Mpox in Democratic Republic of the Congo due to monkeypox virus clade I
On 14th August 2024, WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus, declared mpox a public health emergency of international concern. There has been a recent upsurge in the number of mpox cases identified in the Democratic Republic of the Congo and neighbouring countries.
There are two different types of the mpox virus – called clade I and clade II. The type of mpox that is causing concern in Africa is caused by clade I mpox. This is a different clade to the one that caused the global outbreak in 2022-2023, mainly affecting gay, bisexual and other men who have sex with men.
Ireland
No cases of clade Ia or Ib mpox have been detected in Ireland.
Cases of clade II mpox in Ireland remain low, with 11 cases reported so far in 2024. There were 13 cases of mpox confirmed in Ireland in 2023 and 227 cases in 2022.
European situation
An epidemiological update was published by the European Centre for Disease Prevention and Control (ECDC) on 17th September 2024. One case of clade Ib mpox has been reported in Sweden in a person who had travelled to a country in Africa where mpox is circulating. This is the first imported case of mpox due to MPXV clade Ib in EU/EEA countries and as of 5 September, no secondary cases have been detected. More imported mpox cases due to clade I mpox are likely to occur in the EU/EEA. The overall risk for the EU/EEA general population is currently assessed as low, though the risk for people who have close contact with a confirmed or suspected case from affected areas in Africa is moderate.
Ireland continues to work with the European Centre for Disease Prevention and Control (ECDC) and international partners and is preparing the healthcare system so that we can rapidly identify any potential imported cases and prevent secondary transmission.
About mpox
Mpox is an uncommon disease in Ireland that is caused by infection with monkeypox virus. The virus is found in some animal populations in remote parts of Central and West Africa, and in the past has caused occasional limited outbreaks in local communities and travellers. Since December 2022, a large outbreak of mpox has been ongoing in the Democratic Republic of the Congo, and in recent weeks, cases have been seen in neighbouring countries, Rwanda, Burundi, Kenya and Uganda.
Mpox spreads through close contact, including contact with the skin rash of someone with mpox. People who closely interact with someone who is infectious are at greater risk for infection: this includes sexual partners, household members, and health & care workers.
For symptoms and signs of mpox and advice on what to do if you think you have mpox, please see https://www2.hse.ie/conditions/mpox/
Vaccination
In response to the mpox cases in Ireland in 2022, HSE delivered a vaccine programme to risk groups. Over 11,000 doses of vaccine were delivered, with more than 5,000 people fully vaccinated, which was among the best performing mpox vaccine programmes in Europe. Given the effectiveness of that campaign in controlling infection, the programme had been paused pending a decision on a different approach to vaccination.
With the emergence of a new clade of mpox in Africa, Clade Ib, and the declaration of a Public Health Emergency of International Concern (PHEIC) by the WHO, HSE will consider the need for a new vaccine programme now. HSE will be advised by the National Immunisation Advisory Committee (NIAC). HSE will consider the need for any new vaccination programme and the particular groups potentially in scope for vaccination. Ireland has sufficient supplies of mpox vaccine through the EU HERA Joint Procurement Action to meet any potential needs over the next months.
Travel Advice
To protect yourself and others against mpox, know the signs and symptoms of mpox, how the virus spreads, what to do if you get sick, and the risk of mpox infection in the area that you are planning to travel to. Information on countries affected by mpox is available from the World Health Organization (WHO).
ECDC has assessed the risk for people travelling to or living in the countries affected by Clade I mpox.
- For those who have close contact with affected communities in countries affected by mpox, such as healthcare workers, those who are living in households or those who have multiple sexual contacts, the risk is moderate. The risk is high for those who have a weak immune system.
- For those who do not have close contact with the affected communities in countries affected by mpox, the risk is low.
Mpox needs close or intimate contact to spread, so casual (passing) contact like you might have during travel is not likely to cause infection. If the virus is spreading in the area that you are travelling to, have open conversations with those you come into close contact with about any symptoms they may have. Avoid close contact with anyone who has mpox, including sexual contact. Clean your hands frequently with soap and water or an alcohol-based hand rub.
People can protect themselves by:
- Avoiding close contact (including sexual contact) with people who are sick with signs and symptoms of mpox, including those with a rash (blisters or scabs)
- Avoiding contact with wild animals (alive or dead and including their meat and blood) in areas where mpox regularly occurs. Any food containing animal parts or meat should be cooked thoroughly before eating
- Avoiding contact with contaminated materials used by people who are sick (such as clothing, bedding, towels etc.) or that had been in contact with wild animals
- Wash hands often with soap and water or an alcohol-based hand sanitiser containing at least 70% alcohol.
If you think you might have mpox when you are abroad, seek medical advice as soon as possible, and isolate from others until you have been checked and tested. If you have mpox, you should isolate yourself from others until all your lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath.
When you return from travel
As symptoms of mpox may take time to develop, in the 21 days after your return, if you have any symptoms suggestive of mpox, self-isolate and phone your doctor promptly, telling them about your recent travel, so that you can be assessed.