Learning from Covid pandemic experience to contain the Mpox outbreak

Although there is no need to raise the alarm at this stage, the government should focus on raising awareness among the public and prepare contingency plans

Mpox, or monkeypox, is a zoonotic virus that was recently declared a public-health emergency of international concern (PHEIC) by the World Health Organization (WHO). The sudden emergence of the disease brings back memories of living through the Covid-19 pandemic. The most recent major outbreak of Mpox occurred in 2022. Since then, more than 99,000 cases have been reported, with the disease spreading across 116 countries. This year alone, more than 15,600 cases have been reported, claiming 537 lives. Cases have been steadily increasing in the Democratic Republic of Congo (DRC) and other parts of Africa. In India, the last case was detected in March this year. At the moment, no active Mpox case has been reported in the country. In this regard, the principal secretary to the Prime Minister chaired a high-level meeting to review the status of preparedness for Mpox in the country and related public-health measures.

While the 2022 outbreak was caused by the milder strain and was primarily sexually transmitted, the current outbreak is driven by a more lethal and virulent clade, spread through both sexual and non-sexual contact. However, the present assessment suggests that the risk of a large outbreak with sustained transmission remains low in India. The All India Institute of Medical Sciences (Aiims) has issued a set of guidelines for handling suspected cases. Testing facilities have been set up in 32 Indian Council of Medical Research (ICMR) labs, and isolation wards have been established in three hospitals in Delhi. Health teams at international airports and authorities at state level, including the Integrated Disease Surveillance Programme (IDSP) units, have been sensitised regarding symptoms and management of the disease. To mitigate the spread of the virus, policymakers and health officials have a lot to learn from the experiences of the Covid pandemic, including maintaining strict infection-control measures and proper documentation of cases throughout the process.
 

On the vaccine front, there is none specifically targeting Mpox. Many experts, however, believe that owing to the cross-reactivity property that vaccines possess, children receiving the varicella vaccine against chickenpox and adults who have been vaccinated for smallpox may be immune to Mpox. In fact, both the United States and Japan donated the Jynneos vaccine to DRC, the epicentre of the disease outbreak in 2022. Jynneos, a smallpox/Mpox vaccine, is believed to be able to shield at-risk people from Mpox, which is spread by close contact. Unlike the Covid-19 pandemic, when resources like vaccines, tests, and PPE kits took much longer to reach developing countries, efforts must be made to stop this inequity. Fortunately, since the mode of transmission for Mpox differs from that of Covid and it is easier to identify infected people, outbreaks are relatively easy to contain. As of now, it is not expected to pose any serious economic problem in the short run, though trade with and through African countries may be impacted. At this stage, although there is no need to raise the alarm, the government should focus on raising awareness among the public and prepare contingency plans. All information must be shared with states regularly to keep them prepared.