A new mpox variant has been identified in Germany, marking its first detection in Europe. The risk to public health in Germany is considered low, despite ongoing epidemics in Africa, primarily affecting central regions and impacting children. The WHO declared a Public Health Emergency due to escalating cases. Vaccination initiatives have commenced in Africa, while France continues its targeted vaccination efforts for high-risk populations following reported cases this year. Symptoms include rashes, fever, and fatigue.
On October 22, Germany reported its first case of a new variant of mpox, which was previously referred to as monkeypox. According to the Robert Koch Institute for Health Surveillance, this infection, identified as clade 1b and contracted abroad, was detected on October 18, 2024. Thankfully, the institute noted that the overall risk to public health in Germany remains “low.” This marks the first occurrence of this particular variant in Europe.
Currently, two simultaneous outbreaks are affecting regions in Africa. The first outbreak is linked to clade 1, primarily centered in Central Africa. The Democratic Republic of Congo (DRC) accounts for over 95% of the recorded cases, as reported in a government briefing on October 25. Other countries experiencing cases include Rwanda, Uganda, Burundi, Kenya, the Central African Republic, and Congo, with children being particularly vulnerable. The second outbreak, associated with the clade 1b variant, is predominantly impacting adults in eastern DRC and neighboring nations. Since the start of 2024, there have been approximately 42,000 cases reported across the continent, resulting in at least 1,100 fatalities from mpox, according to the African Union’s health agency. The currently circulating variants in Africa are different from the clade 2b variant responsible for the global outbreak in 2022.
Are We Facing a New Epidemic?
The African Union’s health agency has issued warnings that the epidemic in Africa risks spiraling out of control without necessary interventions. On August 14, 2024, the World Health Organization (WHO) declared a Public Health Emergency of International Concern due to the ongoing crisis in Central Africa, which constitutes its highest alert level. However, the European Centre for Disease Prevention and Control (ECDC) assesses the overall risk of infection in the European Union as low. The risk is moderate for individuals with multiple sexual partners and elevated for those in prolonged contact with imported cases.
The first vaccination campaign against mpox commenced in Africa, starting in Rwanda on September 17. The DRC launched its campaign on October 5 after receiving 265,000 doses of vaccine from the EU and the USA.
Recognizing the Symptoms of Mpox
Mpox is an animal-origin viral infection connected to the same family as smallpox, which was eradicated in 1980. Since 2022, the WHO has recommended the name mpox for this virus, which was first identified in humans in 1970 in the DRC. Symptoms typically manifest as a rash that predominantly affects the face, ano-genital region, and the palms and soles. These symptoms may accompany fever, headaches, body aches, fatigue, and sometimes a sore throat. The virus spreads through close physical contact, including skin or mucous membrane contact with the lesions of an infected individual, often during sexual activity. It can also be transmitted through shared linens, toilet utensils, or less commonly through respiratory droplets from coughing or sneezing.
Status of the Mpox Vaccination Campaign in France
As of October 22, 2024, Santé publique France reported 190 mpox cases since the beginning of the year. A targeted vaccination campaign began in 2022 for individuals at greatest risk of exposure, following recommendations from the Haute Autorité de Santé (HAS) dated August 29, 2024. This includes men who have sex with men and report multiple partners, trans individuals with multiple partners, individuals involved in prostitution, workers in venues providing sexual services, and those living with individuals at high risk of exposure. Post-exposure vaccinations are also available for immunocompromised individuals who have had close contact with at-risk persons.
The Haut Conseil de la Santé Publique (HCSP) additionally recommends vaccinations for travelers engaged in risky sexual practices, healthcare professionals, humanitarian workers visiting areas with active transmission of the virus, immunocompromised individuals, and those coming from regions where MPXV clade I is circulating who are visiting family and friends.