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• The Mpox virus outbreak, primarily in Africa, has led to over 14,000 cases and 524 deaths, prompting WHO to declare it a global health emergency.
• Unlike Covid-19, Mpox spreads mainly through skin-to-skin contact, but respiratory droplets can also play a role in transmission.
• There is currently no proven treatment for Mpox, but vaccines are available and more are being developed.
• To prevent transmission, the public should avoid close contact with infected individuals, practice good hygiene, and stay vigilant.

The world is grappling with a new health concern, the Mpox virus. This viral zoonotic disease, primarily found in the tropical rainforest areas of central and west Africa, has recently seen an outbreak with over 14,000 cases and 524 deaths reported. The World Health Organization (WHO) has declared it a global health emergency, raising alarms worldwide. Mpox, also known as monkeypox, is a disease that causes fevers, headaches, muscle aches, and painful boils on the skin.

Unlike Covid-19, which spreads efficiently through respiratory droplets, Mpox spreads primarily through close, skin-to-skin contact. However, infectious disease experts have suggested that respiratory droplets might play a role in the spread of Mpox, albeit not as efficiently as Covid-19 or the flu. The US Centers for Disease Control and Prevention (CDC) and the WHO maintain that prolonged face-to-face interactions may increase the risk of transmission.

Transmission Dynamics and Global Impact

Dr. Dipu T S, Professor and Unit Chief, Infectious Diseases Department, Amrita Hospital, Kochim, emphasizes that respiratory droplets are considered to play a lesser role in transmission dynamics compared to direct intimate contact and sexual contact. A recent study published by the University of New South Wales in Australia showed that the current outbreak caused by the Clade 1 strain has reported 70 per cent of cases and 88 per cent of deaths in children in the Democratic Republic of Congo (DRC).

The researchers noted that the predominance of children in the DRC epidemic suggests transmission may be respiratory. In fact, smallpox and Mpox are respiratory viruses, and Mpox has been identified in ambient air. The study also showed that the variola virus (smallpox) was highly airborne, with the potential to transmit over long distances. Another study by a team of Spanish researchers in a 2023 study published in the journal The Lancet Microbe also showed that Mpox raised the risk of transmission indoors in poorly ventilated rooms.

Prevention and Vaccine Development

Dr. Lancelot Mark Pinto, Consultant Pulmonologist and Epidemiologist, P. D. Hinduja Hospital & Medical Research Centre, said that the keywords are "prolonged" and "face-to-face". He added that unlike highly transmissible airborne viruses such as influenza and SARS-CoV-2, Mpox isn't likely to spread during casual short encounters. He further emphasized that family transmission, sexual partner transmission, and caregiver transmission is much more likely, and therefore such encounters would need added protection.

Currently, there is no proven treatment against Mpox. However, vaccines are available. Bavarian Nordic's MVA-BN vaccine (Jynneos/Imvanex) -- approved in the US, Europe, and Canada -- is the leading Mpox vaccine worldwide. In addition, KM Biologics' LC16 vaccine is available in Japan and Emergent BioSolutions' ACAM2000 is also under regulatory review for Mpox in the US. The Serum Institute of India (SII), the world's largest vaccine maker, has also announced plans to develop a vaccine for Mpox.

To prevent the transmission of Mpox, the general public should avoid close contact with infected individuals, and practise good hygiene by regularly washing hands and disinfecting surfaces. The Indian government has directed airports, ports, and border authorities to stay vigilant in response to the global rise in Mpox cases. Central hospitals such as Safdarjung, Ram Manohar Lohia, and Lady Hardinge will have facilities for isolating suspected Mpox cases.

While the Mpox virus poses a significant health threat, it is not as easily transmissible as other airborne viruses like Covid-19 or the flu. The primary mode of transmission is through direct skin-to-skin contact. However, respiratory droplets can also play a role in transmission, particularly during prolonged face-to-face interactions.

Efforts are underway to develop a vaccine, and public health measures such as good hygiene practices and avoiding close contact with infected individuals are crucial in preventing the spread of the disease. The Mpox outbreak is a stark reminder of the need for global cooperation and preparedness in the face of emerging infectious diseases.