Is India prepared for mpox after it being declared a global health emergency?

Two days after the World Health Organization (WHO) classified mpox as a global health emergency due to a surge in cases in Africa and Europe, India is pulling out all the stops to thwart the virus.

In response to the WHO’s alert, both central and state governments have sprung into action. High-level meetings are in full swing, and fresh guidelines have been rapidly issued to prevent the virus from spreading.

This Saturday, Union Health Minister Jagat Prakash Nadda will lead a crucial meeting with officials from the Ministry of Health, the National Centre for Disease Control (NCDC), and the Indian Council of Medical Research (ICMR) to scrutinise the situation and reinforce precautionary measures.

As WHO sounded a global alert, is India at risk of viral outbreak? Here’s a look at how India is gearing up to stand firm against the virus

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Has India seen mpox cases before?

India’s history with mpox began with its first recorded case in Kerala in 2022, when a traveller from the UAE tested positive for the virus. Soon after, the virus spread within the country, with cases emerging in Delhi among individuals who had no recent international travel.

Mpox, is a zoonotic infection that has two main clades: clade I, which is more severe, and less deadly clade II, which was responsible for the global outbreak in 2022.

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That year, India reported 27 confirmed cases and one death, according to WHO data. By July 24 of the previous year, the total number of confirmed cases had reached 31, with 12 in Kerala and 15 in Delhi. The latest reported case in India was in March this year, originating from Kerala, PTI reported citing health ministry sources.

So far, India has not recorded any new mpox cases amid the current global spread that has so far affected over 100 countries. However, Professor Dimie Ogoina, Chair of the IHR Emergency Committee, emphasised to The Indian Express, “The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the virus, is an emergency, not only for Africa but for the entire globe.”

“Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself,” he said.

What measures India is taking this time?

In response to the global mpox situation, India is enhancing its preventive measures. The health ministry is set to issue advisories to major entry points such as airports and seaports, instructing them to stay vigilant and manage suspected cases effectively.

In Tamil Nadu, the Directorate of Public Health and Preventive Medicine (DPH) has already heightened alert levels. Airport Health Officers and Port Health Officers are focusing on passengers arriving from the Democratic Republic of Congo and Central African countries.

Both Hyderabad and New Delhi — cities that are popular among African students pursuing higher education — have also been placed on heightened alert.

Director of Public Health TS Selvavinayagam has directed District Health Officers and health officers in Chennai, Tiruchi, Madurai, and Coimbatore to familiarise themselves with mpox symptoms, conduct strict thermal screenings, and verify travel histories for the past 21 days, The Hindu reported.

Meanwhile, the Indian Council of Medical Research (ICMR) has been conducting a serosurvey since last year to assess mpox exposure among high-risk populations in India, a scientist familiar with the matter told Livemint.

Smallpox vaccine to prevent mpox?

While there are no vaccines specifically targeting mpox, existing vaccines for smallpox and chickenpox might offer protection in India. According to Dr. Satish Koul, Senior Director of Internal Medicine at Fortis Memorial Research Institute in Gurugram, these vaccines could be effective against mpox because smallpox and mpox viruses are closely related, he told the Business Standard.

Here’s the science behind it: Vaccines that combat mpox rely on cross-reactivity, a phenomenon where the immune system recognizes different viruses as similar due to their structural likeness. For instance, if someone has been vaccinated against smallpox, their antibodies can also help fend off mpox because both viruses belong to the same genus.

In India, children receive the varicella vaccine against chickenpox between 12 and 15 months, with a booster shot given between ages four and six. Also, “Those vaccinated for smallpox are immune to mpox, so people over 44 are protected,” Dr. Ishwar Gilada, President of the AIDS Society of India told The Indian Express, stressing that the country’s strength in vaccine production should be positively exploited.

Following the isolation of the first monkeypox strain by ICMR researchers in 2022, there has been a call for pharmaceutical companies and diagnostic kit manufacturers to develop vaccines and testing kits for the virus. “Serum Institute of India is working on an mpox vaccine,” a scientist informed Livemint.

Is there a threat?

The current mpox outbreak has resulted in 27,000 cases and over 1,100 deaths since January 2023, predominantly affecting children. On August 15, global health officials confirmed the presence of a new strain of mpox in Sweden, marking its first spread outside Africa. Consequently, the European Centre for Disease Prevention and Control has raised the risk level for mpox from “low” to “moderate.”

Tensions are mounting in India as three cases of the mpox virus have been reported in Pakistan’s Khyber-Pakhtunkhwa province, which borders Afghanistan.

However, experts indicate that the risk of a significant surge in mpox infections in India remains low. “At the moment, the risk of a surge in monkeypox infection is very low in India, and there is no need to panic,” a source told PTI.

Echoing this sentiment, a scientist at the National Institute of Virology (NIV) in Pune told Livemint, “The new mpox strain found in eastern Congo is not present in India right now. We have monkeypox advisories in place and are taking public health measures. There is nothing to panic about at this stage. The ICMR is closely monitoring the situation and reviewing international trends.”

With input from agencies