Swedish health authorities said Thursday they had registered the first case outside Africa of the more dangerous variant of mpox, a viral infection spread through close contact.
The announcement came a day after the World Health Organization (WHO) declared mpox a global health emergency for the second time in two years, warning that the virus could eventually spread across international borders.
Sweden’s public health authority confirmed to Agence France-Presse (AFP) that the case was the same strain of the virus that has been increasing in the Democratic Republic of Congo since September 2023, known as the Clade 1b subclade.
The person was infected when he was staying in a part of Africa where there was a large outbreak of the disease, Olivia Wigzell, director general at the Public Health Agency told a press conference.
“A person who sought care” in Stockholm “has been diagnosed with mpox caused by the Clade I variant. It is the first case caused by Clade I that has been diagnosed outside the African continent,” the authority writes in a statement.
Wigzell said the infected person had received care and instructions in accordance with the health authority’s recommendations.
“The case is the first caused by Clade I to be diagnosed outside the African continent. The affected person was also infected during a stay in an area of Africa where there is a large outbreak of mpox Clade I,” she said.
The authority added that Sweden “has a preparedness to diagnose, isolate and treat people with mpox in a safe way.”
“The fact that a patient with mpox is being treated in the country does not affect the risk to the general population, a risk that the European Center for Disease Prevention and Control (ECDC) currently considers to be very low,” it said.
The Africa Centers for Disease Control and Prevention declared mpox a public health emergency on the continent on Tuesday.
The WHO said there have been more than 14,000 cases and 524 deaths in Africa this year, already surpassing last year’s figures.
To date, more than 96% of all cases and deaths are in a single country – the Democratic Republic of Congo. Scientists are concerned about the spread of a new version of the disease there that can be transmitted more easily among people.
Here’s a look at what we know about mpox and what can be done to contain it:
Mpox, also known as monkeypox, was first identified by scientists in 1958 when there were outbreaks of a “smallpox-like” disease in monkeys. Until recently, most cases were seen in people in central and western Africa who had close contact with infected animals.
In 2022, the virus was confirmed to be sexually transmitted for the first time, triggering outbreaks in more than 70 countries worldwide that had not previously reported mpox.
Mpox belongs to the same family of viruses as smallpox but causes milder symptoms such as fever, chills and body aches. People with more severe cases may develop lesions on the face, hands, chest and genitals.
The number of cases has increased dramatically. Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries. Compared to the same period last year, the agency said cases are up 160% and deaths are up 19%.
Earlier this year, researchers reported the emergence of a new form of mpox in a Congolese mining town that can kill up to 10% of people and can spread more easily.
Unlike previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form of mpox causes milder symptoms and lesions on the genitals.
That makes it harder to detect, meaning people can also make others sick without knowing they’re infected, says Dr. Placide Mbala-Kingebeni, a Congolese researcher who led the research on the new form of mpox.
WHO said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All these outbreaks were linked to the epidemic in the Congo.
WHO Director-General Tedros Adhanom Ghebreyesus said there is concern about the continued spread of the disease within Africa and beyond.
In Ivory Coast and South Africa, health authorities have reported outbreaks of another and less dangerous version of mpox that spread worldwide in 2022.
Kamituga, the region of Congo where the new form of mpox was first seen, is home to a significant transient population traveling through Africa and beyond.
Still, given the resources in rich countries to stop mpox, researchers suspect that if new outbreaks linked to Congo were identified, transmission could be stopped relatively quickly.
Unlike covid-19 or measles, mpox is not airborne and usually requires close skin-to-skin contact to spread.
The WHO’s emergency declaration is intended to spur donor agencies and countries to action. However, the global response to previous declarations has been mixed.
Africa CDC director-general Dr Jean Kaseya said the agency’s declaration of a public health crisis was meant “to mobilize our institutions, our collective will and our resources to act quickly and decisively.” He appealed to Africa’s international partners for help, saying the escalating caseload in Africa had been largely ignored.
Dr. Boghuma Titanji, an infectious disease expert at Emory University, said the WHO’s recent mpox emergency declaration “did very little to move the needle” on getting things like diagnostic tests, medicines and vaccines to Africa.
During the 2022 global outbreak of mpox, gay and bisexual men made up the vast majority of cases and the virus was spread mostly through close contact.
Although some similar patterns have been seen in Africa, children under 15 now account for more than 70% of mpox cases and 85% of deaths in the Congo.
Greg Ramm, head of Save the Children Congo, said the organization was particularly concerned about the spread of mpox in the overcrowded camps for refugees in the east, noting that 345,000 children were “squeezed into tents in unsanitary conditions”. He said the country’s health system was already “collapsing” under the strains of malnutrition, measles and cholera.
Emory’s Titanji said it was unclear why children were disproportionately affected by mpox in the Congo. She said that could be because children are more susceptible to the virus or that social factors, such as overcrowding and exposure to parents affected by the disease, could explain it.
The 2022 outbreak of mpox in dozens of countries was largely shut down with the use of vaccines and treatments in rich countries, in addition to convincing people to avoid risky behavior. But hardly any vaccines or treatments have been available in Africa.
Marks, from the London School of Hygiene and Tropical Medicine, said immunization was likely to help – including inoculating people against smallpox.
“We need a large supply of vaccines so that we can vaccinate populations that are most at risk,” he said.
Congolese authorities have asked for 4 million doses mostly for young children, but no doses have yet been received, said Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee.
