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India must focus on genomic surveillance of Mpox virus to curb spread

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New Delhi, Aug 19 (IANS) India must focus on genomic surveillance to understand the Mpox virus, and develop ways to curb its spread, said experts on Monday.

The deadly Mpox virus is seeing another outbreak, especially in Africa, where so far about 14 countries have been, with 4 nations reporting the infection for the first time. The number of cases reported so far this year has exceeded last year’s total, with more than 15,600 cases and 537 deaths.

This prompted the Africa CDC and the World Health Organization (WHO) to declare the disease as a global health emergency.

In 2022 Mpox had a global outbreak with many countries, including India, being affected. Since then, the WHO has reported 99,176 cases and 208 deaths due to Mpox from 116 countries. India detected a total of 30 cases, with the last case in March 2024.

“We need to focus on genomic surveillance of the virus to understand the genetic epidemiology, the spread, and the evolution of the virus,” noted biologist Vinod Scaria told IANS.

He also called for developing “good diagnostics for faster diagnosis and better care of affected individuals”.

Mpox was first identified in monkeys in research laboratories in the 1950s, and it was not until 1970 that the first human case was discovered.

It has been mostly localised and endemic in the Congo Basin, as well as in West Africa. There have been two types, clade one, which is mostly in the Congo region, and clade two, which is seen primarily in West Africa.

Dr Anurag Agarwal, Dean, BioSciences and Health Research, Trivedi School of Biosciences, Ashoka University, told IANS that the 2022 outbreak was driven by clade 2, which is a less virulent, and the infections were primarily seen in men who had sex with other men.

“The current outbreak that we are seeing in Africa is clade Ib. Clade Ib has a higher mortality and more severe disease than Clade II. And also, while clade one typically does not have human-to-human transmission, here we are seeing infection and deaths in a large number of children, which is making people worry,” he added.

The latest outbreak of monkeypox has not only “played beyond the borders” but also reported “deaths in young children, where you don’t expect any sexual transmission”.

“That is the reason why the WHO has given a global warning for international concern”.

So far, outside of Africa, the infection, driven by the Clade 1b strain of the monkeypox virus, has been detected only in Sweden. Separately, Pakistan (3) and the Philippines (1) have reported lab-confirmed cases of Mpox. However, the variant remains unknown. The US’s California has also reported detecting Mpox in wastewater surveillance.

“The fear is that this virus could evolve. The fear is that this virus could develop respiratory transmission and become deadly. The best way to prevent that is to reduce the number of infections, to keep it within the geography it currently is, and slowly wipe it out,” Dr. Agarwal said, noting the need to build more diagnostics, vaccines, and genomic surveillance as during the Covid-19 pandemic.

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