Sweden’s public health agency has recorded its first case of a more dreaded strain of mpox (formerly called monkeypox). This is another cause for alarm among health experts worldwide and especially so after the World Health Organization (WHO) declared an mpox outbreak in some parts of Africa as a public health emergency of international concern.
Key points
- Sweden reports first case of mpox Clade 1 outside Africa
- WHO declares mpox outbreak in Africa a public health emergency
- Clade 1 strain associated with more severe symptoms and higher mortality
- Patient infected during travel to affected area in Africa
- DRC reports over 15,000 potential cases and 548 deaths in 2024
- Experts warn of potential for more imported cases in Europe
- Vaccines available but concerns about supply and distribution
- Swift international action needed to contain the outbreak
The patient, who visited an African area suffering from a major outbreak of mpox Clade 1, sought treatment in Stockholm. The Clade 1 variant is known to be much worse than the Clade 2 version that caused global panic in 2022.
A close contact viral infection, mpox spreads through sexual activity, skin-to-skin touch and even speaking or breathing near someone infected. It causes flu-like symptoms and painful skin rashes. In severe cases it can be fatal with about four deaths per one hundred cases.
The clade-1 strain particularly this 1b subtype found in the Swedish case shows a more severe course of disease and higher death rate. Since its emergence last September in DRC, it has spread to several African countries including Burundi, Kenya and Rwanda.
The Swedish health authorities say that this single case does not increase the risk for the general population; nevertheless, other health organizations like WHO are closely monitoring events. ECDC also outlines that there will probably be new imported cases of Clade 1 mpox reported across Europe during next weeks.
In particular, there has been a severe outbreak in Africa especially DRC. Since January this year until now there have been over fifteen thousand possible cases reported by the Minister of Health DRC with five hundred forty-eight deaths affecting all provinces within the country leading to national strategic vaccination plans and increased disease surveillance at their borders.
Health experts around the world are apprehensive about potential further spread. One instance outside Africa implies that there might be bigger outbreaks than previously anticipated — Dr Jonas Albarnaz (Pirbright Institute). Dr Brian Ferguson (University of Cambridge) calls it a “concerning development,” but he also added that this is not altogether surprising given the seriousness of the outbreak on the continent.
The WHO’s emergency declaration is intended to galvanise increased international support for the affected areas. Although vaccines are available for those at highest risk or in close contact with infected individuals, experts are concerned about insufficient vaccine supplies and funds to reach these high-risk populations.
It should be noted that mortality rates from this strain might be lower in countries with advanced healthcare systems such as Sweden compared to some parts of Africa. However, there remains concern over further spread since currently, there are no effective measures to prevent imported cases.
ECDC points out that 6-13 days after infection symptoms usually start with fever and headache followed by rashes or sores and muscle pain. Most people suffer only mild or moderate illness and recover fully, although those with weaker immune systems are more likely to become seriously ill.
As with previous disease outbreaks, rapid international action will be key in containing the spread of this more dangerous mpox strain. Global health authorities are now ready and warned against any delayed response following an outbreak.