Mpox viruses are mutating rapidly and Africa is not equipped to cope with the situation

Mpox News: The Mpox virus, once confined to sporadic outbreaks, is now a rapidly mutating threat that is evolving faster than experts anticipated. As the virus spreads unchecked across Africa, with each transmission providing an opportunity for mutation, the continent faces an escalating public health crisis that could spread globally. Scientists warn that Africa may not be adequately equipped to deal with the evolving threat, raising concerns that the world could be on the brink of a major global health emergency.


Mpox viruses are mutating rapidly and Africa is not equipped to cope with the situation

The Mpox virus is rapidly mutating and evolving as it spreads unchecked across Africa, where a variety of factors exacerbate the situation. The diverse immunity statuses of individuals, coupled with the prevalence of other infections such as HIV, create an environment ripe for the virus to churn out new variants. Compounding the crisis is the severe shortage of vaccines and antivirals, leaving many infected individuals receiving incomplete treatments and even vaccination doses, which in turn increases the risk of drug resistance emerging.
 
Thailand Medical News had warned about this situation as early as July 2024 and also stressed that both clade 1 and clade 2 variants were mutating as seen from sequences being uploaded on GISAID.
 
https://www.thailandmedical.news/news/both-clades-of-mpox-is-possibly-mutating-but-no-one-is-willing-to-divulge-the-truth
 
https://gisaid.org/mpox-variants/
 
It is a wrong for many to simply focus on just the Clade 1 or rather in particularly the Clade 1B as the even the new Clade 2B that merged in 2022 is spreading and evolving at a worrisome rate around the world.
 
Rapid Evolution of the Mpox Virus
Mpox, formerly known as monkeypox, has been a public health issue in parts of Africa since 1970. However, it was not until the virus surged internationally in 2022 that it garnered global attention, prompting the World Health Organization (WHO) to declare a global health emergency. While that declaration ended after ten months, the virus has continued to evolve, giving rise to new and more dangerous strains.

One of the most concerning developments is the emergence of a new strain known as clade Ib. This strain is a mutated version of clade I, a form of Mpox that has been endemic in the Democratic Republic of Congo for decades. Unlike its predecessors, clade Ib is spreading more rapidly among humans, driven by a mutation known as APOBEC3, which is a signature of the virus adapting to human hosts.
https://www.biorxiv.org/content/10.1101/2023.06.27.546779v1
 
https://journals.asm.org/doi/10.1128/msph ere.00062-23
 
https://www.science.org/doi/10.1126/science.adg8116
 
Dr. Dimie Ogoina, an infectious disease expert at Niger Delta University Hospital in Nigeria and chair of the WHO's Mpox emergency committee, expressed grave concerns about the situation. He told mainstream media and Mpox News journalists, "We don't understand our outbreak very well, and if we don't understand our outbreak, we will have difficulty addressing the problem. Dr. Ogoina highlighted that clade Ib has evolved to spread among humans in less than a year, a stark contrast to clade IIb, which took over five years to do so in Nigeria.
 
There are also many new Mpox sub-lineages spotting worrisome mutations that have been spotted on GISAID though there have not become predominant in circulation yet possibly due to viral fitness issues, but is only a matter of time.
 
Africa's Limited Capacity to Respond
The rapid mutation and spread of the Mpox virus have exposed significant gaps in Africa's public health infrastructure. Scientists across Africa, Europe, and the United States have pointed out that the lack of funding, equipment, and access to essential supplies, such as chemicals needed for diagnostic tests, is hampering efforts to track and respond to the virus. This lack of resources is particularly problematic in regions like the Democratic Republic of Congo, where healthcare systems are already under immense strain due to ongoing conflicts and widespread displacement.
 
In eastern Congo, where clade Ib is particularly prevalent, only half of the cases are being diagnosed with laboratory confirmation. Dr. Salim Abdool Karim, a South African epidemiologist and chair of the Africa CDC's Mpox advisory committee, explained that many cases are identified based solely on clinical symptoms by overburdened doctors. The challenge of getting samples to laboratories is compounded by the fact that around 750,000 people have been displaced due to fighting between the M23 rebel group and the government, further straining the already fragile healthcare system.
 
To further complicate the matter, current laboratory testing platforms for Mpox are not accurate and reliable as too many false negatives are turning up which is dangerous as it could aid in the further transmission of the disease.
https://www.thailandmedical.news/news/africa-cdc-warns-that-current-mpox-lab-diagnostics-and-tests-are-unreliable-due-to-high-false-negatives
 
The Human Toll of the Mpox Outbreak
The mutated Mpox virus has not only spread rapidly but has also changed the way it is transmitted. Traditionally, Mpox was primarily acquired through contact with infected animals, a mode of transmission still prevalent in Congo due to factors such as deforestation and increased consumption of bushmeat. However, the mutated clade Ib and clade IIb strains are now spreading primarily through human-to-human contact, with clade Ib becoming almost a sexually transmitted disease.
 
Dr. Salim Abdool Karim noted that most cases of the mutated clade Ib strain are among adults, initially driven by an epidemic among female sex workers in South Kivu, Congo. However, the virus has also spread to children, particularly in displacement camps in eastern Congo and Burundi, where crowded living conditions have facilitated its transmission. The WHO has warned that children, pregnant women, and individuals with weakened immune systems are at higher risk of severe Mpox disease and death.
 
Clade I has historically caused more severe disease, with fatality rates ranging from 4% to 11%, compared to around 1% for clade II. While preliminary data from Congo suggests that the new Ib strain may be less deadly, Ogoina cautioned that some of the data might be mixed up, making it difficult to draw definitive conclusions.
 
The need for more research is urgent, but the lack of resources and infrastructure is hindering scientists' ability to conduct the necessary studies.

Global Implications of the Evolving Crisis
The rapidly mutating Mpox virus in Africa is not just a regional issue; it has significant global implications. The spread of the virus to other continents, including confirmed cases in Sweden and Thailand, underscores the potential for a wider outbreak if the situation is not brought under control. The mutation-driven evolution of the virus, marked by the APOBEC3 signature, suggests that the virus could continue to adapt and potentially become even more transmissible or severe.
 
The global health community is faced with the challenge of responding to multiple Mpox outbreaks simultaneously. The complexity of this response is exacerbated by the fact that clade Ib and clade IIb strains are now spreading through human-to-human contact, a mode of transmission that was not previously predominant for Mpox. This shift in transmission dynamics complicates efforts to develop effective vaccination strategies and other public health interventions.
 
Moreover, the situation in Africa highlights the broader issue of global health equity. The inability of African laboratories to access necessary supplies for diagnostic testing reflects the deep-seated disparities in global health infrastructure. As the world grapples with the ongoing threat of the Mpox virus, it is crucial to address these inequities to ensure a more effective and coordinated global response.
 
Conclusion: A Call for Urgent Action
The rapid mutation and spread of the Mpox virus in Africa are a stark reminder of the ever-present threat of emerging infectious diseases. As scientists scramble to understand and respond to the evolving crisis, the lack of resources and infrastructure in Africa poses a significant barrier to effective action. The international community must prioritize support for Africa's public health systems to ensure that the continent is not left to face this growing threat alone.
 
For the latest Mpox News, keep on logging to Thailand Medical News.
 
Read Also:
https://www.thailandmedical.news/news/insights-into-monkeypox-the-role-of-il-10-signaling-and-epigenetics-in-viral-persistence
 
https://www.thailandmedical.news/news/doctor-warns-that-mpox-deaths-can-occur-even-in-healthy-individuals-without-underlying-conditions