Two years ago, more than 100 countries reported outbreaks of the infectious disease Mpox, also known as monkeypox. The wave of infections in 2022, for which the clade IIb virus variant was responsible, was ultimately mild. But now a new Mpox variant is circulating in the Democratic Republic of Congo. “It is by far the most dangerous of the known Mpox variants,” said John Claude Udahemuka, a professor at the University of Rwanda. The World Health Organization (WHO) is concerned: The new clade Ib virus variant, which health experts say causes significantly more severe disease than previously known virus types, could also spread to Europe.
Here you will find answers to questions about Mpox viruses, their earlier distribution, transmissibility, the possibility of vaccination and the consequences of infection.
Where and how is the new Ib virus variant spreading?
It is not known how many infections of the type Ib virus have occurred so far. Only those who were seriously ill have gone to hospital, says Trudie Lang, professor of global health at the University of Oxford: “This is probably just the tip of the iceberg. It is possible that the incubation period is long, meaning people can infect others without knowing it.”
Current information on the development of the wave of infections in the Democratic Republic of the Congo WHO publishes on its website (external link), also global statistics on Mpox infections (external link).
How many Mpox virus infections are there in Germany?
After Information from the Robert Koch Institute (RKI) (external link) 3,800 cases of smallpox have been registered in Germany so far (as of June 26, 2024), mostly in 2022. Deaths were not among them. Less than one percent of the registered infections affected women, adolescents or children.
How can you get infected with the Mpox virus?
Transmission of the Mpox virus from person to person is possible mainly through close physical contact, for example through mucous membranes or open wounds, as well as through burst pustules or blisters associated with the disease. Skin-to-skin contact is according to RKI (external link) main route of transmission of Mpox viruses.
According to the institute, infection by respiratory droplets through so-called “face-to-face contact” is also theoretically possible. However, such transfers have not yet been proven beyond any doubt. writes the RKI on its website (external link). According to the RKI, in endemic areas the virus can also be transmitted via infected animals. As with human-to-human transmission, close contact with the animal, especially with bodily fluids, for example in the case of a bite, is a prerequisite.
What is the risk of Mpox virus infection in Germany?
The RKI classifies the risk of infection with the Mpox virus for the population as quite low. It writes on its website: “The RKI currently assesses a threat to the health of the general population in Germany as low. The RKI continues to monitor the situation closely and, if necessary, adapts its assessment to the current state of knowledge.” (As of: June 26, 2024)
In general, however, anyone who has many partners – regardless of whether they are heterosexual or homosexual – “is also at a correspondingly higher risk, especially if travel also plays a role,” said Christoph Spinner, infectious disease specialist at the Rechts der Isar. Clinic, in an interview with BR at the beginning of 2024.
What is the risk of infection in Europe?
WHO warns: “Experts are alarmed because [die neue Virusvariante] is spreading uncontrollably in the remote region. It could also reach Europe.” “But that would not be my biggest concern,” says WHO emergency relief coordinator Mike Ryan. Rich countries have shown in the 2022 outbreak that they have the resources to contain the spread.
“My biggest concern is that the disease is spreading in populations that live in high levels of poverty, have little access to medical care and may have trouble trusting authorities,” says Ryan.
Mpox: What is most dangerous with the new variant of the virus?
While the new variant initially spread through sex workers, it is now spreading from person to person regardless of contact, says John Claude Udahemuka, a professor at the University of Rwanda. At one school, for example, several children were infected while playing with an infected person. “We are very concerned about the outbreak,” says Rosamund Lewis, a WHO expert on Mpox, about the risk of infection with the new variant of the virus.
What are the symptoms of an Mpox infection?
Fever, chills, muscle aches, headache, fatigue or joint pain are symptoms that, according to the RKI, can occur around five to 21 days after an infection – but not necessarily. Typical of the disease are the blisters and pustules that usually appear on the face and later all over the body, which are highly infectious.
What symptoms occur with the new clade Ib virus type?
According to health experts in Congo, infections with the new clade Ib (Roman 1 b) variant are worse than with other variants. They cause more severe rashes all over the body and longer-lasting symptoms. Women have suffered miscarriages and the disease has been life-threatening for children.
What is the best way to protect yourself against the Mpox virus?
As with the coronavirus, the best protection against infection is vaccination. The Standing Vaccination Commission (STIKO) of the RKI recommends vaccination for three groups of people, namely:
1. People who have had close contact with a person suffering from monkeypox/Mpox
2. People who work in healthcare or laboratories and who have come into contact with the virus – either from patients or from material contaminated with the virus
3. In addition: all men over the age of 18 who have sex with men and change partners frequently
What vaccine is there and how and where is vaccination carried out?
The smallpox vaccine Imvanex has been approved for people aged 18 and over since 2013. In July 2022, the vaccine manufactured in Martinsried near Munich received an extension of the indication to protect against Mpox by the EU.
However: An agreement with the Free State of Bavaria, according to which the billing and reimbursement of the Mpox vaccination was previously carried out, ended at the end of December 31, 2023. Since no agreement has yet been reached with the health insurance companies on the reimbursement of the Mpox vaccination, the vaccination service for the Mpox vaccination is said to be billed privately from January 1, 2024 until further notice. on the website of the Bavarian Association of Statutory Health Insurance Physicians (external link). This also means that since the turn of the year, free vaccination has only been possible in the outpatient clinics of university hospitals because the Free State only delivers the vaccine to university hospitals.
Vaccinations are usually given twice, at least 28 days apart (one dose of 0.5 ml vaccine each). Even if the 28-day vaccination interval has been exceeded, the vaccination series does not need to be restarted. And: Anyone who has already been vaccinated against smallpox only needs one vaccination.
Why have Mpox outbreaks increased since 2022?
According to one in Study published in November 2023 (external link) The Mpox virus has been circulating in the human body for years. More precisely, since 2016. Biophysicist Richard Neher from the University of Basel, who is one of the lead authors of the study, explains why outbreaks only began to increase in May 2022. in an interview in early November 2023 (external link) with the increased travel activity of people after the restrictions of the corona pandemic.
What to do if you suspect an Mpox infection?
Anyone who believes they may be infected with the Mpox virus should avoid contact with other people and, if necessary, contact a GP or HIV clinic.
With material from dpa