India's current Mpox case involves an individual infected in Africa, diagnosed with Clade 2; the strain responsible for the 2022 global outbreak affecting many countries.
Published Sep 11, 2024 | 2:41 PM ⚊ Updated Sep 11, 2024 | 4:22 PM
The Ministry of Health and Family Welfare (MoHFW) announced on Monday, 9 September, that a case of Mpox virus (West African Clade 2) has been confirmed in an isolated patient in India. The MoHFW stated that the case was a travel-related infection, and laboratory tests verified the presence of the West African Clade 2 Mpox virus in the patient.
The ministry advised states and Union Territories to screen and test all suspected Mpox cases in the community and to identify isolation facilities in hospitals for both suspected and confirmed patients.
So the question is should Indian citizens worry about the Mpox infecting other individuals in the country.
The current case detected in India involves a person who appears to have acquired Mpox in another country, reportedly in Africa. The individual was diagnosed with mpox caused by the older Clade 2, which was responsible for the global 2022 outbreak that spread to numerous countries. However, that outbreak was almost exclusively confined to certain high-risk groups, specifically the MSM (men who have sex with men) community,” Chairman of Indian Medical Association Research Cell Kerala State Dr Rajeev Jayadevan told South First.
According to MoHFW, this case is isolated, similar to the 30 cases reported in India since July 2022, and is not part of the current public health emergency (reported by WHO) involving clade 1 of the virus.
Dr Jayadevan added that the Clade 2 did not spread widely in the general population, and the number of women infected was very small. “Clade 2, originating from West Africa, is known to be of a milder nature. Many of the severe outcomes in previous cases were likely due to the individual’s pre-existing health conditions rather than the severity of the virus itself. Overall, the disease caused by Clade 2 was not severe in most instances,” said Dr Jayadevan.
In August 2024, the World Health Organisation (WHO) declared a Public Health Emergency of International Concern (PHEIC) due to a new variant, Clade 1B, which emerged from Central Africa, particularly the Democratic Republic of the Congo (DRC), home to the long-standing Clade 1.
“Clade 1B is new, and genetic analysis indicates that this virus jumped from forest animals to humans as recently as September 2023. Since then, Clade 1B has spread mostly within the DRC and to neighbouring countries in Africa. Outside of Africa, one travel-related case each has even been detected in Sweden and Thailand. The WHO issued the PHEIC early so that other nations could also prepare, monitor for cases, and send samples for sequencing to better understand how Clade 1B behaves outside of Africa,” said Dr Jayadevan.
He added that we have extensive knowledge of Clade 2 and its behaviour outside of Africa, thanks to a large body of research accumulated over the past two years. “For example, it is well-established that Clade 2 does not spread through the air. A recent study published by the CDC, which I referenced in a tweet, showed that over 1000 people who shared space with 113 Mpox patients on various flights did not contract the infection. Thus we can safety say that Clade 2, and its sub-lineage Clade 2B (the 2022 outbreak variant), is now well-understood,” he said.
But he pointed that what remains unclear, however, is how Clade 1B will behave outside of Africa. What we do know is that within Africa, Clade 1B is spreading more quickly and affecting men, women, and children alike.
“Remember that population of the Democratic Republic of Congo (DRC) has an average age of only 16, meaning half the country’s population is under 16 years old. This makes the demographic quite different from many other parts of the world,” said Dr Jayadevan.
Dr Jayadevan said that when we see reports indicating that many infected individuals are children, we must consider this in context. As for transmission, we know that mpox spreads through substantial physical or sexual contact. Whether respiratory droplets play a role is still uncertain, though it’s possible they could play a role during very close contact.
“However, it likely won’t spread from casual encounters, such as sharing a bus ride or classroom with an infected person. This remains an area of uncertainty, so we need to monitor it closely. The spread and severity of cases reported in central Africa could be influenced by the general health status of the population, the congested living conditions in some strife-ridden areas, and the availability of healthcare locally,” said Dr Jayadevan.
It is crucial to observe how this new strain behaves elsewhere, and early action is key. That is why the Indian government is being proactive by identifying suspected cases and determining exactly what they are dealing with.
He advised that to prevent further spread, the process is straightforward: first, diagnose and isolate the case, then track the patient’s contacts both backward and forward. This involves tracing where the person likely contracted the infection and mapping out any potential networks of exposure.
Afterward, identifying the individuals the patient may have come into contact with will help in effective contact tracing. With proper isolation and diligent contact tracing, we can halt the spread of the infection – even after clade 1b arrives in the future.
“The individual, a young male who recently traveled from a country experiencing ongoing Mpox transmission, is currently isolated at a designated tertiary care facility. The patient remains clinically stable without systemic illness or comorbidities,” the MoHFW stated on Monday.
The Ministry added that the case aligns with earlier risk assessments and is being managed according to established protocols. Public health measures, including contact tracing and monitoring, are actively in place to contain the situation. At this time, there is no indication of any widespread public health risk.
Even in the its advisory to states, MoHFW said that WHO highlighted that the clinical characteristics of cases have largely remained consistent. Most cases involve young males, with a median age of 34 years (ranging from 18 to 44). Globally, the most commonly reported mode of transmission is sexual contact, followed by non-sexual person-to-person contact. Among cases where at least one symptom is reported, rash is the most common, followed by fever.
(Edited by Ananya Rao)
(South First is now on WhatsApp and Telegram)
