Over a month ago, the World Health Organization declared the Mpox global health emergency over. However, even though cumulative cases across the world continue to decline, there has been an increase in reported cases from some countries, particularly in Southeast Asia and the Western Pacific Region.
What is monkeypox?
Monkeypox, or mpox, is a viral disease that primarily spread to the human population through zoonotic spillovers, with rodents and primates serving as potential reservoirs. Mpox can be transmitted between humans through close contact and exposure to infected bodily fluids or lesions. Sexual contact is also believed to contribute to the spread of the disease particularly among certain demographics.
Mpox was a rare infection that was predominantly restricted to some countries in Africa until early 2022, when a rise in cases across the globe where the disease was not endemic, particularly in Europe and North America. According to the WHO, over 87,000 cases of mpox have been reported to date since January 2022, including 146 deaths.
Global situation update
In recent weeks, although overall global cases of mpox have been decreasing, some regions are seeing an increase in reported cases. In the European region, new cases have been reported from Spain and the U.K. But overall, the large European and North American outbreaks observed in 2022 have been brought under control through vaccination campaigns and increasing awareness about the disease.
The global situation of mpox is, however, far from being resolved, with an increasing number of reports from new countries, with significant impacts observed in Southeast Asia and the Western Pacific region. In June 2023, China reported four cases of mpox — two from Beijing and two from Guangzhou — raising concerns about the spread of the disease in the country. Two cases were also reported from Sri Lanka, in patients who had a travel history to Dubai. Earlier this year, mpox was also detected in Thailand, Taiwan, Pakistan and Japan. Incidentally, several cases have a travel history to the Middle East, however, reports from Middle East do not indicate an increase in the number of cases.
Cause for concern
Mpox being reported from newer territories is worrisome as the disease is potentially expanding its reach through an undetected spread, posing new challenges in its containment efforts. The lack of a corresponding surge in reported cases suggests that there may be challenges in accurately capturing and documenting cases in the Middle East, suggesting that there may be challenges in detecting cases in the region. This also highlights the need for improved reporting mechanisms to obtain a more comprehensive understanding of the situation in the Middle East. Meanwhile, the African region has also experienced a surge in cases, notably in Cameroon, the Democratic Republic of the Congo, and Nigeria.
Amidst increased globalisation and travel, the need for global public health efforts, cooperation, and resource sharing has never been more crucial. Genomic surveillance of the monkeypox pathogen allows for contact tracing and monitoring of its evolution. However, there is a noticeable lack of genomic data from developing countries, particularly in Asia. As we move forward from the global pandemic, it is crucial to remain vigilant and prepared for future challenges, taking proactive measures to curb infections and protect vulnerable populations.
(Bani Jolly and Vinod Scaria are researchers at CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi.)
