New emerging Monkeypox strain in Congo

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   https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html or https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html ;
Last week the CDC held a COCA Call : Mpox - Clinical Management & Outbreaks, as reports of sporadic infections (clade IIb) continue across the nation (see CBS News S.F. officials monitor rise in domestic mpox cases as global outbreak spreads)
At the same time a far more dangerous clade I mpox virus continues to rage in the DRC, which over the past 18 months has been blamed for more than 20,000 suspected mpox cases and more than 1,000 deaths.

The changing epidemiology and genetic evolution of mpox clade I in central Africa has sparked a number of risks assessments over the past six months, including:
CDC HAN Advisory #00501: Mpox Caused by H-2-H Transmission with Geographic Spread in the Democratic Republic of the Congo

ECDC Risk Assessment On Transmission & Spread of Clade I Mpox From The DRC
Last March a study was published Eurosurveillance: Ongoing Mpox Outbreak in South Kivu Province, DRC Associated With a Novel Clade I Sub-lineage, describing the first genomic analysis of samples from a previously unaffected region of the DRC (the city of Kamituga). 
That study revealed a novel clade I sub-linage had emerged - most likely from a zoonotic introduction - with changes that may render current CDC tests unreliable.
A month later, in Preprint: Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo, we saw a further analysis, which called for this new lineage to be named Clade Ib, and warned of its potential to spread globally.  
While that doesn't appear to have happened yet (based on limited reporting), we have been watching the incursion of Mpox into new regions, including a spike in cases recently reported in South Africa. 
As we've seen with COVID, and other infectious disease reporting around the globe, surveillance and reporting on Mpox is often limited, or sometimes missing entirely.  The WHO describes this situation below:
WHO continues to encourage all countries to ensure that mpox is a notifiable disease and to report mpox cases, including reporting when no cases have been detected (known as ‘zero-reporting’, as outlined in the Standing Recommendations on mpox issued by the WHO Director General).
This report does not highlight non-reporting countries. Therefore, it should be noted that an absence of reported cases from a country may be due to the country not reporting, rather than having no cases. Reporting to WHO has been declining, therefore, the decline in reported cases should be interpreted with caution.    
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Report highlights
In May 2024, a total of 646 new laboratory-confirmed cases of mpox and 15 deaths were reported to WHO from 26 countries, illustrating continuing transmission of mpox across the world. The most affected WHO regions, ordered by number of laboratory-confirmed cases, were the African Region, the European Region, the Region of the Americas, the Western Pacific Region and the South-East Asia Region. The Eastern Mediterranean region did not report any cases in May 2024.
As reporting from countries to WHO has been declining, the current reported global data most likely underestimate the actual number of mpox cases.
Within the African Region, the Democratic Republic of the Congo reported most (99%) of the confirmed mpox cases in the reporting month. With limited access to testing in rural areas, 18% of clinically compatible (reported as suspected) cases in the country are tested, therefore the confirmed case counts are underestimates of the true burden.
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Nearly every WHO DON or disease Situation Report contains diplomatic reminders to member nations of their `duty to report' these types of cases under the IHR 2005 agreement, but compliance remains spotty at best. 
Increasingly, the `political' solution to the rise of inconvenient emerging infectious diseases - like Mpox, COVID, MERS-CoV, and novel influenza - is to limit testing, surveillance, and the reporting of cases, and even deaths.  
Like asking your doctor to `touch up your X-rays', this is a strategy that only works for the short term. 

DJ...So-yes-lots of countries failing to even do the basics to avoid pandemics...(I am not going that crazy...)

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Dutch Josh Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Group Joined: 23 Jun 2024 Status: Offline Points: 554	Post Options Post Reply Quote Dutch Josh Report Post Thanks(0) Quote Reply Posted: 01 Jul 2024 at 6:57am
	https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html or https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html ; Last week the CDC held a COCA Call : Mpox - Clinical Management & Outbreaks, as reports of sporadic infections (clade IIb) continue across the nation (see CBS News S.F. officials monitor rise in domestic mpox cases as global outbreak spreads) At the same time a far more dangerous clade I mpox virus continues to rage in the DRC, which over the past 18 months has been blamed for more than 20,000 suspected mpox cases and more than 1,000 deaths. The changing epidemiology and genetic evolution of mpox clade I in central Africa has sparked a number of risks assessments over the past six months, including: CDC HAN Advisory #00501: Mpox Caused by H-2-H Transmission with Geographic Spread in the Democratic Republic of the Congo ECDC Risk Assessment On Transmission & Spread of Clade I Mpox From The DRC Last March a study was published Eurosurveillance: Ongoing Mpox Outbreak in South Kivu Province, DRC Associated With a Novel Clade I Sub-lineage, describing the first genomic analysis of samples from a previously unaffected region of the DRC (the city of Kamituga). That study revealed a novel clade I sub-linage had emerged - most likely from a zoonotic introduction - with changes that may *render current CDC tests unreliable.* A month later, in Preprint: Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo, we saw a further analysis, which called for this new lineage to be named Clade Ib, and warned of its potential to spread globally. While that doesn't appear to have happened yet (based on limited reporting), we have been watching the incursion of Mpox into new regions, including a spike in cases recently reported in South Africa. As we've seen with COVID, and other infectious disease reporting around the globe, surveillance and reporting on Mpox is often limited, or sometimes missing entirely. The WHO describes this situation below: WHO continues to encourage all countries to ensure that mpox is a notifiable disease and to report mpox cases, including reporting when no cases have been detected (known as ‘zero-reporting’, as outlined in the Standing Recommendations on mpox issued by the WHO Director General). This report does not highlight non-reporting countries. Therefore, it should be noted that an absence of reported cases from a country may be due to the country not reporting, rather than having no cases. Reporting to WHO has been declining, therefore, the decline in reported cases should be interpreted with caution. - Report highlights In May 2024, a total of 646 new laboratory-confirmed cases of mpox and 15 deaths were reported to WHO from 26 countries, illustrating continuing transmission of mpox across the world. The most affected WHO regions, ordered by number of laboratory-confirmed cases, were the African Region, the European Region, the Region of the Americas, the Western Pacific Region and the South-East Asia Region. The Eastern Mediterranean region did not report any cases in May 2024. As reporting from countries to WHO has been declining, the current reported global data most likely underestimate the actual number of mpox cases. Within the African Region, the Democratic Republic of the Congo reported most (99%) of the confirmed mpox cases in the reporting month. With limited access to testing in rural areas, 18% of clinically compatible (reported as suspected) cases in the country are tested, therefore the confirmed case counts are underestimates of the true burden. - Nearly every WHO DON or disease Situation Report contains diplomatic reminders to member nations of their *`duty to report'* these types of cases under the IHR 2005 agreement, but compliance remains spotty at best. Increasingly, the `political' solution to the rise of inconvenient emerging infectious diseases - like Mpox, COVID, MERS-CoV, and novel influenza - is to limit testing, surveillance, and the reporting of cases, and even deaths. Like asking your doctor to `touch up your X-rays', this is a strategy that only works for the short term. DJ...So-yes-lots of countries failing to even do the basics to avoid pandemics...(I am not going that crazy...)

Dutch Josh Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Group Joined: 23 Jun 2024 Status: Offline Points: 554	Post Options Post Reply Quote Dutch Josh Report Post Thanks(0) Quote Reply Posted: 03 Jul 2024 at 1:59am
	https://afludiary.blogspot.com/2024/07/biomedicines-re-emergence-of-mpox-old.html or https://afludiary.blogspot.com/2024/07/biomedicines-re-emergence-of-mpox-old.html ; While much of the world expressed surprise when a clade IIb Mpox (then called Monkeypox) virus began its world tour in the spring of 2022, experts had been warning for years it was not only possible, but increasingly likely. Cautionary reports published between 2020 and early 2022 include: PLoS NTD: The Changing Epidemiology of Human Monkeypox—A potential threat? EID Journal: Reemergence of Human Monkeypox and Declining Population Immunity - Nigeria, 2017–2020 WHO: Modelling Human-to-Human Transmission of Monkeypox While largely ignored, 2 distinct clades of Mpox (I & II) had been spreading across central Africa for decades, mostly in a handful of endemic countries (clade I primarily in the DRC & CAR), with a weaker clade II virus re-emerging in Nigeria after an absence of 40 years in 2017. DJ...no "lab-leak-non-sense" needed ! Very UNwelcome anti-science ! Luckily, it has been the far less-dangerous Clade IIb that has been spreading internationally for the past 2 years. Deaths have only rarely (< 2%) been reported. But we've seen recent increases in the spread of the more pathogenic clade I virus in the DRC, including the emergence of a new, and apparently more transmissible, clade Ib virus (see Eurosurveillance: Ongoing Mpox Outbreak in South Kivu Province, DRC Associated With a Novel Clade I Sub-lineage). While the future course and impact of Mpox is unknowable, there are growing concerns that clade Ib might follow in the footsteps of clade IIb - or worse - clade I could evolve into an even more formidable virus before breaking out of Central Africa. The Mpox virus (MPXV) is known to cause zoonotic disease in humans. The virus belongs to the genus Orthopoxvirus, of the family Poxviridae, and was first reported in monkeys in 1959 in Denmark and in humans in 1970 in the Congo. MPXV first appeared in the U.S. in 2003, re-emerged in 2017, and spread globally within a few years. Wild African rodents are thought to be the reservoir of MPXV. The exotic trade of animals and international travel can contribute to the spread of the Mpox virus. A phylogenetic analysis of MPXV revealed two distinct clades (Central African clade and West African clade). The smallpox vaccine shows cross-protection against MPXV infections in humans. Those who have not previously been exposed to Orthopoxvirus infections are more vulnerable to MPXV infections. Clinical manifestations in humans include fever, muscle pain, headache, and vesicle formation on the skin of infected individuals. Pathognomonic lesions include ballooning degenerations with Guarnieri-like inclusions in vesicular epithelial cells. Alterations in viral genome through genetic mutations might favor the re-emergence of a version of MPXV with enhanced virulence. As of November 2023, 92,783 cases and 171 deaths have been reported in 116 countries, representing a global public health concern. Here, we provide insights on the re-emergence of MPXV in humans. This review covers the origin, emergence, re-emergence, transmission, pathology, diagnosis, control measures, and immunomodulation of the virus, as well as clinical manifestations. Concerted efforts of health professionals and scientists are needed to prevent the disease and stop its transmission in vulnerable populations. DJ, Time to restart a sort of (M)pox vaccination ? But another aspect is travel...diseases travel for free ! Testing has its limits...for climate reasons less travel also would be welcome...