No cases in Jamaica this year, but Mpox is a concern: Here’s an update

As we are probably all aware by now, the World Health Organization (WHO) on August 14, 2024 declared Mpox (formerly called Monkeypox) a Public Health Emergency of International Concern. At the same time, the WHO’s European Director has insisted that it is manageable and is “not the new COVID,” while expressing major concern over its spread in Africa (in particular, the Democratic Republic of Congo, where they have had over 1,000 new cases in the past week).

Mpox is present now in all regions of the globe, and in 122 countries – 115 of which have no previous history of the disease. To date, there are a total of 99,518 confirmed cases – most of them in places where it has not been before.

This morning, the Ministry of Health and Wellness gave a virtual press briefing, which shed some light on what this means for Jamaica. In the past few years, we have had some cases: 18 confirmed cases in 2022 (18 males and three females), three in 2023, and none so far this year. The Ministry is currently in surveillance mode. It is closely monitoring ports of entry and health facilities. So, if you arrive at the airport, you may have someone asking you where you are traveling from, if you have any symptoms that might be Mpox-related. Health officials will also give travellers information and contact cards, just in case.

This sounds rather technical, but in a country where a disease is not endemic (i.e. it is not generally around all the time) even one case of that disease represents an outbreak. So, it is a “Class 1 Notifiable Disease,” meaning that health professionals must report any suspected Mpox cases to the Parish Health Department, even if they might be considering other potential diagnoses.

Meanwhile, what is Mpox and why are we concerned about it now? Well, it is a zoonotic viral disease (in other words, it originates from animals). There are two distinct clades (a clade is a group of organisms that come from one origin or ancestor): Clade I is the Central African one, which is prevalent in the Congo Basin. It is more severe and has a fatality rate of 10 percent. Clade II (note the Roman numerals!) is in West Africa with a much lower death rate of 1 percent. There is a Clade IIa and IIb also.

The concern is regarding the Clade Ib version of the virus, which emerged in 2023. Cases of this variant have emerged in Sweden and Pakistan. Not so much is known about it, and thus as Chief Medical Officer (CMO) Dr. Jacquiline Bisasor McKenzie stressed, “everybody should be concerned” about this new clade. Is this variant more transmissible than earlier ones? It doesn’t seem quite clear yet. In any case, the CMO said, “everybody is at risk.”

How is the disease transmitted? Although its original name referred to monkeys, it is still not clear exactly where the virus resides; there are suggestions that it might be in rats (Gambian Giant Rats, specifically) or squirrels. It moves from animal to human when a person comes into contact with an infected animal, or eats contaminated bushmeat (that is, the meat of wild animals which is consumed in some regions).

Between humans, Mpox can be transmitted by direct contact with the skin lesions, scabs and body fluids, and also by contact with clothing or bed linen used by the infected person. This would include sexual contact. However please note it is also transmissible via droplets – coughing and sneezing. For pregnant women, it can be transmitted via the placenta or during close contact during and after birth.The virus can enter your body through broken skin (even if it’s not visible), the respiratory tract, or the mucous membranes in your eyes, nose, and mouth.

There is a concern over children, as those under 15 years of age appear more susceptible, globally; as well as people living with more advanced HIV, who are immunocompromised (in other words, their body’s defences are weaker).

So, what are the symptoms? The incubation period is from 1 – 21 days and the disease is usually “mild to moderate,” the Ministry reports. Symptoms are fever, aching muscles, intense headache, swollen lymph nodes, back pain, lack of energy, sore throat – and most significantly, a rash which appears up to three days after the fever begins. It starts on the face and then spreads elsewhere (palms of the hands and soles of the feet, for example). The illness is usually “self-limiting” (that is, it goes away by itself) – after two to four weeks. For those with a weakened immune system, it can last longer. The illness may become severe in the more vulnerable: pregnant women, children and immunocompromised people.

It’s important to remember though that a person remains contagious until all the scabs have fallen off the skin and the skin is intact underneath. So, it is not going to go away that quickly.

So, what to do? The Ministry of Health and Wellness recommends wearing masks, physical distancing (avoiding crowded places), frequent hand sanitisation and washing of hands, and safe sexual practices. If you have had close contact with travellers in the past three weeks, or if you have just returned from travel and have fever and/or a rash, contact your doctor.

Although it might not be “another COVID” (one hopes and prays it will not be) I for one will be following the COVID routine, which became almost automatic for us during that terrible era. The irony is we came back from travel in May/June with COVID! In this fast-paced world, where everyone is traveling to and from here, there and everywhere, there is no doubt that these frightening diseases will continue to spread rapidly.

So, take care, take precautions, and be safe!