Could mpox become the next COVID-19 pandemic? Infectious disease experts discuss potential outbreak.

The possibility of a COVID-like pandemic arising from the mpox (formerly monkeypox) virus has been raised as it has been classified as a global public health emergency.

On Aug. 14, the World Health Organization (WHO) classified the mpox outbreak as a "public health emergency of international concern" due to a rise in cases in the Democratic Republic of the Congo (DRC) and several African countries.

Since the outbreak was declared, there have been 545 reports of mpox cases, with 474 confirmed, as per WHO data up to Aug. 17.

According to the CDC, the symptoms of the condition include a painful rash on different body parts, fever, chills, fatigue, muscle aches, headache, swollen lymph nodes, and respiratory symptoms.

There are two types of mpox: Clade 1 and Clade 2.

The CDC noted that Clade 2 was the strain responsible for the 2022 global outbreak, and survival rates for this type are more than 99.9%.

The outbreak in the DRC and Africa is caused by Clade 1, which results in more severe illness and fatalities.

The CDC stated that while some outbreaks have resulted in the death of up to 10% of those infected, recent outbreaks have seen lower mortality rates.

The rapid spread of a new clade of mpox in eastern DRC and the reporting of cases in neighboring countries are very concerning, according to WHO Director-General Dr Tedros Adhanom Ghebreyesus when declaring a public health emergency.

"People are not going to catch mpox by being on the same bus or running into someone at the grocery store."

"To stop the outbreaks of mpox clades in DRC and other African countries and save lives, a coordinated international response is necessary."

Is mpox the next COVID?

The consensus among health officials is that mpox is unlikely to become a pandemic like COVID because it does not spread in the same way.

During a conversation with Planet Chronicle Digital, Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital in Boston, stated, "Certainly not."

The reason COVID-19 is so contagious is that it is a respiratory virus that spreads through aerosols, meaning that even brief contact with an infected person can result in infection.

Kuritzkes emphasized that COVID is contagious from a day or so before symptoms appear.

In contrast to mpox, transmission occurs through skin-to-skin contact in the majority of cases, he stated.

"Although bedding can sometimes be contaminated and infectious, people are unlikely to contract mpox by being on the same bus or encountering someone at the grocery store."

According to Kuritzkes, mpox, although less contagious than COVID, has the potential to cause a "widely distributed epidemic" through sexual contact.

"HIV is now a pandemic, found in all countries across the globe, but despite the high numbers, it is not transmitted by casual contact. Similarly, mpox is also a pandemic."

Dr. Marc Siegel, a senior medical analyst for Planet Chronicle and a clinical professor of medicine at NYU Langone Medical Center, stated that mpox is not the new COVID.

The virus spreads through direct contact, sex, kissing, and very close respiratory droplets, but not over longer distances through respiratory spread, he said to Planet Chronicle Digital.

Siegel stated that Clade 1 is currently located in the Democratic Republic of Congo and neighboring African countries.

"No cases of Clade 1 have been discovered in the U.S. despite increased surveillance, including wastewater analysis."

Karius's chief medical officer, Dr. Brad Perkins, emphasized that mpox is less contagious than COVID-19 for person-to-person transmission.

According to the expert, mpox is mainly transmitted from person-to-person through direct contact, including intimate contact, but on average, fewer individuals contract mpox from a case compared to COVID-19.

Who is most at risk?

Perkins pointed out that although mpox can affect anyone, research indicates that men who have sex with men are disproportionately affected, with a significant disease burden among Black and Hispanic men.

"Early recognition and diagnosis, along with awareness and targeted vaccination of those at highest risk, are crucial in emphasizing the importance of early recognition and diagnosis."

"While mpox can affect anyone, data has shown that men who have sex with men are disproportionately impacted."

Those with weakened immune systems or young children are most likely to experience severe infection, as with other viral infections, according to Kuritzkes.

He stated that the primary concern for mpox is individuals with HIV who are not currently taking effective antiretroviral therapy.

Perkins cautioned that even after the infection has cleared, survivors may still experience long-term effects and complications.

He informed Planet Chronicle Digital about conditions such as vision impairment, encephalitis, and scarring.

"We need deeper research into characterizing and addressing these long-term sequelae."

The CDC advises vaccination against mpox for men who are gay, bisexual or have sex with men, aged 18 or older, and possess certain risk factors.

Among other risks, there is a possibility of new diagnoses of sexually transmitted diseases and a history of multiple sex partners.

To avoid mpox, it is most evident to maintain a distance from individuals with lesions, as advised by Kuritzkes.

"The major challenge is ensuring that the vaccine reaches the population in Central and West Africa to put an end to the ongoing epidemic."

The USAID has dispatched 50,000 doses of the JYNNEOS mpox vaccine to DRC, but the global shortage of this vaccine remains a concern, as it is crucial to halt the spread, particularly if the outbreak expands.

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Perkins emphasized the importance of developing new innovations in mpox diagnostics, therapeutics, and preventive measures in addition to the current vaccines and antiviral treatments.