The World Health Organization (WHO) announced on 14 August that it is declaring mpox a ‘public health emergency of international concern’ — just 15 months after the end of the WHO’s previous mpox emergency. The declaration asks the world's countries to work together and to provide resources to improve surveillance, treat those who are infected and stop the outbreak. Mpox causes fluid-filled skin lesions, which can be painful, and, in severe cases, death.
During the past month, mpox infections have surged in Central Africa, affecting locations in the Democratic Republic of the Congo (DRC), and four countries in the region have reported mpox infections for the first time.
Evidence from past outbreaks indicates that the viral strain spreading in Central Africa is more lethal than the strain that sparked the 2022 global mpox outbreak, which has since infected more than 95,000 people and killed more than 180.
African countries have already reported more confirmed and suspected mpox infections in 2024 than in all of 2023: 17,500 this year, compared with about 15,000 in 2023. Children are particularly vulnerable: around two-thirds of infections in the DRC are in people under the age of 15.
Relatively Stable on Surfaces
Poxviruses can survive on surfaces for varying lengths of time, depending on environmental conditions and the type of surface. Under favorable conditions, some studies suggest that these viruses can remain infectious on surfaces for days to weeks.
Lower temperatures and higher humidity can extend the virus's survival time. For example, in a cool, dark environment, poxviruses may survive for weeks, while in warmer or more exposed environments, they may degrade more quickly.
Poxviruses typically survive for shorter periods on porous surfaces like cloth or paper, as these materials can absorb the virus and inactivate it more quickly.
Non-porous surfaces such as plastic, metal, or glass can harbor poxviruses longer because these surfaces do not absorb the virus, allowing it to remain on the surface and potentially infectious for extended periods.
High humidity can support the virus's survival, while very low humidity might desiccate the virus, reducing its viability.
Ultraviolet light from the sun can inactivate poxviruses, reducing their survival time on exposed surfaces.
Mpox virus can survive on plastic up to 7-10 days, on cloth for several hours to 1-3 days, on wood for a few hours to several days, and on leather for several hours to 1-3 days.
The virus can remain in respiratory droplets for minutes to several hours in, and in secretions for several hours to 3-5 days.
Transmission
Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals; this includes contact which is face-to-face (talking or breathing), skin-to-skin, mouth-to-mouth (kissing), mouth-to-skin contact, respiratory droplets or short-range aerosols from prolonged close contact.
The virus then enters the body through broken skin, mucosal surfaces (e.g. oral, pharyngeal, ocular, genital, anorectal), or via the respiratory tract. Mpox can spread to other members of the household and to sex partners. People with multiple sexual partners are at higher risk.
Human to human transmission occur through respiratory route but previously so many studies are conducted to prove that monkey pox virus was not transmitted through the respiratory route both in animals and humans. But now monkey pox is able to survive in humans due to genetic changes and human to human transmission is possible.
Animal to human transmission of mpox occurs from infected animals to humans from bites or scratches, or during activities such as hunting, skinning, trapping, cooking, playing with carcasses, or eating animals.
People can contract mpox from contaminated objects such as clothing or linens, through sharps injuries in health care, or in community setting such as tattoo parlours.
Symptoms
Mpox causes signs and symptoms which usually begin within a week but can start 1–21 days after exposure. Symptoms typically last 2–4 weeks but may last longer in someone with a weakened immune system.
Mpox is a viral infection with a rash that may be painful. Most people recover without treatment after a few weeks.
People usually develop symptoms 7 to 10 days after being exposed to the monkeypox virus. However, the time it takes to develop symptoms can range from 3 to 21 days after being exposed.
The rash can be painful and could affect any part of the body, such as the face and mouth, arms and legs, hands and feet, anus, rectum and genitals. The rash usually lasts between 2 to 4 weeks and changes through different stages. It finally forms scabs that later fall off. The rash can be accompanied by general symptoms such as fever, chills, headache, exhaustion, swollen lymph nodes, back, joint and muscle pain
Sometimes people may not notice that they have a rash but may have a sore throat or rectal pain.
People are contagious from the onset of first symptoms until the scabs have fallen off on their own and the skin is healed.
People may also be contagious up to 4 days before symptoms begin.
Complications
Children, pregnant people and people with weak immune systems are at risk for complications from mpox.People with mpox can become very sick. For example, the skin can become infected with bacteria leading to abscesses or serious skin damage. Other complications include pneumonia, corneal infection with loss of vision; pain or difficulty swallowing, vomiting and diarrhea causing severe dehydration or malnutrition; sepsis (infection of the blood with a widespread inflammatory response in the body), inflammation of the brain (encephalitis), heart (myocarditis), rectum (proctitis), genital organs (balanitis) or urinary passages (urethritis), or death.
Persons with immune suppression due to medication or medical conditions are at higher risk of serious illness and death due to mpox. People living with HIV that is not well-controlled or treated more often develop severe disease.
Disinfection
It's important to remember that the mpox virus can be easily killed using household disinfectants and regular laundry detergent.
At room temperature, a monkeypox virus that is capable of replicating can survive on a stainless-steel surface for up to eleven days, and at four degrees Celsius for up to a month. Consequently, it's very important to disinfect surfaces. Alcohol-based disinfectants are very effective against monkeypox viruses, whereas hydrogen peroxide-based disinfectants have proved inadequate.
Disinfection (after cleaning) by bleach or alcohol solutions is recommended for all areas where a person with mpox has spent time during their infectious period, including vehicles, and frequently touched items in the home (TV remote, chairs, door handles).
Prevention
Smallpox vaccines are proven to be protective against mpox virus, but their use is currently limited to people who work in a lab with the variola (smallpox) virus.
Prevention depends on decreasing human contact with infected animals and limiting person-to-person spread. Avoiding contact with infected animals (especially sick or dead animals). Avoiding contact with bedding and other materials contaminated with the virus.
Because poxviruses can survive on surfaces, practicing good hygiene, including regular handwashing with soap and water and avoiding touching the face, is essential in preventing transmission, especially in outbreak scenarios. Proper sanitation and surface disinfection are crucial in limiting the spread of the virus.
Thoroughly cooking all foods that contain animal meat or parts. Avoiding contact with people who may be infected with the virus. Using personal protective equipment when caring for people infected with the virus.
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