Understanding Mpox: Risks and Transmission

The World Health Organization (WHO) recently declared a public health emergency of international concern (PHEIC) regarding mpox, a disease that has resulted in nearly 19,000 cases and 541 deaths across Africa since the start of the year. This declaration comes despite the ongoing stigma associated with the disease, which has led to a name change from monkeypox to mpox in November 2022. The name change was prompted by concerns over racist and stigmatizing remarks directed at affected populations, particularly within African and LGBTQ+ communities. The term "monkeypox" is retained for the virus itself, which was first identified in 1958 in a colony of monkeys in Denmark. Health authorities continue to recommend the use of smallpox vaccines, such as the Bavarian Nordic vaccine, to combat mpox. The distinction between "clades" and "variants" is significant in the context of mpox, with clade 1 identified in the Congo Basin, including the Democratic Republic of the Congo (DRC) and surrounding areas. Subclade 1a has been endemic in the region since the 1970s, while subclade 1b emerged in September 2023 in eastern DRC, raising concerns among international organizations due to its potential spread to neighboring countries. Additionally, subclade 2b, which diverged from subclade 2a in 2017, has seen extensive spread outside Africa during 2022-2023, further complicating the public health response to the disease.