On Thursday, U.S. health authorities raised concerns about a lethal strain of mpox (formerly known as monkeypox) spreading in the Democratic Republic of the Congo (DRC). The Centers for Disease Control and Prevention (CDC) issued a warning, urging at-risk populations to get vaccinated to prevent a potential international spread.
The CDC’s concern centers on the Clade I strain of the mpox virus (in DRC), which has seen a significant increase in infections in the country over the past year. This strain is more lethal than the Clade II (West Africa) strain responsible for the 2022 global outbreak. While Clade I has a death rate ranging from 1.4% to about 10%, Clade II’s mortality rate was much lower, about 0.1% to 3.6%. The 2022 outbreak led to over 30,000 cases and nearly 60 deaths in the U.S.
While Clade I cases have not been reported outside of Africa to date, the CDC stresses the importance of global action to contain the virus. There is particular concern about the upcoming Pride festivities in June, which could allow the virus’s spread.
One of the most important challenges is the decline in vaccination coverage. Following the 2022 outbreak, vaccination efforts have waned. The CDC says that less than one in four Americans have received the two doses necessary for effective protection. Behavioral changes that helped curb the initial outbreak, such as reduced sexual activity among gay and bisexual men, have been difficult to sustain, leading to a false sense of security and a drop in vaccination rates.
The DRC has no stockpile of mpox vaccines and struggles with vaccine hesitancy and regulatory delays. In addition, the complex logistics of vaccine administration—requiring either two doses or intradermal injection—further complicate efforts in the conflict-affected region.
Researchers have revealed that the 2022 epidemic worsened by asymptomatic infections, with many individuals unknowingly spreading the virus. This finding highlights the need for comprehensive contact tracing and robust vaccination programs to prevent future outbreaks.
Most suspected Clade I cases in the DRC are among children under 15, but in the U.S., children are less likely to be affected due to better living conditions and hygiene practices. The virus spreads through close, sustained contact, often linked to interactions with infected animals or individuals. The CDC recommends precautions and vaccinations to prevent a potential global health crisis, and closely monitors the situation.
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