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New Delhi: After being successfully mitigated through vigilant efforts in 2023, ampox has re-emerged globally, spreading through familiar channels, especially in vast areas of Africa. With the confirmation from the world’s leading public health body, speculation is no longer an option.
Recent cases in Sweden and Pakistan indicate that the disease has moved out of its epicenter and may potentially spread further. Proactive measures are crucial to achieving a favorable outcome, as recent developments show. India,
Following WhoAnnouncing Mpox Public health emergency Issues of International Concern (PHEIC) on 14th August 2024, Prime Minister Narendra Modi Prime Minister Modi is closely monitoring the situation. His Principal Secretary Dr PK Mishra has chaired a high-level meeting to review the country’s preparedness and public health measures related to ampox.
In the wake of this worrying development, ETHealthWorld consulted several health experts to analyse the issue and its potential impact.
“Ampox is not a new disease. Like smallpox, it was first detected in humans in 1970 in the Democratic Republic of Congo,” said Dr Anurag Agrawal, head of the Koita Centre for Digital Health at Ashoka University. CongoMainly affecting countries in Central and West Africa. Clade I seen in the Congo Basin had low human-to-human contact Transmission But this resulted in more serious infections and deaths. Clade IIThe first, seen in western Africa, spread more widely, but with milder infections. The large international outbreak that began in July 2022, driven primarily by sexual contact between men, was caused by clade IIb, which has even lower virulence.”
“2022 Ampox outbreak Thus it was mostly a self-limited disease, with few complications. mortality rate “Despite this, around 200 deaths occurred, most of them in countries where ampox had never been reported before,” he said.
Simplifying it further, another expert, Dr. Gunisha Pasricha, Chief Scientist, Infectious Diseases Department, MedGenome, said, “According to WHO, so far this year, 15, 664 cases of ampox and 537 deaths have been reported in the Democratic Republic of Congo (DRC) alone, which is more than the total number of last year, which is a record in itself. Last month, four neighbouring countries of DRC, which had not previously reported ampox, have also reported more than 100 cases of clade 1b: Burundi, Kenya, Rwanda and Uganda. Also, Sweden has reported its first case of ampox clade 1b infection. The rapid spread of clade 1b in African countries and Sweden is the main reason for WHO declaring it a public health emergency of international concern.”
Describing the ongoing debate as different, Dr Agarwal warned, “The current outbreak seems to be different. It is clade I, which is likely to have a higher mortality rate. Cases are being reported from several countries neighbouring the DRC and most of the deaths are in children, raising fears of non-sexual human-to-human transmission. Though there is no clear evidence of respiratory transmission, there is fear that the disease may spread.” Virus is evolving. Smallpox can spread via the respiratory route, making it a terrifying pandemic. Every new infection is an opportunity for the virus to evolve, as we learned during the SARS CoV2 pandemic. Efforts must therefore be directed towards stopping the ongoing spread of MPox.”
Taking a similar view, Professor Gautam Menon, Dean of Research and Professor of Physics and Biology, Head of the Centre for Climate Change and Sustainability (3CS) at Ashoka University, said, “The variants of MPox detected outside Africa, first in Sweden and now in Pakistan, belong to clade 1b, which appears to be a more infectious form. The WHO has now warned that more cases are expected in Europe. Children seem to be particularly affected in this outbreak, especially those who live in crowded unhygienic conditions, such as in refugee camps. So far, our understanding is that transmission between people requires intimate contact, so it would be difficult to have a situation where the number of infected can grow explosively.”
To prevent an outbreak in India, Dr Agarwal suggested, “The best preventive measures we can take are those that prevent the infection from reaching us. The capacity we built during the SARS-CoV2 pandemic – in diagnostics, vaccines, genomic surveillance – can be used as part of global South-South cooperation. Serving others can sometimes be the best way to serve ourselves.”
Prof. Menoin said, “At this point, it would be prudent for India to screen for symptoms at the airports at the point of entry and isolate infected persons. Passengers arriving from countries where cases of ampox have been reported recently should be screened, especially. It is also important to track incoming passengers who may later report the disease, so that people who have come in contact with them can be informed and tested. Indian medical agencies should also ensure that they stay at the forefront of what is known about the epidemiology of ampox, whether a person can carry it without symptoms, modes of transmission, etc.”
Regarding the global attenuation of mPox, Dr. Pasricha stressed, “The declaration of an emergency underscores the need for affected countries to tackle the virus together and requires all countries to enhance surveillance, share data and work to better understand transmission; share tools such as vaccines; and apply lessons learned from prior public health emergencies of international concern in tackling the current outbreak.”
As ampox is re-emerging globally, experts have emphasised that India must proactively use its pandemic preparedness strategies to prevent its re-emergence within its borders. Early identification, vigilant surveillance of travellers and public awareness are critical to prevent the spread of ampox. By acting swiftly and collaboratively, India can minimise the risk of a widespread outbreak and protect public health.
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