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First case of ultra-deadly mpox strain has hit Europe, Swedish officials confirm
A new deadly strain of mpox has officially reached Europe, health officials have reported.
Sweden's public health agency has recorded what it says is the first case of a ultra-deadly and more contagious variant of mpox — called clade 1 — outside of Africa.
It comes as infectious disease warn that this type of the infection will likely reach the UK and could soon lead to British deaths.
Yesterday the World Health Organization (WHO) declared an ongoing mpox outbreak across several central African nations a 'public health emergency of international concern'.
This is the same designation the WHO gave Covid in late January 2020, just a few weeks before the virus ripped across the world, and some scientists have compared the current outbreak to the 'early days of HIV'.
This map shows the location of mpox cases by UK nation between January 2023 and as of the end of July this year
It is a far cry from the 2022 outbreak where thousands of cases were recorded, mostly in London
The UK Health Security Agency (UKHSA) today announced they are 'already planning' for UK cases. So what exactly is the new strain — and how worried should you be?
This map shows areas where cases of the new mpox strain has been confirmed (shaded in red) and those where nations deemed to be at risk of cases emerging according to UK health officials
The mpox currently spreading rampantly in countries like the Democratic Republic of Congo (DRC) is a different, deadlier strain, than that which reached Europe in 2022, and is detailed in the maps above.
That outbreak, mainly limited to gay and bisexual men, was a milder strain dubbed clade II, and only killed roughly about one in every 500 people that caught it.
The strain currently striking alarm among health experts is a new version of the far more dangerous clade I variant, called clade Ib, and kills about one in 20 adults it infects, rising to up to one in 10 children.
Infections have also been linked to an alarming rise in miscarriages among pregnant women.
Urgent guidance issued to British health workers will remind them clade I mpox is a pathogen of the highest possible concern to public health and all suspected cases need to be alerted through official channels.
Mpox, also known as monkeypox, spreads between people through skin-to-skin contact.
This can be through sex, or by a simple touch like when caring for children, though it can also spread by secondary contact like sharing towels or bed linen for example.
It causes characteristic lumpy lesions, as well as a fever, aches and pains and fatigue.
However, in a small number of cases, it can enter the blood and lungs, as well as other parts of the body, when it becomes life-threatening.
Professor Paul Hunter, an expert in infectious diseases from the University of East Anglia, told MailOnline the new mpox strain would likely reach Europe, and by extension, the UK.
'This clade Ib is spreading predominantly through intimate and sexual contact and so could well spread rapidly to areas around the world,' he said.
'It probably will spread to Europe, but that doesn’t mean we should stop trying to control it now.'
He added that while the new mpox strain could lead to fatalities in developed nations, they could be lower due to better access to a higher standard of health care.
'It is difficult to extrapolate death rates from Africa to Western Europe as the health care access is so different,' he said.
However, Professor Hunter, said there was reason for optimism, as given countries managed to control the 2022 spread of the clade II strain, nations could use the same measures against clade I.
Jean Kakura Biyambo, a father of six from the Muja internally displaced persons camp in DRC, gestures from a general hospital where he has been receiving treatment for mpox, on July 16
A child with skin lesions receives treatment at the treatment centre in Munigi, DRC, on July 19
Vials of single doses of the Jynneos vaccine for mpox are seen from a cooler at a vaccinations site in Brooklyn, New York on August 29, 2022 as the disease swept through the United States
'The behavioural and vaccine measures used to control that pandemic will be just as effective against the new clad,' he said.
Such measures included encouraging people to avoid having sex with new partners during outbreaks and deployment of the smallpox vaccine.
The smallpox vaccine targets a close relative of the mpox virus, meaning it offers a degree of protection against the disease.
Professor Hunter said while data was yet emerging it is likely those who had clade II of mpox will enjoy some immunity from the new clade as their bodies have already experienced a similar infection.
Dr Simon Clarke, an infectious disease expert University of Reading, said while people shouldn't panic, mpox will likely reach the UK.
'All countries should be aware of the risk that this new variant of the virus will spread, indeed it’s already doing so in Africa and likely find its way to Europe and the UK in due course, so it’s important that authorities in the developed world assist with containing this wave of infections,' he said.
'This will spread beyond Africa and may already have begun to do so, but nobody really knows to what extent.'
Thankfully he said it is unlikely we will see anything near the same level of travel restrictions as during Covid, but added that health systems like those in the UK still need to prepare for cases.
'There is already an NHS vaccination programme in place for those judged to be at high risk, he said.
'The authorities need to be vigilant and ensure that there are enough vaccine doses available and that they reach the right people quickly.'
Cases of the new mpox strain centred in the DRC with its neighbouring nations reporting more than 17,000 suspected cases, and 517 deaths, according to the Africa Centres for Disease Control and Prevention (CDC).
This is a 160 percent surge compared to the same period last year.
A total of 13 countries have reported cases. And in the past month, at least 50 mpox cases have been reported in four other countries bordering the DRC - countries that have not experienced the virus previously.
The city of Goma in the DRC also has an international airport providing frequent direct flights to Europe — which experts have warned is a possible path for the virus to enter a new continent.
And Kenya, which has also been struck by the outbreak has direct 9-hour flights from Nairobi to London.
The WHO hopes that by classifying the outbreak as a global emergency will bring focus efforts on providing mpox vaccines, which are available, to those in Africa that need them the most.
Professor Jimmy Whitworth, an expert in epidemiology at the London School of Hygiene and Tropical Medicine, is one person hoping WHO's announcement will lead to action.
'The amount of vaccine required has been estimated by Africa CDC to be 10 million doses,' he said.
He added that the world needed to avoid what happened during the Covid pandemic where rich nations stockpiled vaccines for their own use.
'The cost and availability of vaccine is going to be a great challenge, but it is really important that, unlike in the Covid-19 pandemic, there is global solidarity, that the vaccine reaches the people who need it most and that it is not stockpiled by rich countries,' he said.
'This is a real challenge for the global health security community to demonstrate that they can work together for global public good and not for narrow national interests.'
'Let us hope they take that opportunity, otherwise we risk this epidemic spreading across the African continent, and possibly beyond.'
Dr Brian Ferguson, an expert in immunology at the University of Cambridge, said the mpox situation is concerning in part because of how many children it was infecting.
'40 per cent of cases are in children under 5 years old. As mpox disease is more severe in immunocompromised individuals, it is also a concern that the current outbreak is taking place in a region where HIV prevalence is relatively high but access to antiretroviral drugs is poor,' he said.
'There is further concern about the lack of access to vaccines and a globally slow response to vaccine production and distribution.
'Even though there are existing effective vaccines, there are not enough doses and they are not being getting to where they are needed.
'The WHO is attempting to address these issues, but this requires greater international effort to produce and deliver vaccines.'
Sanjaya Senanayake, an expert in infectious diseases and at The Australian National University said it would be a mistake to consider the outbreak an Africa only issue.
'Although the epicentre for this new outbreak is the DRC, it has spread to a number of East African nations, highlighting its pandemic potential with so many large airports in the region,' he said.
But he added there was hope that mpox vaccines can turn things around.
'Two doses of a vaccine are very effective in preventing the infection, although this usually applies to adults rather than children, in which most of the cases have been; therefore, hopefully, the announcement by the WHO of this being a public health emergency of international concern will galvanise global resources to contain the outbreak within Africa, and ultimately terminate it.'
Dr Meera Chand, deputy director at the UK health Security Agency, said the current threat to the UK by the new mpox strain is 'currently considered low'.
But she added: 'However, planning is underway to prepare for any cases that we might see in the UK.
'This includes ensuring that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission.'
WHO Director-General Dr Tedros Adhanom Ghebreyesus in a statement yesterday said: 'The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying.
'On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.'
The WHO and the NHS recommends a vaccine within four days of contact with someone who has the virus or within up to 14 days if there are no symptoms.
Healthcare workers and men who have sex with men are advised to receive a vaccine even if they have had no mpox exposure.
Symptoms of mpox include a rash, skin lesions, fever, headache, muscle aches, back pain and swollen lymph nodes.
There are no direct treatments for mpox infection available with instead medics focused on supporting a patient to help their body fight off the virus.