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Stefano Musumeci, Frédérique Jacquerioz, Olivier Segeral, Alexandra Calmy, Effectively protecting health care workers as clade 1 mpox epidemic complexifies: a call for vaccine and antivirals deployment, Journal of Travel Medicine, Volume 31, Issue 7, October 2024, taae120, https://doi.org/10.1093/jtm/taae120
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In 2022, monkeypox virus (MPXV) clade 2b was responsible for the first WHO mpox-related public health emergency of international concern (PHEIC) declaration, due to a worldwide epidemic in non-endemic countries, spreading mainly through sexual contact, disproportionally affecting men having sex with men (MSM).
In 2024, WHO declares mpox for the second time a PHEIC due to the upsurge of cases in the Democratic Republic of the Congo (DRC) and the emergence of a new clade of mpox (renamed 1b) in Eastern DRC and neighbouring countries. Since January 2024 the DRC has reported over 15 000 suspect mpox cases and around 500 deaths, more cases than for the whole year of 2023.1
While clade 1 cases were largely related to zoonotic spillover and household transmission, mostly affecting children, the clade 1b, firstly described in South Kivu,2 seems to be driven by sexual contact and it’s causing sustained community transmission.3 Historically, clade 1 has been linked to a more severe disease and higher mortality than clade 2. At present, there is no evidence that clade 1b is more severe or more transmissible than clade 1a.3 So far, the Republic of Congo and Central African Republic already declared a national mpox epidemic, while as of August 2024 Burundi, Kenya, Rwanda and Uganda reported cases of clade 1b.