Mpox: ‘We are inundated with worried travelers’

Mr. Fell, the World Health Organization (WHO) has declared the highest level of alert, a “health emergency of international proportions.” How worrying do you think the situation is?

The highest alert level is particularly important so that affected countries in sub-Saharan Africa can now receive targeted and rapid support to control the current health crisis. They must now be provided with the necessary resources, vaccines, medicines, and resources to monitor infections. The idea is not that this will scare the world.

So does everything remain the same for us?

As a second step, northern hemisphere countries should also pay more attention to Mpox again. This means that doctors should also consider this disease and send swabs of suspicious rashes for laboratory analysis. We should be prepared for a situation like this in 2022 with an increase in infections. However, we have not heard of any cases of the new branch 1b yet. There are currently no other signs that we Swiss need to worry about. So please: No alarmism, no panic!

What about travelers to Africa — should they get vaccinated?

There is no reason for travellers to be concerned at the moment. There are no warnings at the moment. Our travel medicine centre in Zurich has been receiving inquiries from concerned travellers since this morning. Commercial providers are now obviously considering whether they should cancel trips. Domino effect For example, if tourism as a key economic sector collapses on a large scale, it could ultimately have a negative impact on sub-Saharan African countries.

If I book Kenya now…

…and then to Kenya.

According to the Federal Office of Public Health, men who have sex with men (MSM) are at particularly increased risk of infection. If they travel to an affected country, should they get vaccinated?

At the moment we cannot really talk about risk groups. With the new clade 1b, we see that all parts of the population are affected, including women and children. The situation was different in the 2022 outbreak. However, a different strain of Mpox was circulating in Europe at that time. As before, we still recommend that MSM at higher risk get vaccinated if they haven’t already. The Mpox vaccination rate among them is still not very high. This is because we in Switzerland received the vaccine too late because the Federal Council, the army and industry could not reach an agreement for too long. By the time it was available, the wave had leveled off and people no longer wanted to get vaccinated.

Unlike 2022, drugs also exist. How good are these?

They are very effective against the clade II Mpox infections we have found so far. Unfortunately, initial indications are that these are not having the same positive effects overall in clade I.

What do we know about the new variant today?

This is similar to what happened when new SARS-CoV2 variants emerged. We are all too familiar with this by now: you encounter a new case and you first have to find out what properties clade Ib has. It is too early to give a definitive answer. We are not sure if the new variant is actually more contagious or more deadly than before. This is why it was important for the World Health Organization to declare a health emergency. It means that resources can now flow into the affected countries and effective surveillance can be established, the severity of the disease documented and reliable diagnostics, including viral sequencing.

Apparently Mpox thrives better in humans. Do viruses adapt to us?

We don’t know all this yet. But this is also similar to Sars-CoV-2 and other infectious diseases. The biological principle is that due to new mutations, variants with transmission advantages will prevail, or in other words, such variants will be eliminated. This evolution seems to have occurred in Mpox of evolutionary branch 1b, which is beneficial to the spread of the virus.

Could this also lead to a larger outbreak here — or even a pandemic?

As of today, we are still far from a pandemic. Nevertheless, we must take the current outbreaks seriously and control them. We must not let them get out of control. Maybe you could also say that we should have dealt with this problem earlier. Because the virus has not disappeared since the last outbreak. These countries keep seeing infections and severe illness, which is why new variants are appearing now. We should think more sustainably in the future, otherwise we will chase every fire that breaks out, but it may be too late. We must learn not to be interested in what is happening in the southern hemisphere when this disease comes to us. This is also too short-sighted.

The emergency declarations by the World Health Organization have been criticized in some quarters. They are seen as unnecessary alarmism. What do you think?

No, I don’t think so. I think it’s cynical to talk about alarmism. The WHO signal is very important for the affected sub-Saharan African countries. These countries really need our support. When the last Ebola crisis broke out in 2018, the World Health Organization was criticized for declaring an emergency too late.