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By Maria Cheng LONDON (AP) — The World Health Organization on Wednesday declared a global emergency over a smallpox outbreak in Congo and elsewhere in Africa, with confirmed cases of smallpox in children and adults and a new form of the virus emerging in more than a dozen countries. Vaccine supplies are running low on the continent.
Earlier this week, the Africa Centers for Disease Control and Prevention declared an African swine fever outbreak that has killed more than 500 people a public health emergency and called on the international community to help stop the spread of the virus.
“This is something that should concern us all… The potential for further spread in Africa and beyond is very worrying,” said WHO Director-General Tedros Adhanom Ghebreyesus.
The Africa CDC previously said that monkeypox has been found in 13 countries this year, with more than 96% of cases and deaths occurring in Congo. Compared with the same period last year, cases have increased by 160% and deaths have increased by 19%. So far, there have been more than 14,000 cases and 524 deaths.
“We are now in a situation where (MPox) poses a threat to more neighboring countries in Central Africa and beyond,” said Salim Abdul Karim, a South African infectious disease expert and chair of the Africa CDC’s emergency response team. He said the mortality rate of the new MPox spreading from Congo appears to be about 3-4%.
In 2022, the WHO declared MPox a global emergency after it spread to more than 70 countries where it had not previously been reported, primarily affecting gay and bisexual men. Less than 1% of the population died in that outbreak.
Michael Marks, professor of medicine at the London School of Hygiene & Tropical Medicine, said declaring Africa’s latest sheeppox outbreak an emergency would be justified if it would gain more support to contain it.
“It is a failure of global society that things have gotten so bad that the resources needed cannot be released,” he said.
Nearly 70% of Congo’s cases have been in children under the age of 15, and 85% of the deaths have occurred in children under the age of 15, Africa CDC officials said.
Jacques Alonda, an epidemiologist working with international charities in Congo, said he and other experts are particularly worried about the spread of MPOX in refugee camps in the country’s conflict-ridden east.
“The worst case I have seen was a six-week-old baby who was infected with MPOX at two weeks old,” Alonda said, adding that the baby had been in their care for a month. “He was infected because the hospital was overcrowded and he and his mother were forced to share a room with another person who had the virus, which was not diagnosed.”
Save the Children says Congo’s health system is “crumbling” under the pressure of malnutrition, measles and cholera.
The U.N. health agency said MPox was recently detected for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks are linked to the outbreak in Congo. In Ivory Coast and South Africa, health authorities reported a different and less dangerous version of MPox, which spread globally in 2022.
Earlier this year, scientists reported the emergence of a new, more deadly strain of MPox in a Congolese mining town that kills up to 10% of people and they fear it may be more easily spread. MPox spreads mainly through close contact with an infected person, including through sex.
Unlike previous MPox outbreaks, which mainly appeared on the chest, hands and feet, the new virus causes milder symptoms, with lesions appearing on the genitals. This makes it harder to detect, meaning people could be spreading the virus to others without knowing it.
Prior to the 2022 outbreak, the disease was primarily seen in sporadic outbreaks in Central and West Africa when people came in close contact with infected wild animals.
During the 2022 pandemic, Western countries mostly stopped the spread of mpox with vaccines and treatments, but such treatments are rare in Africa.
Marks of the London School of Hygiene & Tropical Medicine said that because Western countries have not yet approved a smallpox vaccine, officials could consider vaccinating people against smallpox-related diseases. “We need a large supply of the vaccine so that we can vaccinate those most at risk,” he said, adding that this means sex workers, children and adults living in epidemic areas.
Congo has not received any of the MPox vaccines it has requested.
Congolese authorities say they have requested 4 million doses of the vaccine, Chris Kasita-Osako, coordinator of Congo’s monkeypox response committee, told The Associated Press. Kasita-Osako said the vaccines will be used primarily for children under 18.
“The United States and Japan are two countries that are ready to provide us with vaccines,” said Casita Osako.
Dr. Dimie Ogoina, a Nigerian MPOX expert who chairs the WHO emergency committee, said there were still major gaps in understanding how MPOX spreads in Africa. He called for increased surveillance to track the outbreak.
“When we are unable to test all suspected cases, we are working blindly,” Ogoina said.
While WHO emergency declarations are intended to spur donors and countries to action, global response to previous declarations has been mixed.
Dr. Bogma Taitangi, an infectious disease expert at Emory University, said the last time WHO declared an emergency over Salmonella typhi infection “did little to help get supplies like diagnostic tests, medicines and vaccines to Africa.”
“The world now has a real opportunity to take decisive action to avoid a repeat of the past, but it will require more than just an (emergency) declaration,” Taitangi said.
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