness, as well as the implementation of effective control measures to prevent further transmission. The situation calls for a coordinated response at both national and international levels to address the multifaceted challenges posed by Mpox.

Mpox is a viral zoonotic disease primarily found in tropical rainforest areas of central and west Africa and can occasionally be exported to other regions. The virus was first identified in monkeys in the 1950s, and the first human case was discovered in 1970. This historical context provides insight into the origins and evolution of Mpox, as well as its potential to cause outbreaks beyond its endemic regions. The zoonotic nature of Mpox highlights the complex interactions between humans, animals, and the environment in the emergence and spread of infectious diseases. Understanding these interactions is crucial for developing comprehensive strategies to prevent and control zoonotic diseases like Mpox.

WHO chief Tedros Adhanom Ghebreyesus is expected to convene an emergency committee to decide whether the Mpox outbreak constitutes a public health emergency of international concern (PHEIC). A PHEIC is the highest health alarm declared by the WHO and signifies a serious, sudden, unusual, or unexpected public health event that requires immediate international action. The declaration of a PHEIC would mobilize global resources and attention to address the Mpox outbreak and implement coordinated response measures. The upcoming emergency committee meeting will be held under the International Health Regulations (IHR), which provide a framework for global health security and cooperation. The main purpose of the meeting is to discuss and determine the global response to the ongoing Mpox outbreak, ensuring that appropriate measures are taken to protect public health and prevent further spread of the virus.