“It is clear that we can have international transmission,” warns the WHO

The World Health Organization on Wednesday raised its highest level of international alert after a surge in cases of the disease, formerly known as monkeypox, in Africa.

The WHO is sounding the alarm about MPOX, the disease formerly known as monkeypox, which is circulating in Africa. “It is “It is clear that we can have an international transmission”warns Sylvie Briand, director of the epidemic and pandemic risk department at the World Health Organization, Wednesday, August 14 on franceinfo. A few hours earlier, the WHO triggered its highest level of international alert after a multiplication of cases of this disease in Africa, formerly called monkeypox.

franceinfo: Why is the situation critical? ?

Sylvie Briand : First of all because we have a new strain circulating, strain 1-B. And secondly, because we also have a significant increase in the number of cases, with new population groups affected, including children and pregnant women, who unfortunately also present much more serious signs of the disease. On the other hand, we now have cases of Mpox that are also detected in countries that previously had never had it, such as Burundi, Rwanda, Uganda or Kenya.

Do we know why?

Viruses evolve and the more they are transmitted between humans, the more opportunities they have to change. So this creates new strains which then, like this strain 1-B, are more transmissible and also more serious than strain 2 which was previously circulating in Europe and other continents since 2022.

For the moment, it is limited to Africa and these new countries that you have just mentioned, where the risk of a global pandemic exists again. ?

To the extent that we see that this strain has left its ecological niche, which was rather the Democratic Republic of Congo, it is clear that we can have international transmission and that is why the WHO declared this emergency situation so that all countries are well alerted. But what we must understand is that the incubation of this disease is much longer, for example, than Covid. So, we can indeed have international distribution, but it will take longer than what we have seen, for example for respiratory-transmitted pathogens.

What means do you have at your disposal to stem this epidemic?

The problem is that it occurs in countries that have very weak, very fragile health systems, so it’s even more complicated. Unlike Covid, we still have vaccines, we have antivirals that exist and so we can treat people and prevent the disease. But these resources and these tools are limited in number. So we will have to not only make them available to infected African countries, but also have good strategies to focus on the groups most at risk and be sure that the few resources we have will be used as best as possible.

Which groups are most at risk?

Until now, we had mainly seen that it was homosexual communities, sex workers, and it was an essentially sexual transmission. Now, we see that the other modes of transmission of Mpox are at work and so it is by contact, especially when people have a skin rash. The blisters that they have on the skin are contagious and so we have to be very careful at that time.

And this is new? Because of the mutation of the virus?

It would seem that this strain actually gives more rashes since strain 2 that had circulated previously gave relatively few of these vesicles. So there were fewer opportunities for transmission by direct contact. It would seem that this one gives more rashes. And above all, for example in children, it can be confused with other rash diseases like chickenpox. So it is also more complicated to make the diagnosis.

Should we launch an appeal for international aid, particularly to finance the vaccines needed to overcome this epidemic?

Absolutely. And that’s also one of the reasons why the WHO issued this alert, to promote international collaboration and for countries that have vaccines in stock to be able to donate more quickly. It’s also about ensuring that, since the virus crosses borders, this coordination between countries helps reduce international transmission. The WHO has made a request for $15 million to start supporting these countries and giving them diagnostic tests and to be able not only to obtain the vaccines, but also to distribute them because vaccination is not free.

What are the screening methods? What are the warning signs of this disease? What should alert you?

We don’t have rapid diagnostic tests yet, but with laboratory tests, we can actually make the diagnosis. The problem is, like all viral diseases, at the beginning, we have signs that are not very specific. They are fever, fatigue, muscle pain. And it is only when, obviously, we have the rashes that we can be certain of the diagnosis. Moreover, in Africa, many diagnoses are made on the basis of clinical symptoms since in certain rural communities very far from the laboratory, it is very difficult to make a diagnosis for all the cases that arise.

Are there any ways to protect yourself against Mpox?

Yes, most people who were born before smallpox was eradicated, that is, before 1978, had received a vaccine at the time. And normally, this immunity is long-lasting. So these people are protected. It is the new generations who have not been vaccinated who are therefore more at risk. But for the moment, the virus linked to strain No. 2 is circulating rather in certain homosexual or sex worker communities and is not in the general population. But obviously, with this new strain, 1-B, we must be even more careful and even more vigilant as soon as we see a case appear.