Mpox: Belgium 8th non-African nation to report new variant, WHO says situation ‘especially concerning’

Even as the World Health Organization (WHO) maintains the mpox situation in Africa is “especially concerning”, the disease has been reported in another country outside of the continent.

In the latest weekly bulletin, the European Centre for Disease Prevention and Control (ECDC) said that a case of mpox has been detected in Belgium. The mpox virus in the case is from the clade 1b.

With this, Belgium became the eighth non-African country to report mpox infection from clade 1b. The other countries are Canada, Germany, India, Sweden, Thailand, the United Kingdom, and the United States.

The clade 1b of mpox emerged last year in the Democratic Republic of Congo (DRC) and appears to be spreading from persons to persons during sexual activities and not from animals to humans.

Mpox is a viral disease caused by the virus of the same name. It causes lesions on the body which are often accompanied by fever and swollen lymph nodes. The symptoms usually last for two to four weeks. The virus can spread from an infected animal to humans but the current outbreak in Africa and elsewhere appears to be driven completely by person-to-person close contact primarily during sexual activities.

In its latest report, the WHO said that mpox’s clade 1b is spreading “among young adults via close physical contact, often sexual contact”. In African countries like DRC and Uganda, the disease has also spread via paid sex work. Once the disease gets into a community via sexual activities, it is also transmitted to children. In fact, in several communities, the disease is now largely circulating among children, suggesting that while the disease gets into the community with sex at first, it then spreads via non-sexual close contact.

The WHO notes, “The spread of clade Ib MPXV to new areas seems to occur mostly through transmission among young adults via close physical contact, often sexual contact. Where initial clusters expand and as the outbreak progresses, transmission patterns appear to evolve, with more spread within households and communities through close direct physical contact, leading to a progressive shift in age and sex distribution, with a rising proportion of cases among children.”

So far, Africa has reported 13,769 mpox cases this year with 60 deaths. The DRC has reported most cases at 9,513.

As per the current understanding, unlike HIV, it is not believed that mpox spreads through a sexual act itself. Instead, it is believed that mpox spreads from close contact during sexual activities.

“Mpox can spread through close contact of any kind, including through kissing, touching, oral and penetrative vaginal or anal sex with someone who is infectious. People who have sex with multiple or new partners are most at risk…While the monkeypox virus has been found in semen, it is currently not known whether mpox can be spread through semen or vaginal fluids,” says WHO on its website.