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The global fight against Mpox and the race for effective vaccines, ET HealthWorld

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By Prarthana Sharma

According to the World Health Organisation (WHO), there are over 70,000 diagnosed cases globally, with Mpox spreading to more than 80 countries, posing a significant risk to public health. Developing vaccines is crucial not only for immunising those infected but also for preventing further transmission or mutation of the virus.

The Current Mpox Outbreak vs. Other Virus Outbreaks

Highlighting that international partnership and transparency are key to controlling the Mpox outbreak, Dr Rakesh Gupta, Senior Consultant at Indraprastha Apollo Hospital, said, “The Mpox outbreak can be controlled through transparency and international cooperation. This allows for fast global evaluation alongside collective reactions by providing data on known cases (epidemiological data), all virus sequences (genomic sequences), and clinical settings.” Moreover, it promotes equal access to diagnostics and vaccines while accelerating research. For example, to enhance preparedness and response, the WHO is proposing real-time data-sharing mechanisms, standardisation of protocols, and reinforcement of global health security.

In fighting outbreaks, three major actions are essential: breaking down political barriers, combating misinformation, and establishing communication channels across all fronts. Governments should forge stronger alliances with non-governmental organisations (NGOs) and the private sector to respond effectively to global health threats.

Distinguishing Clinical Characteristics of Mpox and Improving Early Detection

Mpox has distinct clinical characteristics that set it apart from other viral diseases. The unique body rashes and swollen lymph nodes seen in Mpox distinguish it from other viral diseases like chickenpox or measles, according to Dr Ankita Baidya, Consultant in Infectious Diseases at Manipal Hospital Dwarka. Mpox spreads through close contact and sexual transmission. Early detection is possible by suspecting its presence in time and testing vesicular fluid for the virus.

The Mpox rash progresses through several stages, including papules, vesicles, pustules, and crusts, often starting on the face, hands, and feet. Swollen lymph nodes usually occur alongside fever, chills, fatigue, headache, and other symptoms. Enhancing early detection can be achieved by strengthening public health surveillance systems and training healthcare providers to recognise Mpox symptoms and apply diagnostic standards. Rapid diagnostic tests, such as PCR, along with efficient contact tracing, are vital in managing outbreaks among vulnerable populations.

Evaluating the Probability of a Mpox Outbreak

Comparing Mpox to COVID-19, Dr Shilpa Bhatte, MBBS, MD, Chief Program Officer at CureBay, noted that Mpox poses a lower risk of becoming epidemic compared to SARS-CoV-2, as it typically spreads through bodily and physical contact, and its severity is lower in comparison. She added, “Compared to serious contagious diseases like SARS-CoV-2, the likelihood of Mpox becoming a pandemic is lower. The disease spreads mostly through personal contacts, making it less severe than smallpox. The outbreak has been controlled effectively through public health interventions such as contact tracing and isolating infected persons; however, new variants, global travel, unequal access to vaccines, or lack of awareness could increase the associated risks. A Mpox pandemic is not on the horizon, but vigilance and effective measures are still necessary.”

While Mpox is less likely to become a global disease than highly infectious ones like SARS-CoV-2, which spread via airborne droplets and can be more lethal, several factors could increase its risk. These factors include potential mutations, unequal access to vaccines and healthcare, public awareness issues, and international travel. Therefore, effective health measures are essential to manage these risks and prevent any escalation into pandemics. Prevention requires vigilance, proactive monitoring, and systematic threat assessment.

The Role of Transparency and Global Collaboration

The Mpox outbreak can be controlled through transparency and international collaboration. Dr Rakesh Gupta, Senior Consultant in Internal Medicine at Indraprastha Apollo Hospital, explains, “Controlling the Mpox outbreak involves transparency and international cooperation. Sharing epidemiological data, genomic sequences, and clinical information enables rapid global assessment and coordinated responses. This facilitates equal access to diagnostics and vaccines and accelerates research. Improved real-time data sharing, protocol standardisation, and global health security are critical for enhancing preparedness and response.”

Breaking down political barriers, combating misinformation, and establishing open communication lines are vital for managing outbreaks. Governments must forge stronger partnerships with NGOs and the private sector to respond effectively to global health threats.

Challenges in Low-Resource Settings and Global Support

“Serum Institute of India has made considerable progress in developing an Mpox vaccine. They have stated that updates and good news will be forthcoming within a year. This is exciting news in the battle against the virus,” stated Dr Rishikesh Dess, Consultant, Department of Medicine, Sir Gangaram Hospital.

Addressing the Mpox outbreak is particularly challenging in low-resource settings. Dr Rishikesh Dess, a Consultant in the Department of Medicine at Sir Ganga Ram Hospital, commented, “There is no definitive treatment for Mpox; however, supportive care, including pain management, hydration, and treating secondary bacterial infections, is crucial. Tecovirimat, an antiviral agent, has shown some promise but is difficult to obtain. Controlling epidemics and minimising their impact relies on early detection of outbreaks, supportive care, and vaccination, such as the smallpox vaccine, which provides cross-protection.”

In areas lacking healthcare infrastructure, managing the Mpox outbreak presents numerous challenges. The virus is mainly transmitted through close contact with infected individuals or animals, and its variable clinical presentation complicates diagnosis and containment. The outbreak has exposed weaknesses in healthcare infrastructure, including low diagnostics and poor availability of antiviral treatments.

The Contribution of International Collaboration and Public Health Initiatives

Vaccine development is crucial in controlling Mpox outbreaks. Dr R. S. Mishra, Principal Director of Internal Medicine at Fortis Escorts, noted that “Mpox vaccines include JYNNEOS (Imvamune or Imvanex) and ACAM2000. JYNNEOS is considered the better option due to its fewer side effects.” Vaccination is essential for controlling outbreaks, especially in high-risk groups.

According to healthcare experts, public health actions, such as promoting sanitary behaviors, issuing travel alerts, and undertaking immunisation programs, are necessary to control Mpox transmission. Public education on the signs and symptoms of the virus and how it spreads can help prevent further infections and reduce the stigma associated with Mpox. Additionally, screening for international travel and surveillance can detect potential outbreaks early before they become uncontrollable. Efficient handling of Mpox outbreaks requires broad-ranging governmental policies that facilitate global participation to ensure good health for all.

While Mpox poses public health challenges, advancements in vaccine production and international collaboration offer multiple ways to manage it. Scientists at the Serum Institute of India are working on formulating vaccines against this disease. Effective management requires ongoing research, prompt vaccination distribution, and robust public health systems to control and prevent its spread. Through global unity and vigilance, we can mitigate the impact of Mpox and safeguard health worldwide.

  • Published On Sep 2, 2024 at 12:35 PM IST

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