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The World Health Organisation have declared a global public heath emergency in response to the new outbreak of the Mpox virus, with cases of the new clade detected in Europe, Ireland based experts were asked to comment.
Dr John P Gilmore, Assistant Professor in Nursing and Health Systems, University College Dublin, said:
“This new surge in cases is related to a different type or clade of the mpox virus, one which is more transmissible and causes more serious disease, with a higher mortality rate. We are now seeing cases of this clade 1 type of mpox being declared outside of Africa and many public health organisations are on alert. There has been no notified case of this type of mpox in Ireland, and there have been fewer than 10 cases of mpox this year in Ireland.
There is no evidence right now of clade 1 mpox being transmitted amongst communities of gay and bisexual men, and the majority of cases remain contained to regions of central and Western Africa. There are currently no plans for a top up vaccination programme in Ireland but the Health Protection and Surveillance Centre at the HSE are keeping it under consideration. Experts are confident that the Jynneos vaccine administered during the 2022 public health emergency (PHEIC) would be effective for this clade also.
While we saw a significant impact of the vaccination programme on decreasing transmission of mpox during the 2022 PHEIC, these programmes by and large were restricted to western countries and administered to communities of gay and bisexual men. Minimal vaccines were sent to the countries where mpox is endemic and what we are seeing right now is an abject failure of a global public health intervention. Infectious diseases do not respect borders, and new surges of mpox are inevitable while there is an inequity in how vaccines are administered.
Research we conducted in Ireland in 2022 and 2023 showed the significant impact stigma has on communities impacted by mpox, and showed how public health messaging and interventions are most effective when they are carried out in collaboration with community organisations.
The main message is that we shouldn’t panic right now. We should continue to observe and the biggest issue is that we need to take an equitable global health response to communicable diseases if we want to prevent international public health emergencies.”
Dr Connor Bamford, Lecturer, School of Biological Sciences, Queen’s University Belfast (QUB), said:
“We need to focus our attention on containing and eradicating mpox from the human population. This will require efforts in Africa as well as globally, which should involve sharing of crucial life-saving vaccines with the affected African nations and seeking to eliminate spread in other regions through robust surveillance measures
The latest outbreak is distinct from the last, which was the focus of the WHO’s PHEIC 2 years ago. This one is caused by a different variant of MPOX virus, which has jumped from animals and has begun spreading in people causing a significant outbreak. This variant is estimated to be more fatal than the other one.
Ireland remains at risk, like most other countries globally, due to increasing global connectivity either coming directly or indirectly from the affected African countries.
While helping Africa contain the virus, Ireland must enhance its monitoring of this strain like it demonstrated during epidemic last year Multiple introductions of monkeypox virus to Ireland during the international mpox outbreak, May 2022 to October 2023 – PubMed (nih.gov)”
Dr Eoghan De Barra, Consultant in Infectious Diseases, Beaumont Hospital, and Senior Lecturer, RCSI University of Medicine and Health Sciences said:
“The story of Mpox currently unfolding in West Africa is a major challenge in countries already managing a heavy burden of Infectious Disease and will have impacts beyond the African continent. In 2022 Mpox spread widely across Europe for the first time. Infections were generally limited to those with close physical contact with other infected people and most were mild. These infections were caused by a less virulent clade, or strain of the virus. Testing, education and vaccination programmes were implemented and the impact of that strain has been limited, though surveillance and vaccination programmes are ongoing. The current outbreak, focused on the Democratic Republic of the Congo and already with an imported case in Europe is with the a more virulent clade or strain. The impacts of this infection are more serious for individuals in terms of severity of disease and risk of death. The moves by the WHO focus the research and medical communities and signal to governments that they should assess their planning and preparedness. We have the tools to limit the impact of Mpox on human health, but need resources, education and ongoing scientific investigation to optimise them.”
Declarations of interest:
Dr John Gilmore: John is an expert in gender and sexual minority health and led the HSE funded community needs analysis of gay and bisexual men in Ireland during mpox with partners at HIV Ireland and University of Galway.