Utah Measles Outbreak: Cases Slowing, but Vigilance Remains
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African Outbreak Intensifies: Mpox cases reported in Africa during the first three months of 2025 are nearing half the total reported for all of 2024, according to the Africa CDC.
Hotspots & Challenges: The Democratic Republic of the Congo (DRC), Uganda, and Burundi accounted for 95% of recent confirmed cases. However, the true scale in the DRC is uncertain due to low testing capabilities hampered by conflict and foreign aid cuts.
Clade I Spreading: The ongoing outbreak in Central and Eastern Africa involves clade I mpox, historically associated with more severe illness compared to the clade II strain responsible for the 2022 global outbreak.
Travel Advisory: The U.S. CDC has reissued a Level 2 Travel Health Advisory for Burundi, Central African Republic, DRC, Kenya, Republic of the Congo, Rwanda, Tanzania, Uganda, and Zambia due to person-to-person transmission of clade I mpox.
Treatment Study Results: An international NIH study (STOMP) found that the antiviral tecovirimat (TPOXX), when used alone, did not significantly shorten the duration of clade II mpox lesions or improve pain control compared to a placebo.
Why this matters: The rise of the more dangerous clade I mpox in Africa, coupled with international travel, presents a significant public health risk. Understanding the limitations of current treatments and addressing funding challenges for response efforts in affected regions are critical.
The mpox situation in Africa is becoming increasingly concerning. Africa CDC Director Dr. Jean Kaseya highlighted that case numbers in early 2025 are rapidly approaching 50% of the 2024 total. While Uganda and Burundi report significant numbers, the situation in the DRC is particularly worrisome due to conflict in eastern provinces and funding cuts impacting sample collection, transport, and testing (only 18.4% coverage). Ghana also reported a new clade 2 case in a patient with no travel history, underscoring the need for robust surveillance everywhere.
Compounding these challenges, the Africa CDC faces a potential 70% drop in official development assistance between 2021 and 2025. They've released a concept paper proposing new health financing strategies, including domestic funding increases, innovative tools like airline levies, and blended financing for local medical countermeasure manufacturing.
Globally, the risk is amplified by the spread of clade I mpox. The U.S. CDC's updated Level 2 advisory urges caution for travelers to nine Central and Eastern African nations. The advisory specifically recommends the JYNNEOS vaccine for individuals anticipating potential sexual exposure risks during travel to these areas. Vaccination involves two doses administered at least 28 days apart, ideally completed before travel.
On the treatment front, the STOMP trial provided valuable data on tecovirimat for clade II mpox. While the drug is used under an Expanded Access protocol, the randomized controlled trial showed it offered no significant benefit over placebo in terms of time to lesion resolution or pain reduction when used as a standalone therapy. This highlights the need for continued research into optimal treatment strategies, potentially involving combination therapies.
Q: What is Mpox?
A: Mpox (formerly Monkeypox) is a viral illness typically characterized by fever, headache, muscle aches, swollen lymph nodes, and a distinctive rash with lesions.
Q: What's the difference between clade I and clade II Mpox?
A: There are two main types (clades). Clade I, predominantly found in Central Africa, has historically been linked to more severe disease and higher mortality rates than clade II, which caused the global outbreak starting in 2022.
Q: Is there a vaccine for Mpox?
A: Yes, the JYNNEOS vaccine is approved for Mpox prevention and is recommended by the CDC for people at higher risk, including certain travelers to regions with ongoing clade I outbreaks.
Q: How effective is the antiviral drug tecovirimat (TPOXX)?
A: A recent large international study (STOMP) indicated that tecovirimat, when used as the sole treatment for clade II Mpox, did not significantly speed up recovery from lesions or reduce pain compared to a placebo. Its role in combination with other treatments requires further study.
Be aware that Mpox continues to be a global health issue, with a concerning rise in the more severe clade I strain in Africa.
If traveling to affected African countries, check current CDC advisories and discuss vaccination with your doctor.
Understand that while treatments exist, recent studies show limitations for some antivirals when used alone against certain strains.
Follow reliable health organizations for updates and practice recommended prevention measures.
How concerned are you about the spread of clade I Mpox? Let us know your thoughts in the comments!
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CIDRAP: Mpox activity in Africa on pace to pass 2024 total target="_blank"
Vax-Before-Travel: Mpox Travel Advisory Reissued in April 2025 target="_blank"
Windy City Times: NATIONAL mpox drug, Ritchie Torres, Amber Ruffin, NBJC on TDOV target="_blank" (Relevant section on NIH study)
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