Britain has announced the first case of a new deadly strain of mpox which has ripped through several African countries, as MailOnline reveals all the countries where the virus has now spread.
The unnamed patient was on holiday in an African country currently experiencing an outbreak earlier this month.
They started suffering flu like symptoms on October 21 then developed a rash three days later.
Seeking medical advice, the case was flagged with The UK Health Security Agency (UKHSA) as potentially being the new mpox strain of concern, dubbed ‘clade 1b’.
Laboratory testing confirmed the patient has the disease and they are being treated by specialist staff at the Royal Free Hospital in London.
No further details on the patient’s condition have been revealed.
UKHSA said they are tracing ‘less than 10’ people who are believed to have been in close contact with the patient during the potential period he was infectious.
Officials currently do not suspect the patient was infectious on the flight back from the as yet unnamed African country where they contracted the disease from.
A map showing the African countries where the Clade I strain has been confirmed
This graphic shows the number of confirmed cases in England since January 2023
It is currently unknown how the patient got the new strain of mpox, which can kill about one in 20 adults, though skin-to-skin contact is suspected.
Officials say they still consider the threat clade 1b poses to the public as ‘low’.
In July, the World Health Organization (WHO) declared an ongoing mpox outbreak across several central African nations as a ‘public health emergency of international concern’.
This is the same designation the WHO gave Covid in late January 2020, just a few weeks before the virus ripped across the world, and some scientists have compared the current outbreak to the ‘early days of HIV’.
So what exactly is the new strain — and how worried should you be?
Clade 1b has swept through central Africa killing at least 1,000 people, since the outbreak began.
Countries like the Democratic Republic of Congo have been hit especially hard with cases also spotted in Burundi, Rwanda, Uganda, Kenya.
Britain’s case now means it joins countries such as Sweden, Thailand, India and Germany in having cases outside of Africa.
Officials say they still consider the threat clade 1b poses to the public in Britain as ‘low’
Clade 1b is considered far deadlier than the clade 2 strain which spread globally in 2022 and primarily hit gay and bisexual men.
The strain is estimated to kill about 5 per cent of adults who contract it, but the mortality rate rises to one in 10 in children.
Infections have also been linked to an alarming rise in miscarriages among pregnant women.
In comparison, Clade 2 only killed roughly about one in every 500 people that caught it.
However, experts say fatality rates of clade 1b from central Africa are unlikely to be replicated in developed nations like the UK due to better access to higher quality healthcare.
Urgent guidance issued to British health workers will remind them clade I mpox is a pathogen of the highest possible concern to public health and all suspected cases need to be alerted through official channels.
Mpox, also known as monkeypox, spreads between people through skin-to-skin contact.
This can be through sex, or by a simple touch like when caring for children, though it can also spread by secondary contact like sharing towels or bed linen for example.
It causes characteristic lumpy lesions, as well as a fever, aches and pains and fatigue.
However, in a small number of cases, it can enter the blood and lungs, as well as other parts of the body, when it becomes life-threatening.
The infection is mainly passed through close person-to-person contact with someone who is infected or through contact with contaminated materials such as bed sheets.
Anyone with symptoms should continue to avoid contact with other people while symptoms persist.
It can also cause fever, headaches, muscle aches, back pain, low energy and swollen lymph nodes.
UKHSA also said they are securing more supplies of mpox vaccines as part of further roll out of the jab.
Current mpox vaccines, which are designed to work on smallpox a close relative of the mpox virus, were used during the 2022 outbreak against the milder strain.
But they have yet to be widely tested against the more potent clade 1b strain.
Diseases like clade 1b mpox are treated at what are called ‘high consequence infectious diseases’ units in the NHS, like that at The Royal Free.
The Royal Free famously treated Ebola patients in this unit in 2015.
Dr Brian Ferguson, an expert in immunology at the University of Cambridge, said the mpox situation is concerning in part because of how many children it was infecting.
’40 per cent of cases are in children under 5 years old. As mpox disease is more severe in immunocompromised individuals, it is also a concern that the current outbreak is taking place in a region where HIV prevalence is relatively high but access to antiretroviral drugs is poor,’ he said.
‘There is further concern about the lack of access to vaccines and a globally slow response to vaccine production and distribution.
‘Even though there are existing effective vaccines, there are not enough doses and they are not being getting to where they are needed.
Vials of single doses of the Jynneos vaccine for mpox are seen from a cooler at a vaccinations site in Brooklyn, New York on August 29, 2022 as the disease swept through the United States
‘The WHO is attempting to address these issues, but this requires greater international effort to produce and deliver vaccines.’
Sanjaya Senanayake, an expert in infectious diseases and at The Australian National University said it would be a mistake to consider the outbreak an Africa only issue.
‘Although the epicentre for this new outbreak is the DRC, it has spread to a number of East African nations, highlighting its pandemic potential with so many large airports in the region,’ he said.
But he added there was hope that mpox vaccines can turn things around.
‘Two doses of a vaccine are very effective in preventing the infection, although this usually applies to adults rather than children, in which most of the cases have been; therefore, hopefully, the announcement by the WHO of this being a public health emergency of international concern will galvanise global resources to contain the outbreak within Africa, and ultimately terminate it.’
Dr Meera Chand, deputy director at the UK health Security Agency, said the current threat to the UK by the new mpox strain is ‘currently considered low’.
But she added: ‘However, planning is underway to prepare for any cases that we might see in the UK.
‘This includes ensuring that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission.’
WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement in July: ‘The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying.
‘On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.’
The WHO and the NHS recommends a vaccine within four days of contact with someone who has the virus or within up to 14 days if there are no symptoms.
Healthcare workers and men who have sex with men are advised to receive a vaccine even if they have had no mpox exposure.
There are no direct treatments available with medics focused instead on supporting a patient to help their body fight off the virus.
