1 Thread on #mpox which is in the news again since a returning traveller was diagnosed in Sweden with a new more dangerous strain which reached Europe for the first time.
In the 2022-23 global outbreak I was clinical advisor to @WHOEurope
Here’s what I think you need to know.
In the 2022-23 global outbreak I was clinical advisor to @WHOEurope
Here’s what I think you need to know.
2/
What does mpox look like:
Painful sores and ulcers on the body especially around the anus and genitals, as well as ulcers in the mouth and genitals.
My group @shareresearch @QMUL published the largest series on clinical features in the @nejm.
🔽🔽rb.gy/0ghwpq
What does mpox look like:
Painful sores and ulcers on the body especially around the anus and genitals, as well as ulcers in the mouth and genitals.
My group @shareresearch @QMUL published the largest series on clinical features in the @nejm.
🔽🔽rb.gy/0ghwpq
3/
Who can it affect?
Viruses don’t discriminate!
Clade 2b strain spread mainly through sexual networks of men who have sex with men. It also affected women. It spreads via close contact, respiratory droplets and is sexually transmitted.
@TheLancet:
rb.gy/ph1mhp
Who can it affect?
Viruses don’t discriminate!
Clade 2b strain spread mainly through sexual networks of men who have sex with men. It also affected women. It spreads via close contact, respiratory droplets and is sexually transmitted.
@TheLancet:
rb.gy/ph1mhp
4/
Most concerningly we showed that people living with advanced #HIV who are immunosuppressed (CD4<200) can get a severe and life-threatening form of mpox which also affects lungs and other organs.
Read our @Lancet paper here
rb.gy/emqtli
Most concerningly we showed that people living with advanced #HIV who are immunosuppressed (CD4<200) can get a severe and life-threatening form of mpox which also affects lungs and other organs.
Read our @Lancet paper here
rb.gy/emqtli
5/
Meanwhile a deadlier strain Clade 1a strain has caused around 16000 infections in D.R.C in 2023 in central rainforest regions mainly affecting children <15 years & women with ~ 650 deaths in 2023. Mortality rate 4-10% mainly in under 5’s. Spread is thru close contact.
Meanwhile a deadlier strain Clade 1a strain has caused around 16000 infections in D.R.C in 2023 in central rainforest regions mainly affecting children <15 years & women with ~ 650 deaths in 2023. Mortality rate 4-10% mainly in under 5’s. Spread is thru close contact.
6/ What is new this year?
In 2024 a new subtype - Clade 1b has caused -around 15,000 cases this year alone and > 500 deaths. This subtype has mutated to become sexually transmissible and it is spreading rapidly. Mortality is high around 3-4%.
In 2024 a new subtype - Clade 1b has caused -around 15,000 cases this year alone and > 500 deaths. This subtype has mutated to become sexually transmissible and it is spreading rapidly. Mortality is high around 3-4%.
7/ It started is Kivu- in the East of D.R.C. near the border with Burundi, Rwanda and Uganda. It has spread to at least 9 countries in Africa triggering the African CDC to declare a public health emergency of continental security and the @WHO to declare a PHEIC the next day.
8/ The smallpox vaccine (MVA Bavarian Nordic) works against both clades. However there is almost no vaccine in D.R.C. and other African countries that need it. It costs around $100 per vaccine. A complete vaccine course means two vaccine doses.
ft.com/content/47e345…
ft.com/content/47e345…
9/ US and EU have offered to provide around 250 000 doses to D.R.C. from their stockpiles however millions of doses are needed in DRC and neighbouring regions to curb the spread.
healthpolicy-watch.news/mpox-vaccine-m…
healthpolicy-watch.news/mpox-vaccine-m…
10/ There is no plan from the company to sell the vaccine at discounted prices in Africa and no plan for it to be produced in Africa . The hope is that donor organisations will donate it.
This is not good enough.
This is not good enough.
11/ To stop this outbreak we need free testing in affected countries, the ability to sequence the virus to tell which clade is causing the infection, and enough vaccine to be deployed in immunisation campaigns delivered for and with affected communities where it’s needed.
12/ the PHEIC will allow better coordination, improved surveillance and has already allowed emergency licensing of the vaccine in affected countries. It is hoped this will allow GAVI and @UNICEF to deploy it.
13/ The risk to the general public in the UK, US & is very low. However travellers to affected countries are at risk as are people they mix with when they return.
Returning travellers who have symptoms should ring 111. Travel vaccination is not being offered to the public in UK
Returning travellers who have symptoms should ring 111. Travel vaccination is not being offered to the public in UK
14/ it is essential not to stigmatise communities and countries affected by mpox.
We all need to do our bit to pressure governments and agencies to provide vaccine to the millions who need it in affected countries and not to stockpile it in well-resourced settings.
We all need to do our bit to pressure governments and agencies to provide vaccine to the millions who need it in affected countries and not to stockpile it in well-resourced settings.
15/ I am delivering scientific communications for @skynews @bbcnews @eveningstandard @nbc as I want to ensure people get accurate information. Feel free to RT this if helpful.
16/ Follow amazing journalists like @benryanwriter @LizHighleyman @apoorva_nyc and info from reputable sources like @ukhsa @ecdc @cdc @who scientists and activists like @Boghuma @TeamPrepster @KrutikaKuppalli @HIViBase to name a few.
@benryanwriter @LizHighleyman @apoorva_nyc @UKHSA @cdc @WHO @Boghuma @TeamPrepster @KrutikaKuppalli @HIViBase @rupert_pearse @drlaurajwaters @tristanjbarber @BrendaCrabtreeR @AnuHazraMD
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