As alluded to on Monday (see WHO D-G Considering Convening IHREC Meeting Over Growing Clade I Mpox Concerns), today WHO D-G Dr Tedros Adhanom Ghebreyesus announced during media event that he would seek to convene an IHRREC meeting `as soon as possible' following the recent spread of clade I of Mpox to several non-endemic nations in Africa.
Unlike the milder clade II Mpox virus, which began its world tour in 2022, clade I produces far more severe illness, and carries a significant fatality rate.
Over the past 6 weeks we've revisited this growing crisis repeatedly, including:
ECDC Risk Statement On Mpox As Cases Continue to Spread In Africa
WHO: Mpox - South Africa
Biomedicines: The Re-Emergence of Mpox - Old Illness, Modern Challenges
WHO Multi-country Outbreak of Mpox : External Situation Report #34
COCA Call Today: Mpox - Clinical Management & Outbreaks
Last week, we saw reports of Mpox detections in 3 non-endemic countries; Kenya and Uganda in east Africa, and Côte d'Ivoire on the west coast (see More African Nations Reporting Mpox - Africa CDC Mpox Update (Jul 30th)).
Since our our collective immunity from the smallpox vaccine - which was discontinued in the late 1970s - continues to dwindle, there are increased opportunities for pox viruses like Mpox to make a comeback.
We've been following the emergence of a new subclade of the virus in the DRC - dubbed clade Ib - for nearly a year (see Preprint: Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo).
While this new clade has not been confirmed outside of central Africa, there are concerns that if not contained, it could follow clade II's example, and become an international threat.
Complicating matters, last March we saw a pair of studies that suggest the duration of protection offered by the JYNNEOS vaccine may be less than originally hoped.
ECCMID 2024 Study: Mpox (monkeypox) Antibodies Wane Within A Year of Vaccination
Immune response to MPXV wanes rapidly after intradermal vaccination with MVA-BN (Jynneos)
Immunity is based more than just detectable neutralizing antibodies, and anecdotal reports suggest the vaccine provides significant protection. But boosters may be required sooner than originally planned (see ACIP Evidence to Recommendations for Use of JYNNEOS (orthopoxvirus) Vaccine Booster Every 2 Years).
Since the eradication of smallpox in the 1970s, there is a general feeling that poxviruses are a thing of the past, a relic of the 20th century.
But viruses have been around far longer than humans, and nature is nothing if not persistent, making it unwise to bet against their long-term success.
