List of countries that have discovered a new strain of monkeypox and the risk of further spread

According to Al Jazeera, the current monkeypox cases originate from a relatively new strain of the virus, classified as clade 1, which has been spreading in African countries since 2022.

Earlier this year, it was reported that the Democratic Republic of Congo was experiencing its largest outbreak on record. As of June, the country had recorded tens of thousands of cases. The Congolese government declared monkeypox a pandemic in December 2022.

Last week, the Africa Centers for Disease Control and Prevention (Africa CDC) said monkeypox has now been detected in at least 13 countries on the continent. Compared to the same period last year, the agency said cases increased by 160% and deaths increased by 19%.

Which countries has the monkeypox virus spread to?

On August 16, Pakistan's Ministry of Health confirmed the first case of monkeypox virus infection, a person from Saudi Arabia.

Health officials say sequencing is underway to determine the exact strain of the virus the patient was infected with.

A day earlier, Swedish health officials also reported the country's first case of monkeypox. Officials confirmed it was clade 1 and said the person had contracted the virus in Africa and was being treated.

According to experts, branch 1 virus strain tends to cause more severe infections and appears to be more easily transmitted through casual close contact, including sexual intercourse.

On August 16, the European Center for Disease Control and Prevention (CDC) raised its risk alert level from “low” to “moderate” and asked countries to maintain a high level of awareness for travelers from affected areas.

How does the new virus attack the human body?

Monkeypox mainly infects humans and animals. The monkeypox virus is from the same family of viruses as smallpox, but it causes milder symptoms — such as fever, chills, and body aches. However, the virus can cause severe illness and even death in some cases.

The virus enters the human body through broken skin or through the respiratory tract. It then spreads through the blood, causing the infected person to have flu-like symptoms and develop skin lesions.

Scientists “don't think monkeypox has a direct effect on the immune system,” says Michael Marks at the London School of Hygiene and Tropical Medicine.

“Apart from the fact that all cases clearly have a temporary response in the immune system, we do not believe that the monkeypox virus has a lasting effect on the immune system,” he said.

Dr. Ngashi Ngongo, Chief of Staff at the Africa CDC, also said that the virus only causes symptoms that last for about 2 to 4 weeks.

How the virus spreads

The monkeypox virus spreads through close contact with infected people or animals. In human-to-human infections, the virus can be transmitted through contact with skin lesions, skin-to-skin contact, or talking or breathing too closely with an infected person.

The virus can also be spread through contaminated objects such as surfaces, bed linens, clothing and towels, as the virus enters the body through broken skin, the respiratory tract or the eyes, nose and mouth.

The most serious form of infection is through skin-to-skin contact, because the virus can remain detectable in skin lesions for about three weeks, rather than through the respiratory system, because in most people the virus is cleared from the throat after seven to 10 days, Mr Marks said.

For human-to-animal transmission, the virus usually enters the body through a bite, scratch, or contact with a wound on an infected animal.

Symptoms of infection with the new monkeypox virus

People infected with the monkeypox virus may develop flu-like symptoms and pus-filled lesions. The disease is usually mild but can be severe enough to be fatal.

Most people have a relatively mild illness with symptoms such as fever, muscle aches and a rash with five to 25 lesions, Marks explains.

“Some people become very ill and they can develop more serious disease with hundreds of lesions all over their body,” he said.

While the disease causes mild symptoms in most people, some people are at higher risk of experiencing severe symptoms.

“For example, people with untreated HIV (a sexually transmitted disease) or weakened immune systems are still at higher risk of severe disease. Children also appear to be at higher risk of severe disease,” Marks said.

He explained that children are more likely to be affected by monkeypox than adults for a number of reasons.

“Most of the infections are occurring in densely populated areas with many children. Children tend to run around and have more direct skin-to-skin contact with others, which makes it easier for the virus to spread. While adults have less direct contact with others,” he said.

Children are also at higher risk because their “defense mechanisms” – their immune systems – are still developing, Ngongo added.

Treatment

There is currently no treatment for monkeypox, but several antiviral drugs are being tested, Marks said.

“Vaccines are effective in reducing the risk of disease. Therefore, it is necessary to prioritize the provision of adequate vaccines to the most vulnerable populations in the DRC and neighboring countries,” he stressed.

He explained that if we can vaccinate people at risk, they will be protected against the virus and this will help control the epidemic.

But Mr Ngongo explained that the monkeypox vaccine used by many Western countries during the 2022 outbreak has not yet been distributed to poorer countries in Africa.

“Africa has no vaccines. The rest are stored in the West as part of their emergency preparedness. But we are seeing an emergency unfolding in Africa,” he said.

Through donations, the Africa CDC has managed to secure 280,000 doses of the vaccine, Ngongo explained. However, for the vaccine to be effective, each person needs to receive two doses, and that is only enough for 140,000 people.

Mr Ngongo advised people to “return to basic personal hygiene practices” and remember to wash their hands, avoiding contact with people who are sick. He said it was important to go to hospital if symptoms appeared to prevent serious illness.

Risk of monkeypox virus spreading further

Scientists believe that if new outbreaks involving Congo are identified quickly, the risk of transmission could be contained relatively quickly.

The big risk now is concentrated in central Africa, where the disease is spreading, Mr Marks said.

“There is the possibility of a small number of cases spreading further afield, as in Sweden, but the big risk and focus of action needs to be on central Africa,” he said.

Mr Ngongo also called on people to learn lessons from the COVID-19 pandemic and “act now”.