Will Mpox be the new Covid?
Not if Mpox can be contained, says the World Health Organisation. But will it be?
Mpox is a viral disease originating in central Africa that causes skin rashes and lesions along with flu-like symptoms. Most cases typically present with mild symptoms, and there is complete recovery within two to four weeks. However, in severe forms, the disease leads to brain inflammation and sepsis, and can be fatal. The disease was first identified in captive laboratory monkeys in Denmark in 1958 and was formerly known as monkeypox. In addition to monkeys, the virus has been detected in Gambian pouched rats, dormice and African squirrels, which are often used as food. The first cases in humans were identified in 1970, and sporadic cases were reported in central and east Africa in the decades since then. A major global outbreak occurred in 2022-2023, and there are now widespread fears of a far worse one. Last month, the World Health Organisation (WHO) declared Mpox an international public health emergency of major concern, in response to a deadly outbreak in the Democratic Republic of Congo (DRC).
How is Mpox transmitted?
It’s a so-called “zoonotic” disease, which is spread from animals to humans via bites or scratches, or activities such as hunting and skinning infected animals. The pathogen enters the body via broken skin, or “mucosal” surfaces such as the mouth and respiratory tract, and can then be passed on to others during prolonged periods of intimate face-to-face interaction, in particular, that involving close contact and touching. During the recent global outbreak – the first of its kind since the identification of the virus – human-to-human transmission was almost exclusively via sexual contact (and mostly affected men who have sex with men). The outbreak spread from Africa to 115 countries, on every continent, where Mpox had never been seen before, resulting in about 100,000 reported cases globally and roughly 200 known deaths, though this is widely thought to be an underestimate. Internationally, the first cluster of cases was found in the UK, linked to a patient who had visited Nigeria.
What’s happening this time?
Already, far more people have died of Mpox – with more than 1,300 known deaths in the DRC alone. Almost 30,000 cases have been identified in that country, and the virus has spread to neighbours including Burundi, Rwanda, Uganda and the Central African Republic. Two cases have been reported in Sweden and Thailand, both in people who had recently visited the region. There’s a crucial difference this time: a different strain of Mpox is involved, which is more dangerous and more deadly – the “clade 1” version and, in particular, a strain known as “clade 1b”, which has a fatality rate of between 1.4% and 10%. Sexual activity is still a primary means of transmission. Female sex workers, their male customers and gay men are all highly vulnerable groups and are hard for health workers to reach in countries where prostitution and homosexual acts are illegal. But this time, unlike in the previous outbreak, many of those with Mpox are children. According to the Africa Centres for Disease Control, almost 70% of Congolese cases are children aged under 15, and they account for 85% of the deaths. One medical charity running an isolation site near Goma (a city in the DRC on the Rwandan border) says 75% of cases there have been children under 10.
Subscribe to MoneyWeek
Subscribe to MoneyWeek today and get your first six magazine issues absolutely FREE
Sign up to Money Morning
Don't miss the latest investment and personal finances news, market analysis, plus money-saving tips with our free twice-daily newsletter
Don't miss the latest investment and personal finances news, market analysis, plus money-saving tips with our free twice-daily newsletter
Why are children so vulnerable?
Children are more likely to have weaker immune systems due to malnutrition, recent cholera and measles outbreaks, and untreated HIV infections. They may also be more vulnerable because Mpox has some similarities to smallpox; older generations who had the smallpox vaccine may have some protection. Another reason for the rapid spread, says Leana Wen in The Washington Post, is the ongoing civil unrest in the DRC. In the eastern provinces of North and South Kivu, nearly a million displaced people are living in desperately crowded refugee camps, including hundreds of thousands of children – an ideal breeding ground for the virus. Meanwhile, the M23 armed rebels in control of swathes of North Kivu falsely claim there are no cases there.
Will Mpox become a pandemic?
According to Airfinity, a health-data firm, London and Dubai are the global cities at greatest risk of importing the new strain. However, “Mpox is not the new Covid”, says the WHO. There is every chance of the outbreak spreading globally and causing deaths. But Mpox is harder to pass on and there is no evidence the virus spreads easily, like Covid, via respiratory droplets and airborne particles. Moreover, children in rich countries are healthier and better nourished, and far less likely to become infected. On the other hand, there’s no room for complacency. The WHO’s confidence depends partly on the outbreak in Africa being contained – and at the moment it isn’t.
What about vaccines?
The global population’s collective immunity against pox viruses has deteriorated in recent decades after the eradication of smallpox in 1980 meant that vaccines were no longer necessary, says The Economist. Vaccines against related pox viruses provide some immunity from Mpox, but scientists are not yet certain how effective they are. Last month there was disappointment when an antiviral drug, tecovirimat, also known as TPOXX – which had shown promising results against clade 2 – did not reduce the severity of illness with clade 1. International help has been slow to arrive, in part due to hold-ups in approving new vaccines. But last week the first donation of Mpox-specific vaccines – 200,000 doses of Bavarian Nordic’s Imvanex vaccine – were sent to Kinshasa, as part of an EU donation programme. In all, about 380,000 doses of Mpox vaccines have been pledged by donors including the EU and US, according to Africa CDC. However, three million doses are needed. Distribution will be difficult. Of the two main vaccines, one needs refrigeration; the other uses a rare specialised needle. What Congo is crying out for is more help, says The Economist. “Because all countries stand to benefit, all should contribute what they can to organising a swifter, more rational response.”
This article was first published in MoneyWeek's magazine. Enjoy exclusive early access to news, opinion and analysis from our team of financial experts with a MoneyWeek subscription.
Sign up to Money Morning
Our team, led by award winning editors, is dedicated to delivering you the top news, analysis, and guides to help you manage your money, grow your investments and build wealth.
Simon Wilson’s first career was in book publishing, as an economics editor at Routledge, and as a publisher of non-fiction at Random House, specialising in popular business and management books. While there, he published Customers.com, a bestselling classic of the early days of e-commerce, and The Money or Your Life: Reuniting Work and Joy, an inspirational book that helped inspire its publisher towards a post-corporate, portfolio life.
Since 2001, he has been a writer for MoneyWeek, a financial copywriter, and a long-time contributing editor at The Week. Simon also works as an actor and corporate trainer; current and past clients include investment banks, the Bank of England, the UK government, several Magic Circle law firms and all of the Big Four accountancy firms. He has a degree in languages (German and Spanish) and social and political sciences from the University of Cambridge.
-
Investors pull money from UK equities as government warns of “painful” Budget
The government’s post-election honeymoon period has been short-lived, and investors are shying away from UK equities as a result
By Katie Williams Published
-
Top global fintech companies to invest in
One British fintech hogs the headlines, but there are two top performers in the US. We explain where you should put your money
By David C. Stevenson Published
-
Modi’s reforms set Indian stocks on fire
Indian stocks pass a new milestone, but global fund managers are holding back. Are there signs of overheating?
By Alex Rankine Published
-
Is China following Japan's economy and stock market?
China is dealing with deflation and an unappealing stock market. Is it following in the footsteps of Japan?
By Alex Rankine Published
-
Mexico passes controversial judicial reform – will it hurt investors?
What will Mexico's new reform mean for investors and the country's economy?
By Alex Rankine Published
-
Has the world conquered inflation?
The Central Bank has tackled inflation around the world – but what was the pay-off?
By Alex Rankine Published
-
Why are tourists a problem around the world?
Tourists are good for the economy, but not always for residents, says Alex Rankine
By Alex Rankine Published
-
Ukraine invades Russia – what are the political implications?
Ukraine's surprise invasion into Kursk could change the course of the war politically
By Stuart Watkins Published
-
UK stocks have become a global favourite – should you invest?
The world is taking to UK stocks – but how long will it last?
By Alex Rankine Published
-
Middle East conflict: is an all-out war inevitable?
Events have taken an ominous turn in the Middle East after Iran’s attacks on Israel. Will Israel and its allies retaliate, and how bad can it get?
By Dr Matthew Partridge Last updated