Background of the Rapid Spread of Mpox: Emergence of “Highly Virulent 1b” Strain and the Role of Prostitution in Transmission

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Background of the Rapid Spread of Mpox: Emergence of “Highly Virulent 1b” Strain and the Role of Prostitution in Transmission

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Background of the Rapid Spread of Mpox: Emergence of “Highly Virulent 1b” Strain and the Role of Prostitution in Transmission 

On August 14, the World Health Organization (WHO) declared Mpox (formerly known as monkeypox) a “Public Health Emergency of International Concern” (PHEIC) after a significant surge in cases was observed in Africa.

This marked the first such declaration in nearly two years since July 2022.

Originally a zoonotic disease endemic to rodents in Africa, Mpox had infected around 100,000 people globally in just two years. While the spread had seemed to stabilize, 2024 saw a sudden and alarming acceleration.

This article explores the reasons behind this resurgence and provides insights from a veterinary perspective.

Recent Developments and the Rapid Spread of Mpox

Mpox was once a disease confined to specific regions in Africa, with few cases reported globally. However, since 2022, the virus began spreading rapidly, infecting nearly 100,000 people worldwide, with 207 deaths reported. While not typically highly lethal, Mpox poses a significant threat, particularly to individuals with HIV, and can cause severe disfigurement.

Initially, the majority of cases were reported outside Africa, with only 4,322 infections and 31 deaths in African endemic regions. However, the situation dramatically changed in 2024.

According to the WHO’s PHEIC declaration on August 14, over 15,600 cases and 537 deaths have been reported in Africa. However, these figures likely underrepresent the true scale of the outbreak. The African Union (AU) stated on August 17 that 17,541 cases had been reported, with 2,822 confirmed and 14,719 suspected. Due to limited testing capacity in Africa, many cases remain unconfirmed, and the actual number of infections could be much higher.

The speed of this outbreak has been unprecedented.

Mpox Becoming a Sexually Transmitted Infection through Prostitution

The Africa Centres for Disease Control and Prevention (Africa CDC) reported that Mpox had spread to six additional countries within a week as of August 10. By August 17, it had reached three more countries. This rapid spread, particularly in countries like Rwanda, Uganda, and Kenya, suggests a significant change in the virus’s behavior.

Recent reports indicate that Mpox is now spreading as a sexually transmitted infection (STI) in Africa, a development that was not previously observed. A study published in March 2024 by an international group of researchers from Congo and other countries revealed that prostitution is a primary transmission route for Mpox in Africa.

This study, focusing on an outbreak in the eastern province of Kivu in the Democratic Republic of the Congo in August 2023, analyzed the transmission routes among hospitalized patients. Of the 51 patients studied, 37 (73%) were confirmed cases of Mpox. Symptoms included fever (75%), rash (88%), oral lesions (41%), and genital or anal lesions (63%).

A significant number of the infected individuals were women engaged in the sex trade, accounting for nearly half of the cases. Heterosexual intercourse was identified as the primary transmission route, with 92% of the patients being heterosexual and 61% reporting multiple sexual partners in the past six months. These findings highlight the critical role of prostitution in the spread of Mpox, underscoring the need for urgent intervention in the sex industry.

The Key Differences Between the 2022 and 2024 Outbreaks

The Mpox outbreak in 2024 differs significantly from the one in 2022. While the 2022 outbreak predominantly involved men who have sex with men (MSM) in Europe, the Americas, and Asia, the 2024 outbreak in Africa appears to be driven by heterosexual intercourse and prostitution.

The 2022 outbreak began with a case in the UK involving a traveler from Nigeria, and soon after, non-travelers were also infected. The virus spread rapidly, leading to nearly 100,000 infections globally by 2024, mostly among MSM. This was confirmed by multiple studies, which found that 95% of the cases involved sexual contact between men.

In contrast, the 2024 outbreak in Africa is linked to prostitution and heterosexual intercourse, reflecting a shift in the virus’s transmission dynamics. This change suggests that the current outbreak is driven by different social and behavioral factors compared to the 2022 outbreak.

Conclusion

The rapid spread of Mpox in Africa in 2024, driven by changes in the virus’s transmission dynamics and human behavior, highlights the need for targeted public health interventions. While the 2022 outbreak was primarily associated with MSM, the current outbreak involves broader social factors such as prostitution and heterosexual intercourse. This shift underscores the importance of adapting public health strategies to address the evolving nature of the disease and its transmission routes.

Background of the Rapid Spread of Mpox: Emergence of “Highly Virulent 1b” Strain and the Role of Prostitution in Transmission

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(source:internet, reference only)

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