The risk of Mpox to the general population in countries outside the affected regions remains low but there is a need to learn more about the death rate and the factors influencing the spread of the virus, a former medical officer at the World Health Organisation (WHO) told News18.
Krutika Kuppalli, former medical officer for Covid-19 and Mpox Health Operations at WHO, said it’s important to increase community engagement and education about Mpox, which includes educating about “risk factors, modes of transmission, signs and symptoms, and how to access care”.
“Overall, the risk to the general population outside of the affected countries remains low,” she added.
On September 8, the Union Health Ministry said a young male patient, who recently returned from a country with ongoing Mpox transmission, has been identified as a suspected case of the virus. The patient has been isolated at a designated hospital and is reportedly stable.
Kuppalli, who has worked at the Geneva-based headquarters of WHO for the emerging diseases and zoonoses unit supporting Covid-19, and more recently Mpox, to develop tools and normative guidances applauded India’s swift efforts to recognise the first case.
“It is important to notice what India has done — detected a suspect case who had recently travelled to an affected country, quickly test, isolate and provide treatment while waiting for results,” she told News18.
Should We Be Worried About the Lethal Variant Clade 1B?
The previous attacks of Mpox were due to Clade IIB but, this time, the fear is Mpox Clade 1B. This clade, perhaps, has a higher rate of transmission. However, experts are not yet sure as the pool of patients is still small and adequate studies have not been done.
When asked about the risk of Mpox Clade 1B, Kuppalli said there are many things we are still learning about the new variant detected in South Kivu in September 2023”.
“We are seeing increased cases of Mpox in Africa, with the Democratic Republic of Congo (DRC) being the epicentre. Cases of Clade 1B have been found in Uganda, Burundi, Kenya, and Rwanda.”
She also highlighted that so far, most of the cases reported are Clade 1A, which has historically been found in DRC. The world, she said, is also seeing cases of Clade IIB which caused the global outbreak in both Africa and outside of Africa.
“It’s important to remember that since the 2022 outbreak of Mpox, which was due to Clade IIB, we have continued to see small outbreaks around the world since the last PHEIC (Public Health Emergency of International Concern) was lifted.”
She added: “Clade 1B is a variant of Clade 1. We are still understanding the evolution of the virus which is why we need to increase testing and sequencing. Sequencing helps us identify new mutations in the virus which may occur.”
But is this really lethal?
Kuppalli said Clade IA has a Case Fatality Rate (CFR) of about 3.4-3.6 per cent and, thus far, the information on Clade 1B has a CFR of about 0.6 per cent.
Case Fatality Rate (CFR) calculates the severity of a disease by defining the total number of deaths as a proportion of reported cases at a specific time. In this case, of the 100 people who have the disease, approximately 3.6 are anticipated to die from it.
“There is still lots to learn about CFR and how various things may affect it — such as the impact of high-quality supportive care, prior vaccination, co-infections, genetics and nutritional status,” said Kuppali, who also supervised treatment efforts at an Ebola treatment unit in Sierra Leone during the 2014 West Africa outbreak.
“Each of these elements can affect the severity and outcome of diseases, either reducing or increasing the likelihood of death among those infected.”
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