The European Centre for Disease Prevention and Control (CDC) raised its risk alert level for mpox on Friday, and asked countries to maintain high levels of awareness among travellers visiting from affected areas.
The agency said it now sees a “moderate” risk of mpox, compared to “low” earlier, for the broader population and travellers. It added that the likelihood of sustained transmission in Europe remained very low, provided the imported cases are diagnosed quickly and control measures implemented.
The current outbreak in the Democratic Republic of Congo began with the spread of an endemic strain, known as clade I. But a new variant, clade Ib, appears to spread more easily through routine close contact, including sexual contact.
“Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” said the agency’s director, Pamela Rendi Wagner.
Earlier this week, the World Health Organization declared the outbreak of the disease in Africa a public health emergency after clade Ib cases began spreading to neighbouring countries of Congo. On Thursday, a case of the new offshoot was confirmed in Sweden, the first sign of its spread outside Africa.
The European CDC recommended that public health authorities plan and prepare for quick detection of any clade I cases that may reach Europe. It predicts the impact from this strain of the virus will be low in Europe if proper surveillance and control measures are implemented.
Mpox is a viral infection that causes flu-like symptoms and pus-filled lesions, and while usually mild, it can be fatal in rare cases.
Risk for people
The severity of the disease can vary depending on several factors including how the virus is transmitted, how susceptible the person is to the virus, and how much of the virus a person is exposed to.
Complications of mpox in areas where it is most common include:
- encephalitis
- related bacterial skin infections
- dehydration
- conjunctivitis
- inflammation of the cornea
- pneumonia
- long-term effects such as disfiguring scars and permanent corneal lesions.
The mortality rate of mpox ranges from 0-11% in outbreaks, with young children being the most affected. Immunocompromised individuals are at a higher risk of severe disease and HIV-positive patients may experience more severe symptoms.
How it spreads
The MPXV is transmitted to people by close contact with infected animals or people, or by touching virus-contaminated materials. It enters the body through (often invisible) injuries or wounds in the skin, or the mucous membranes. Monkeypox can be passed from one person to another during sexual contact and the risk of infection increases after sexual exposure.
Vaccination and treatment
Most people completely recover from mpox without treatment. Treatment is primarily symptomatic and supportive (alleviation of fever, itchy skin, pain, and hydration), including the prevention and treatment of related bacterial infections.
Although there is no specific vaccine for mpox, the smallpox vaccine can be used to protect people exposed to MPXV. Once vaccinated, people can still become infected, but the severity of the disease and the risk for hospitalisation are reduced.
Protective measures
When someone is diagnosed with mpox, it is important they isolate themselves until their rash completely heals, as this indicates that they can no longer transmit the disease. General protective recommendations include:
- Isolate yourself in your room and do not share household items with other members of the family.
- Avoid contact with immunocompromised persons and other persons at risk for severe disease until the rash heals completely.
- You can temporarily leave your home, but you should wear a medical face mask and make sure to cover the rash before going out.
- Maintain good respiratory and hand hygiene and wear a face mask when in contact with other people.
- Abstain from sexual activity until the rash heals completely.
