Carpha urges people to be vigilant after WHO declares mpox a public health emergency

THE Caribbean Public Health Agency (Carpha) is urging member states to be vigilant, considering the World Health Organization (WHO), on August 14, declared mpox a public health emergency of international concern (PHEIC).

The declaration came after an upsurge of infections by the virus in the Democratic Republic of the Congo (DRC) and an increasing number of cases in other African nations.

A statement from Carpha on August 16 said it was the second PHEIC declaration related to mpox in two years and the highest level of global alert recognising the potential threat this virus poses to countries around the world.

“This current outbreak of mpox is caused by clade I, which is more transmissible and causes more severe illness. Clade II was responsible for an outbreak that WHO declared to be a global health emergency from July 2022 to May 2023,” the statement said.

“Presently, no cases of clade 1b mpox have been reported in the Caribbean and its neighbouring countries, including the US, UK, Canada and Latin America. There is also a limited number of travellers and no direct commercial flights from the DRC or its neighbouring countries to the Caribbean.”

Carpha interim executive director Dr Lisa Indar said the agency is monitoring the situation closely.

She was quoted in the statement saying: “The current risk to Caribbean population from mpox clade 1b is low to moderate, as no cases of mpox have been identified in the Carpha member states.”

“However, the identification of the first case of clade 1b outside of Africa, is a warning call for public health authorities to be vigilant and necessitates enhanced surveillance by all Caribbean countries.”

These include monitoring incoming passengers and, rapid/early identification of potential cases, and a well-co-ordinated regional and international response.

Mpox, formerly known as monkeypox, is a viral disease that can spread easily between people and from infected animals.

It can spread through direct contact with bodily fluids, such as during sex, and through contaminated materials like sheets and clothing used by an infected person.

Common symptoms are skin rash or mucosal lesions, which can last two to four weeks, accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.

Two mpox vaccines have been approved by the WHO-listed national regulatory authorities. The process for Emergency Use Listing has been started, which improves the capacity for vaccine distribution in low-resourced areas and countries.

Acting director of surveillance, disease control and prevention at Carpha, Dr Horace Cox, said mpox virus testing capacity had been established at the agency’s medical microbiology laboratory.

“Additionally, Carpha is collaborating with regional public health partners to respond to any surge in mpox cases in the region,” Cox said.

“We are liaising with Caricom Implementation Agency for Crime and Security (IMPACS) for Advanced Passenger information for people arriving from countries that have reported mpox.”

Carpha issued a watching brief on mpox and recommended enhanced vigilance, saying people should act quickly and transparently and report if any imported cases of mpox are identified.

Another measure is for people to enhance surveillance systems to identify imported cases presenting with fever and rash rapidly.

People should also enhance case investigation for mpox, including alerting port health officials to be vigilant for possible cases.

Carpha also suggested that people develop and disseminate public education materials on mpox as a re-emerging zoonosis.

Carpha also called on countries to promote awareness and preventative measures among clinicians, other frontline health workers and public health professionals to be alert to people presenting with rash without a clear alternative diagnosis.

Emphasis should be placed on those with a travel history from countries that have reported mpox, within two weeks preceding the onset of signs and symptoms.

Carpha said people should maintain basic hand hygiene – wash hands frequently with soap and water or an alcohol-based hand sanitiser to reduce exposure to and transmission of the virus.

People should stay informed about the risk of mpox and be on alert for any unusual rashes or lesions on the genitals or other parts of the body.

Carpha also said people should avoid close contact with people who are sick with signs and symptoms of mpox, including those with skin lesions or genital lesions.

The agency said people should avoid contact with wild animals (alive or dead) in areas where mpox regularly occurs.

People should also avoid contact with contaminated materials used by people who are sick (such as clothing, bedding or materials used in healthcare settings).

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