Respiratory droplets might play a role in the spread of Mpox but not as efficiently as Covid-19 or even flu, said infectious disease experts on Wednesday.
Mpox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions. The disease is currently seeing an outbreak in Africa with over 14,000 cases and 524 deaths have been reported, and the World Health Organization (WHO) has declared it a global health emergency.
It majorly causes fevers, headaches, and muscle aches, as well as painful boils on the skin. It spreads from person to person through close, skin-to-skin contact.
According to the US Centers for Disease Control and Prevention (CDC), prolonged face-to-face interactions (such as talking or breathing)” may increase the risk of transmission. The WHO also maintains that respiratory droplets (and possibly short-range aerosols) can result in Mpox transmission.
“This suggests that respiratory droplets might play a role in transmission. That being said, it’s considered to play a lesser role in transmission dynamics as compared to direct intimate contact and sexual contact which are the primary modes of transmission,” Dr. Dipu T S, Professor and Unit Chief, Infectious Diseases Department, Amrita Hospital, Kochi told IANS.
A recent study published by the University of New South Wales in Australia showed that the current outbreak caused by the Clade 1 strain has reported 70 per cent of cases and 88 per cent of deaths in children in the Democratic Republic of Congo (DRC).
“The predominance of children in the DRC epidemic suggests transmission may be respiratory. In fact, smallpox and Mpox are respiratory viruses, and Mpox has been identified in ambient air,” the researchers noted.
The study showed that the variola virus (smallpox) was highly airborne, “with the potential to transmit over long distances”.
Another study by a team of Spanish researchers in a 2023 study published in the journal The Lancet Microbe also showed that Mpox raised the risk of transmission indoors in poorly ventilated rooms.
Referring to the US CDC, Dr. Lancelot Mark Pinto, Consultant Pulmonologist and Epidemiologist, P. D. Hinduja Hospital & Medical Research Centre, said that the keywords are “prolonged” and “face-to-face”.
“Unlike highly transmissible airborne viruses such as influenza and SARS-CoV-2, Mpox isn’t likely to spread during casual short encounters,” Pinto told IANS.
“Family transmission, sexual partner transmission, and caregiver transmission is much more likely, and therefore such encounters would need added protection,” he added.
The 2022-2023 global outbreak of Mpox was caused by a strain known as clade IIb. Since 2022, the WHO has reported 99,176 cases and 208 deaths due to monkeypox from 116 countries.
A total of 30 cases were detected in India, with the last case in March 2024.
Global scientists claim that if the more pathogenic Clade I Mpox becomes highly transmissible between humans, it may pose a greater pandemic threat than Clade IIb.
However, Hans Kluge, WHO regional director for Europe, in a recent media briefing stated that Mpox, regardless of Clade IIb or Clade Ib, is not the new Covid, as speculated. He said health authorities know how to control its spread.
Currently, there is no proven treatment against Mpox.
Bavarian Nordic’s MVA-BN vaccine (Jynneos/Imvanex) — approved in the US, Europe, and Canada — is the leading Mpox vaccine worldwide.
In addition, KM Biologics’ LC16 vaccine is available in Japan and Emergent BioSolutions’ ACAM2000 is also under regulatory review for Mpox in the US.
The Serum Institute of India (SII), the world’s largest vaccine maker, has also announced plans to develop a vaccine for Mpox.
“Serum Institute of India is currently working on developing a vaccine for Mpox,” said CEO Adar Poonawalla, in a statement, adding that the company will share “positive news within a year’s time”.
“To prevent the transmission of Mpox, the general public should avoid close contact with infected individuals, and practise good hygiene by regularly washing hands and disinfecting surfaces,” Dipu told IANS.
How India can protect itself from Mpox
The deadly new strain of Mpox, often called monkeypox, first appeared in Central Africa and has since spread throughout the continent and beyond, posing a serious threat to public health worldwide.
The virus, which was previously limited to isolated areas, is now approaching India as Pakistan has already reported initial cases. The unanswered question is: Is India well equipped to handle one more possible pandemic?
“It is evident that Mpox is highly transmissible through close human contact, particularly during intimacy or through sexual fluids. This includes actions such as touching, hugging, kissing, or even sharing utensils or clothing of an infected person,” Dr. Prashant Sinha, Head- Emergency, PSRI Hospital told IANS.
He said that the virus can also spread through contact with contaminated materials like bedding, towels, or surfaces that have been exposed to the virus.
“We need to be highly alert in terms of coming close to an infected person or a potential carrier who has a history of travel particularly to any African nation,” Dr. Sinha added.
On Wednesday, the World Health Organization (WHO) announced a global health emergency due to the rapid spread of malaria in 13 African nations, including the Congo, where there have been documented cases of 14,000 and 524 deaths.
“Mpox affects the functioning of the brain and a headache is just one manifestation of it. The virus can cause inflammation in brain tissues, leading to more serious conditions such as encephalitis. We need to be vigilant and monitor patients closely, particularly those who present with neurological symptoms, to ensure timely intervention,” Dr. Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital told IANS.
He added that the neurological impact of Mpox calls for the need for a multidisciplinary approach to managing the disease.
Experts suggest a multi-pronged approach to prevent Mpox spread in India, including public awareness campaigns, vaccination drives, and strengthening healthcare infrastructure.
Early detection and isolation of cases are crucial, and WHO recommends contact tracing and quarantine measures.
Public awareness campaigns and preparedness are essential to prevent Mpox from becoming a widespread epidemic. The COVID-19 pandemic lessons should serve as a wake-up call for India.
Previously referred to as monkeypox, Mpox is an infectious disease brought on by the MPXV virus, which belongs to the Orthopoxvirus genus.
This virus belongs to two different genetic clades: Clade I and Clade II. The illness mainly spreads by direct contact with infected people, animals, or contaminated objects. Symptoms include severe rashes, fever, and enlarged lymph nodes.
The virus was originally discovered in 1958 in Danish research monkeys and the first case of humans was documented in Congo in 1970. Following smallpox’s elimination in 1980, Mpox started to emerge in Central, Eastern and Western Africa. (IANS)