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We advise the government of the Democratic Republic of the Congo to stop the infection internationally

29/08/2024
We advise the government of the Democratic Republic of the Congo to stop the infection internationally
This summer, the World Health Organization (WHO) declared an international health emergency related to the outbreak of mpox that has been declared in Africa and the increase in infections caused by this virus, formerly known as monkeypox. To find out the extent of the infection and, above all, to find out what has been discovered so far, we spoke with Dr. Oriol Mitjà, researcher at the Fight Against Infections Foundation and doctor at the Infectious Diseases Service at the Germans Trias i Pujol Hospital, who is advising the government of the Democratic Republic of the Congo in trying to stop the spread of the disease.

What is mpox?

Mpox or monkeypox is a zoonotic infection that is usually transmitted from animals to humans and, in this case, is caused by a virus of the Orthopoxvirus genus. This infection was mainly found in limited outbreaks in forested areas of central and western Africa, but in 2022 there was a global epidemic outbreak of sexual transmission with more than 90,000 affected. In this case, it was a mild or moderate infection that mainly caused blisters in the mouth, genitals and anal area. However, this summer the WHO declared an international health emergency due to a new outbreak located in central-eastern Africa, especially in the Democratic Republic of the Congo, which is more contagious and not sexually transmitted.

What is the difference between the 2022 mpox outbreak and this summer’s?

The 2022 and 2024 mpox outbreaks have some important differences in terms of spread, health response and public awareness. As for the 2022 mpox outbreak, it was the first large-scale outbreak outside endemic areas in Africa, as it also affected populations in Europe and North America. Furthermore, its transmission was mainly sexual, with a high concentration among men who have sex with men. Thus, we can say that it was a mild or moderate infectious outbreak. In contrast, the mpox infection this summer has been very different, as transmission has been direct and not just sexual, i.e. through skin lesions, contact with infected animals or through contaminated objects. It should be noted that this outbreak in the Democratic Republic of the Congo has affected 30,000 people in the last two years. 75% were children under 15 years of age and there were around 1,200 deaths, mostly among children who had other predisposing factors, such as malnutrition.

There has been much talk about clade 1 and clade 2 variants. What are the main differences between them?

Monkeypox is classified into different variants known as clades. The two main variants are clade 1 and clade 2. The clade 2 strain is the one that caused the infectious outbreak in 2022. This summer, the WHO declared an international health emergency due to clade 1 mpox. In general, we could say that the clade 1 strain is more serious than the one that has been circulating until now because it has a higher mortality rate.

What are the symptoms of mpox?

Most people who contract monkeypox recover within a few weeks of becoming infected, but in some cases the illness can become severe, depending on the strain of the virus itself, access to medical care, and the health status of the infected person.

The main symptoms of the disease are:

  • Fever
  • Headache
  • Muscle aches
  • Fatigue
  • Swollen lymph nodes
  • Skin rashes that develop into pustular lesions

In terms of vaccinating the population, where are we now?

At the moment, no vaccine has yet arrived in Africa. The Democratic Republic of the Congo has made an initial request for 200,000 vaccines, which are expected to arrive this October. In Catalonia, the vaccine began to be administered in 2022. Specifically, it was received by people who had been in contact with infected people and, as a precaution, it was also administered to certain at-risk groups. In fact, from the research group that I lead at the Fight Against Infections Foundation, we also want to assess the effectiveness of the available vaccines with respect to this new outbreak of mpox, as we did in relation to the outbreak in 2022.

Should we be worried?

The outbreak that occurred in 2022 taught us many things that we have been able to apply in this new wave of contagion, such as the diagnostic tools and vaccination that is necessary to deal with the infection. Without a doubt, these are great steps to take into account, since if we compare it with the case of Covid-19, we did not have any of these factors under control. It must be said that, for now, the greatest risk of contagion continues to be found in the at-risk populations of the Democratic Republic of the Congo.

What research has been done so far?

At the Fight Infections Foundation, I lead a research group that addresses mpox. In fact, I would dare say that we are the leading experts in the field internationally, which is why we are directly advising the government of the Democratic Republic of the Congo with the aim of stopping the infection. Specifically, we have led international studies through which we have been able to collect data regarding the clinical presentation of cases, identify the transmission routes of the mpox virus, as well as propose treatments and containment strategies with specific recommendations for risk groups. If anyone is interested in learning more about the studies we have published, they can be seen in the medical journal The Lancet.

Why is it important to support research financially?

As the president of our Foundation, Dr. Bonaventura Clotet, says, scientific research is worth a lot of money and without it, unfortunately, we cannot continue to move forward. Seed money is key to the success of many research projects. In fact, many of them are financed thanks to the charitable contributions that different organizations and people make throughout the year. Therefore, I take this opportunity to encourage everyone to join our research, offering us a donation, however small. Global health depends on everyone.

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