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.
-
RICS: Housing market continues to strengthen but 2025 could be challenging
The latest survey by the Royal Institution of Chartered Surveyors reports a resilient UK housing market, but warns of headwinds next year
By Ruth Emery Published
-
Bitcoin price one of the most-asked questions on Alexa - here's how to buy the cryptocurrency
According to figures from Amazon, which cover September 2023 to November 2024, pop star Taylor Swift and Bitcoin were named among the most popular Alexa queries of 2024
By Chris Newlands Published
-
Has Javier Milei succeeded in transforming Argentina's economy?
Javier Milei won an election last year on an “anarcho-capitalist” platform, promising to take a chainsaw to the overbearing and bloated state. How’s it going?
By Simon Wilson Published
-
Brazil booms – but why do investors remain wary?
Brazil is booming, but you wouldn’t think so from looking at the stock market. What's behind the market paranoia?
By Alex Rankine Published
-
German chancellor Olaf Scholz's coalition collapses – what went wrong?
EU Economy After Olaf Scholz fired a key minister, Germany's coalition has collapsed. But political turmoil in the country couldn’t have come at a worse time
By Emily Hohler Published
-
Are Chinese consumer brands challenging global chains?
A new wave of Chinese consumer brands is starting to push out into global markets. Complacent Western giants are not nearly ready for the threat that they pose
By Matthew Lynn Published
-
Will turmoil in the Middle East trigger inflation?
The risk of an escalating Middle East crisis continues to rise. Markets appear to be dismissing the prospect. Here's how investors can protect themselves.
By Philip Pilkington Published
-
The Gulf states: a new competitor for the City's financial crown?
Bahrain and other Gulf states could eventually threaten London's financial dominance.
By Matthew Lynn Published
-
Working from home: is it working?
While Labour plans to make working from home the legal default, some employers are calling workers back into the office. What does the future hold?
By Simon Wilson Published
-
Israel conflict: the concerns of a wider war
Israel's raids into Lebanon have raised fears of a wider war
By Dr Matthew Partridge Published