A recent declaration by the World Health Organization (WHO) that the Mpox outbreak, originating from the Democratic Republic of the Congo, is now a Public Health Emergency of International Concern has set alarm bells ringing everwhere.
However, it’s crucial to recognize that Mpox is not another COVID-19 and both differ fundamentally in their nature, transmission, and the response required. COVID-19 is caused by the SARS-CoV-2 virus, a coronavirus known for its enveloped structure and single-stranded RNA genome. This family of viruses generally causes mild cold-like symptoms, but SARS-CoV-2, along with its counterparts SARS-CoV and MERS-CoV, is capable of causing severe respiratory illnesses. The notorious spike protein of SARS-CoV-2, which has been the focal point of mRNA vaccines, enables the virus to invade human cells.
In contrast, Mpox is caused by a poxvirus, which is structurally more complex, possessing a double-stranded DNA genome. Unlike coronaviruses, poxviruses have a larger number of proteins on their outer envelope, allowing them to infect multiple cell types. Though Mpox shares a family with now-eradicated smallpox, it is far less deadly, with no strain so far exhibiting the high fatality rates associated with smallpox.
The modes of transmission between Mpox and SARS-CoV-2 also differ significantly. Initially, COVID-19 was thought to spread primarily through contaminated surfaces and close contact, leading to widespread hygiene measures like handwashing and social distancing. However, it was later understood that the virus could also linger in the air, spreading over longer distances than initially anticipated, making ventilation and air filtration key in mitigation efforts.
Mpox, however, spreads primarily through direct contact with infected individuals or contaminated objects, including sexual contact. The virus can remain infectious on surfaces for some time, emphasizing the importance of thorough disinfection. Fortunately, as enveloped viruses, both Mpox and SARS-CoV-2 are susceptible to most hand sanitizers if soap and water are not available.
Furthermore, Mpox and COVID-19 present different challenges. COVID-19 can affect multiple organ systems, leading to a broad spectrum of symptoms and the risk of long-term COVID, where individuals experience lingering health issues even after mild infections. While researchers are still uncovering the full impact of SARS-CoV-2, the virus’s behavior inside the body continues to pose significant questions.
Mpox, on the other hand, has been studied for longer, providing a clearer understanding of its progression. The virus typically enters the body through the mouth, nose, or skin breaks, replicating at the inoculation site before spreading to the lymph nodes and other organs. The disease is characterized by an initial fever, headache, and muscle pain, followed by the appearance of a rash with lesions that can persist for weeks.
Treatment for both diseases focuses on symptom management, with antiviral medications and hospitalization necessary for severe cases. However, vaccines have been game-changers for both. COVID-19 vaccines, while not entirely preventing infection, have reduced the severity of the disease and the risk of death. Similarly, two approved vaccines for Mpox are being distributed, especially in the hardest-hit regions, to curb the outbreak.
Despite the alarming headlines, the situation with Mpox is different from COVID-19. We are not on the brink of another global lockdown. Dr. Hans Kluge, WHO’s Europe regional director, recently said at a press conference that we have the tools needed to stop the spread of Mpox, thanks to our experience with a similar outbreak in 2022.
“Two years ago, we controlled Mpox in Europe thanks to the direct engagement with the most affected communities of men who have sex with men,” Dr. Kluge said.
“Will we choose to put the systems in place to control and eliminate Mpox globally, or will we enter another cycle of panic, then neglect?”
