22 Aug WHO Issues Global Alert: Monkeypox Declared a Public Health Emergency of International Concern (PHEIC)
This article covers “Daily Current Affairs” and topic details of Monkeypox.
Syllabus mapping:
GS- 3: Science and Technology: Diseases and related issues.
GS-2: Governance: health and related issues.
For Prelims:
What is the MPox virus and its mode of transmission? What is a public health emergency of international importance? What is the difference between, epidemic, pandemic, and health eminency?
For Mains:
What are the causes of the Mpox and what various measures are taken to control it? What is an action taken by the government of India to control the spread of the Mpox?
Why in the News?
On August 14, the World Health Organization (WHO) once again designated Mpox as a Public Health Emergency of International Concern. This decision was made in response to the virus’s significant prevalence and widespread transmission across numerous regions in Africa. The WHO’s updated data reveals that, since the onset of the outbreak in 2022, Mpox has affected over 99,000 individuals and resulted in 208 fatalities across 116 countries worldwide. This global spread and the impact on public health prompted the WHO to elevate the alert status to better coordinate and intensify international efforts in managing and containing the disease.
What is the MPOX?
Mpox, previously known as monkeypox, is an infectious disease caused by the monkeypox virus (MPXV), an enveloped double-stranded DNA virus in the Orthopoxvirus genus. It can present with a range of symptoms including a painful rash, swollen lymph nodes, and fever. While most individuals recover fully, some can experience severe illness.
Historical Outbreaks and Patterns
1970s: Following the first human case in 1970, monkeypox has exhibited several distinct patterns of outbreaks. Initially, sporadic cases were reported in Central and East Africa, attributed to clade I, while West Africa experienced similar sporadic cases linked to clade II.
2003: In 2003, an outbreak in the United States was traced to imported wild animals from Africa, specifically clade II.
2005-2021: From 2005 to 2021, the Democratic Republic of the Congo (DRC) reported thousands of suspected cases each year, predominantly involving clade II. In 2017, monkeypox re-emerged in Nigeria, continuing to spread within the country and to travelers, also linked to clade II.
2022-2023: The global outbreak of 2022–2023 marked a significant expansion of cases, and a subsequent outbreak in the Republic of Sudan in 2022 further highlighted the virus’s spread.
2024: In 2024, the situation escalated to a public health emergency, underscoring the ongoing challenges in managing and controlling the disease.
Virology of Monkeypox Virus (hMPXV)
Virus Classification:
Family:Poxviridae
Genus: Orthopoxvirus
Species: Monkeypox virus (hMPXV)
Related Viruses: Smallpox (Variola), Vaccinia, Cowpox
Virus Characteristics:
Type: Linear double-stranded DNA virus
Size: 200 to 250 nm in diameter
Shape: Brick-shaped
Envelope: Enveloped with a lipid bilayer
Mechanism of Entry:
Binding: hMPXV attaches to host cells through glycosaminoglycans found on the cell surface.
Entry Mechanism: As an enveloped virus, hMPXV may employ classical apoptotic mimicry, where the virus mimics the signals of dying cells to facilitate entry into host cells.
Clades:
Etymology: The term “clade,” derived from the Greek word “klados” meaning branch, describes a group of organisms originating from a common ancestor and including all its direct descendants.
In Virology: A clade represents a group of viruses that have evolved from a common ancestral virus through genetic variations.
Clades of Mpox Virus:
Clade I:
Geographical Distribution: Predominantly found in Central Africa.
Severity: Linked to more severe disease and higher mortality rates.
Clade II:
Geographical Distribution: Common in Western Africa.
Severity: Typically associated with milder symptoms compared to Clade I.
Recent Developments:
Clade 1b: Identified in September of the previous year, this clade has been responsible for the current severe outbreak, raising concerns due to its increased severity compared to other
Modes of Transmission
Person-to-Person:
Direct Contact: Involves touching infectious skin lesions or mucosal surfaces, such as through kissing or sexual contact.
Respiratory Droplets: Spread through prolonged close contact or face-to-face interactions.
Animal-to-Human:
Bites or Scratches: From animals infected with the virus.
Handling Animals: Activities like hunting or preparing food from infected animals.
Contaminated Objects:
Clothing, Linens, or Needles: Transmission can occur through contact with contaminated materials.
Symptoms
Initial Symptoms: Include fever, muscle aches, sore throat, headache, back pain, fatigue, and swollen lymph nodes.
Rash: Starts as flat sores, progresses to blisters filled with fluid, and then forms crusts. The rash typically begins on the face and may spread to other areas of the body, including palms and soles.
Complications: Can involve secondary bacterial infections, pneumonia, vision issues, severe dehydration, sepsis, encephalitis, and potentially death.People with compromised immune systems face a higher risk
Diagnosis
PCR Testing: The primary method for detecting mpox, involving the analysis of skin lesion samples. Blood tests are generally not recommended for diagnosis.
Differential Diagnosis: Important to differentiate mpox from other similar conditions, such as chickenpox, measles, and sexually transmitted infections.
Treatment and Vaccination
Supportive Care: Aims to alleviate symptoms and prevent complications.
Vaccination: Recommended for individuals at high risk, particularly during outbreaks.The vaccine provides optimal protection when given within 4 days of exposure, though it can still be administered up to 14 days afterward.
Antiviral Medications: Drugs like Tecovirimat are used, with ongoing research into their effectiveness.
Prevention Measures
Avoid Contact: Limit physical contact with infected individuals, animals, or contaminated items.
Vaccination: Get vaccinated if you are at high risk or during an outbreak.
Isolation: Infected individuals should isolate themselves until all lesions have healed and new skin has formed.
Monkeypox Preparedness and Measures in India
Actions Taken by the Union Ministry of Health & Family Welfare
Preparedness Measures:
Health Units: Efforts are underway to enhance the awareness and preparedness of health units stationed at airports, seaports, and ground crossings. This includes training personnel to recognize and respond to potential cases of Monkeypox effectively.
Testing Facilities: The country is proactively preparing 32 specialized testing laboratories to facilitate prompt and accurate diagnosis of Monkeypox cases. These labs are being equipped and staffed to handle potential outbreaks efficiently.
Health Facilities: Measures are being taken to ensure that health facilities across the nation are well-equipped to detect, isolate, and manage any suspected cases of Monkeypox. This includes upgrading infrastructure and resources to support effective patient care.
Current Situation and Risk Assessment:
Disease Characteristics: Monkeypox generally follows a self-limiting course, with symptoms typically lasting between 2 to 4 weeks. Transmission of the virus usually requires prolonged close contact, such as through sexual contact, direct interaction with bodily fluids or lesions, or contact with contaminated clothing.
Indian Data: The situation is being closely monitored to manage and mitigate any further spread.
Ongoing Monitoring and Response:
Ongoing Surveillance: The Ministry of Health is diligently overseeing the Monkeypox situation, maintaining vigilant surveillance to detect any new cases and ensure that appropriate measures are taken if the situation evolves.
Public Communication: The Ministry is committed to providing continuous updates and advisories to keep the public informed and prepared. Regular communication will help in maintaining awareness and ensuring that preventive measures are followed effectively.
The World Health Organization (WHO)
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health.
Headquarters: Geneva, Switzerland
Establishment: April 7, 1948
Member Countries: 194.
Composition and Structure: The WHO is composed of the World Health Assembly (WHA), the Executive Board, and the Secretariat. The WHA is the decision-making body, consisting of representatives from member countries. The Executive Board implements the decisions and policies of the WHA, while the Secretariat, led by the Director-General, manages day-to-day operations.
Classification of health Emergencies by WHO:
Public Health Emergency: A public health emergency is defined as “an occurrence or imminent threat of an illness or health condition, caused by bioterrorism, epidemic or pandemic disease, or an infectious agent or biological toxin, that poses a substantial risk to humans by either causing a significant number of human fatalities or permanent or long-term disability.” This definition also encompasses serious threats such as influenza (“the flu”) that can lead to widespread health impacts.
Outbreak: An outbreak is defined as a situation where the number of cases of a disease surpasses what is normally anticipated for a specific time and place. This threshold is determined based on historical data and the typical incidence rates of the disease within a given area. Essentially, an outbreak occurs when the frequency of cases significantly exceeds the baseline level or expected rate. This excess indicates an unusual increase in disease occurrence that warrants investigation and public health response. Example currently Dengue in Iran.
Epidemic: An epidemic is defined by the World Health Organization (WHO) as a situation where cases of an illness, specific health-related behavior, or other health-related events occur in a community or region at a level significantly higher than what is normally expected. The term “epidemic” indicates a marked increase in cases beyond typical expectations, highlighting an unusual surge in disease or health-related events. An epidemic can affect a specific community, region, or even a broader area, depending on its scale. For example Cholera, Rift Valley fever.
Pandemic: A pandemic is defined as “an epidemic occurring worldwide or over a very wide area, crossing international boundaries and usually affecting a large number of people.” Pandemics are characterized by their extensive reach and high number of cases, affecting a substantial portion of the global population and leading to widespread health consequences. COVID-19 is the best example of a recent pandemic.
PRELIMS QUESTION:
Q.With reference to the Money Pox (Mpox) virus, Consider the following statement:
1. The Mpox virus is a single-stranded RNA virus
2. The Mpox virus is declared a global pandemic by the WHO
3. The animal to human transmission is common in the Mpox virus.
How many of the above-given statements are correct?
A. Only one
B. Only two
C. All three
D. None
ANSWER: A
MAINS QUESTION:
Frequent health emergencies require prompt action from the WHO. However, the organization faces numerous challenges. What strategies could be implemented to make the WHO more effective in handling such emergencies?
(250 words 15 marks)
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