How concerned should you be about the mpox outbreak?

the Democratic Republic of Congo says it hopes to receive its first aox vaccine from the US and Japan by next week as the number of cases in the country continues to climb officials say there have been more than 16,000 registered cases and 570 deaths so far this year with the disease now affecting all 26 provinces in the country the US EU and Japan have confirmed they will provide vaccines to Congo and other affected nations in Africa the World Health Organization declared empo a global Health Emergency last week after after a new deadlier strain of the virus spread across Africa outside the continent the first case of the new strains been confirmed in Sweden countries around the world are ramping up preventive measures to counter the outbreak led by increased vaccinations and testing Asia is now on high alert the Philippines reported its first impo case of the Year yesterday a 33-year-old male with no race and travel history his symptoms began more than a week ago when he had a fever in rashes Health officials are still establishing The Strain but have reassured the situation is under control a case was also confirmed in Pakistan last week authorities have determined it is not the new more serious strain still precautionary measures have been ramped up all travelers arriving in the country will be screened for empo we are joined by Dr Mel delja senior scholar at John's Hopkins Center for Health security doctor thank you very much for joining us you know it was just a few years ago the who declared a public health emergency over empo so I wonder what's changed and how concerning is the latest outbreak what's changed is that the virus has evolved and there is a new strain of this virus that's spreading pretty rapidly in the DRC and it's happening in a place where they don't have the resources to stem that spread and and this is now spreading to neighboring countries like Burundi for example and that's what's triggered this Public Health Emergency of international concern it's to Galvanize the world to get the resources to the DRC to be able to put a stop to the spread of this new strain as well as other strains of empo that are continuing to spread we've never really dealt with empo at its source and and that's always going to be a problem until empo is dealt with in those endemic countries in Africa the world will remain at risk and those countries will remain at risk for FL apps just like this well Dr ader the world went through covid-19 and presumably some lessons were learned and based on based on what you're seeing what you're hearing right now are the lessons being put into practice and I guess you know more importantly quickly enough well certainly the who acted pretty promptly when this outbreak occurred in the DRC when there were uh cries for help from the DRC and from those country there wasn't any kind of delay in declaring a public health emergency of international concern so in that sense they are being proactive but if you look at empo historically from at least the mid 2000s this has been a problem that has been allowed to spiral out of control that's why we had the first Public Health Emergency of international concern and this problem still was not fixed it was fixed in a lot of Western countries like the United States for example but it wasn't fixed at the source so in that sense I think the lessons of Co still haven't been learned enough to be proactive to be aggressively dealing with infections at their Source but this is definitely a better response than we've seen in the past and hopefully it's it's a Harbinger for better things in the future um Dr doel I want to ask you about the somewhat different approaches that we're seeing right now I I think you touched on it you know when you talked about tackling it at a source so right now we know that many countries outside of Africa are increasing surveillance they doing screening they monitoring but we also know that the US and Japan and EU sending vaccines to Africa can you explain to us why there is this difference in terms of the approach I think you have to do both at the same time you have to be prepared to aggressively identify imported cases diagnose them treat them isolate them and Trace their contacts and at the same time you have to deal with the source of those imported cases because you can't just deal with the imported cases without dealing with the source because the same thing will happen again and again and again so so this this has to be kind of an all-encompassing approach where countries are ready to to deal with any cases that may be imported within their borders and have the appropriate infrastructure in place to identify them and to vaccinate in their home countries uh the atrisk population but we also have to get rid of this actual problem at at at its source at its origin so you can't do one without the other if you're going to have a sustainable approach to removing empo as a threat to to humans drct there's no current treatment for enox right now but as you mentioned vaccination is a way to help reduce the risk could you tell us how effective these occurring vaccines are against I don't know Clay one and Clay 2 the vaccines are highly effective it's a two- dose regimen the main one that we're seeing given is called genos there is another Japanese vaccine called lc16 that's also going to be used both of those are highly effective but the key thing is making sure they get into the arms of the individuals that are at at risk so for example in the United States only about 25% of our atrisk population of men who have sex with men have been vaccinated so we still have a ways to go but the vaccine is highly effective if people get both Doses and there is a treatment it's called Tio verat there is an antiviral it may be less effective against Clay 1B but it was used in clay 2 with success drangel tell us a little bit about the difference between you know the the two clate one and and clate 2 and also their Associated mortality rates so clay one and Clay 2 are two different versions of moox and what's happened within Cade 1 is it's further differentiated it's a cade 1 a and 1B and this 1B seems to be efficiently transmitting between humans or more efficiently than other versions of the virus and historically clay one has had a higher mortality rate than clay 2 it's considered to be a more dangerous strain but we're unclear on that because all that data comes from countries that may not have health infrastructure to actually treat cases so that that uh that mortality R may be more similar to Clay 2 if it's treated in a modern hospital where there's ability to do supportive care such as IV fluids for example so historically yes c one has been more dangerous but we don't know if that data will hold up for example in in western style hospitals doctor a handful of countries outside of Africa have now reported anox cases some of them here in Asia as well it's a summer season I mean vacation season for some uh what sort of role does international travel play in the spread of empo and what sort of measures on this front could help mitigate wider spread well we know from the prior empo outbreak that engulfed the world that international travel played a major role when this virus found its way into a sexual Network and then spread all over the all over the world including to the United States to Canada to to Europe and and that same risk is there with this clate however this is coming from the DRC where there's less international travel from the DRC for example to the United States but what we've seen is international travel to Sweden for example with this clay being diagnosed in a patient in Sweden so it is important that countries be still aware that empo irrespective of the clay Cay one clay two could be in their countries could be spreading and you need to have the infrastructure to be able to diagnose it to have the the public health authorities be able to isolate and give that person guidance and Trace their contacts and to use the vaccine uh strategically as well as antiviral strategically so you need to have a plan in place to deal with the case in your borders because it it not be that this stays only in one place and as we've seen in the past empo can spread and already is spreading in other countries and and remember empo never went away so for example in the United States even though our cases are very low we've still had simmering cases a handful every day five to six cases diagnosed a day on average so empo still is a problem in countries that dealt with the outbreak in the past and had it somewhat controlled Dr adala thank you very much for the information and the advice I'm a ad a senior scholar at John S Hopkins Center for Health security