LONDON — The spread of smallpox in Africa, which prompted the World Health Organization to declare a global emergency, was largely due to decades of neglect and the international community's failure to stop sporadic outbreaks among people with little immunity to related diseases, leading African scientists said Tuesday.
According to Dr Dimier Ogoyena, chair of the WHO's MPOX Emergency Committee, carelessness has allowed new, more contagious strains of the virus to emerge in countries with few resources to stop it spreading.
Mpox, also known as monkeypox, spread largely undetected in Africa for years before becoming an outbreak in more than 70 countries in 2022, Ogoyina said in an online press conference.
“What's happening in Africa right now is different from the epidemic that will emerge globally in 2022,” he said. While the 2022 epidemic was overwhelmingly concentrated among gay and bisexual men, MPOX in Africa is now spreading through sexual transmission as well as through close contact between children, pregnant women and other vulnerable groups.
Most people over 50 are likely to have been vaccinated against smallpox, and so may have some protection against the disease, but Ogoyna said this is not the case for Africa's younger populations, who are mostly susceptible to the disease.
Mpox is in the same family of viruses as smallpox, but causes milder symptoms such as fever and body aches. It is primarily transmitted through close skin-to-skin contact, including sexual contact. Severe cases cause noticeable blisters on the face, hands, chest, and genitals.
Earlier this month, the WHO declared the MPOX outbreak, which is surging in Congo and 11 other African countries, a global emergency.
The Africa Centers for Disease Control and Prevention said Tuesday that there have been more than 22,800 MPOX infections and 622 deaths on the continent, a 200% increase in cases over the past week. The majority of infections and deaths have occurred in Congo, with most MPOX infections in children under the age of 15.
Dr Placid Mbala Kingebeni, a Congolese scientist who helped identify the latest MPOX, said it makes it difficult to track the spread of the variant because diagnostic tests used in the country do not always detect it.
Mbala Kingebeni, lab director at Congo's National Biomedical Institute, published a study in May that showed a new type of MPOX that may be less deadly but more contagious. He said the mutations he saw suggest the virus is “better adapted to infect humans,” but that a lack of testing in Congo and elsewhere is complicating efforts to monitor the outbreak.
The new variant has been detected in Sweden as well as four other African countries, where health authorities this month said they had identified their first case of the more contagious MPOX variant, which they had contracted while in Africa.
The WHO said the data available to date does not suggest that the new form of MPOX is more dangerous, but that research is ongoing.
Marion Koopmans, a virologist who studies MPOX at the Erasmus Medical Center in the Netherlands, said scientists are now seeing the severe effects of the disease, with pregnant women miscarrying or losing their fetuses and some babies being born with MPOX infection.
Ogoyina, a professor of infectious diseases at Nigeria's Niger Delta University, said that in the absence of a vaccine or medicine, and given the stigma that often accompanies MPOX, health workers in Africa should focus on providing supportive care, such as making sure patients are well fed and offering mental health support.
“It's a real shame that MPOX has been prevalent for 54 years and we're only now thinking about a cure,” he said.
Mbala Kingebeni said that given limited vaccine numbers, a strategy previously used to contain Ebola outbreaks in Africa could help. Officials estimate that Africa needs about 10 million doses of the vaccine, but only about 500,000 have actually arrived, and it's unclear when the vaccines will arrive, she said.
“It may help to target hotspots, like we did with Ebola, by finding cases and vaccinating around them,” he said.
Koopmans said it would be unrealistic to wait for more vaccines to be produced, given the urgent demand for them in Africa.
“In the short term, it's about who has the vaccine and then where we can best utilize the vaccine,” she said.
The Spanish Ministry of Health announced on Tuesday that it would donate 20% of its MPOX vaccine stockpile, or about 500,000 doses, to African countries battling MPOX.
“We see no point in hoarding vaccines where they are not needed,” the Spanish Health Ministry said in a statement, adding that it would recommend the European Commission offer all member states to donate 20 percent of their vaccine stocks.
Spain's donation alone exceeds the amounts pledged by the European Union, Vaccine Bavarian Nordic and the United States. Last week, the Africa CDC announced that the EU and Bavarian Nordic had pledged 215,000 doses of the pox vaccine, while the United States said it would donate 50,000 doses of the same vaccine to the Congo. Japan is also donating some vaccines to the Congo.
The Africa CDC said it does not expect any vaccines to arrive on the continent until next month, when political and health leaders will be discussing how best to mobilize limited resources for the MPOX response.
Meanwhile, the United States on Tuesday donated 10,000 doses of the MPOX vaccine to Nigeria, the first known donation to Africa since the outbreak began, with the country seeing dozens of cases this year.
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Associated Press writers Joseph Wilson in Barcelona, Spain, and Chinedu Asadu in Abuja, Nigeria, contributed to this report.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science Education Media Group. The AP is solely responsible for all content.
