• Rising cases in DR Congo alarm global health body
• No cases in Pakistan yet as NCOC convenes today to review preparedness

ISLAMABAD: The National Command and Operation Centre (NCOC) will meet today (Thursday) to take stock of measures in place to stem the spread of mpox (formerly known as monkeypox), after the World Health Organisation declared it a global public health emergency.

Worried by a rise in cases in the Democratic Republic of Congo and their spread to nearby countries, the WHO hastily convened a meeting of experts to study the outbreak on Wednesday.

“Today, the emergency committee met and advised me that in its view, the situation constitutes a public health emergency of international concern. I have accepted that advice,” WHO chief Tedros Adhanom Ghebreyesus told a press conference.

A ‘public health emergency of international concern’ is the highest level of alarm under the International Health Regulations, which are legally binding on 196 countries.

“The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” said Mr Ghebreyesus.

Mr Ghebreyesus said the more than 14,000 cases and 524 deaths reported so far this year in DR Congo had already exceeded last year’s total.

Maria Van Kerkhove, the WHO’s epidemic and pandemic preparedness and prevention director, insisted: “We can stop transmission of mpox with a concerted effort.”

But she said experts needed a “much better understanding of the epidemiology” and the transmission patterns, which would help make sure the limited number of vaccines could be deployed to best effect.

Two vaccines for mpox are recommended by WHO immunisation experts.

NCOC preparations

Today’s NCOC meeting, to be chaired by NCOC director general Dr Shabana Saleem and attended by the provincial DGs via video link, will discuss the availability of testing kits, arrangements at entry points and availability of isolation wards and beds in hospitals across the country.

Although no cases of mpox have been reported in Pakistan yet, the meeting was called in anticipation of the WHO announcement.

“Border Security Services has been also invited to attend the meeting so that a foolproof arrangement would be made to stop the arrival of virus in the country or in case of arrival of an infected patient, he/she would be isolated without any delay,” NCOC Deputy Coordinator Dr Mumtaz Ali Khan told Dawn before the WHO announcement.

In the past, he said, Pakistan received cases of mpox from Gulf countries and there were chances that the people arriving from that region may again carry the virus.

Dr Khan, who is an infectious disease specialist, said mpox was being reported in African countries but it can reach any country. A control room has already been set up at the NCOC to tackle possible Mpox spread in Pakistan, he said.

Replying to a question, he said that a testing kit was used to collect fluid from wounds of patient and polymerase chain reaction (PCR) test was conducted to confirm the virus.

What is mpox?

Formerly called monkeypox, the virus was first discovered in humans in 1970 in what is now the DRC.

Mpox is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.

The disease causes fever, muscular aches and large boil-like skin lesions.

This is the second successive public health emergency of international concern declared on mpox — albeit this one focuses on a different, and more deadly, strain of the virus.

In May 2022, mpox infections surged worldwide due to the clade 2b subclade. The WHO declared a public health emergency, which lasted from July 2022 to May 2023. The outbreak, which has now largely subsided, caused some 140 deaths out of around 90,000 cases.

Later in November, the WHO named the disease mpox to replace the older term ‘monkeypox’, citing con­cerns of stigma and racism associated with the name.

The clade 1b subclade, which has been surging in the DRC since September 2023, causes more severe disease than clade 2b, with a higher fatality rate.

Such an emergency has only been declared seven times previously since 2009: over H1N1 swine flu, poliovirus, Ebola, Zika virus, Ebola again, Covid-19 and mpox.

With input from AFP

Published in Dawn, August 15th, 2024