Mpox Public Health Emergency: Essential Information for Travelers

The WHO declared the PHEIC following advice from the International Health Regulations (IHR) Emergency Committee. The African region has seen an unprecedented increase in mpox cases since early 2024, with previously unaffected countries like Burundi, Cote d’Ivoire, Kenya, Rwanda, and Uganda reporting cases.

Over 17,500 cases and 517 deaths have been reported from Jan. 1 to July 31, a 160% increase compared to the same period in 2023. The Democratic Republic of the Congo (DRC) is the most affected, with over 16,000 cases.

The upsurge in the DRC is driven by two separate outbreaks of different virus strains. Northwestern DRC is experiencing an outbreak of clade 1a, primarily affecting children. Meanwhile, northeastern DRC is dealing with a novel clade 1b (first detected in the DRC in September 2023), spreading rapidly through sexual transmission. Clade 1b has also been reported in Burundi, Kenya, Rwanda, and Uganda. Cases of clade 1a have also been reported this year in the Central African Republic and the Republic of Congo.  Clade 2 has been reported in Cameroon, Côte d’Ivoire, Liberia, Nigeria, and South Africa. Clade 1a and 1b cause more severe disease than clade 2, which spread globally in 2022.

Mpox has also been reported outside of Africa, including in the Americas, European, Western Pacific, and South-East Asia Regions, indicating ongoing global transmission. The strain circulating outside of Africa primarily involves clade 2, the clade responsible for the global outbreak in 2022. On Aug. 15, Sweden was the first country to report a case of clade 1b outside of Africa. The case sought medical attention in Stockholm but was infected during a stay in a part of Africa reporting clade 1 transmission.

The rapid spread of mpox beyond non-endemic countries necessitated an urgent, coordinated response to prevent further disease transmission. Many East African and Central African countries lack the resources to monitor and detect mpox outbreaks early, leading to delayed responses and wider spread. The WHO’s declaration aims to prompt a coordinated international response, improve surveillance, accelerate vaccine distribution, enhance public health measures, and mobilize resources to control the outbreak. The declaration aims not only to protect African populations but also to prevent the global spread of Mpox by containing the outbreak before it becomes a global health crisis.

The WHO advises affected countries to strengthen their public health response, including enhancing surveillance, improving vaccination efforts, and boosting laboratory capacities to detect and manage cases efficiently. Collaboration with international partners is encouraged. Travelers may encounter stricter health protocols at ports of entry, including increased screening, and potential quarantine measures.

Mpox is transmitted to humans through contact with infected individuals, animals, or contaminated materials. Symptoms typically appear 3-17 days after exposure but can develop up to 21 days after. These include fever, headache, muscle and back aches, swollen lymph nodes, chills, exhaustion, and a distinctive rash.

As of Aug. 16, there are no restrictions related to the PHEIC declaration. However, travelers should be aware of the symptoms above and take precautions to avoid infection:

• Practice basic health precautions, including frequent handwashing with soap and water or using an alcohol-based hand sanitizer.
• Avoid close, skin-to-skin contact with people with a rash that looks like mpox and animals that carry the mpox virus.
• Avoid contact with potential mpox-contaminated objects and materials.
• Avoid overcrowded areas such as nightclubs and consider using safe sexual practices such as physical barriers (condoms).
• Get vaccinated, especially if you are at risk for mpox. Check with your healthcare provider to determine if the mpox vaccine is recommended for you.
• Seek medical attention if symptoms develop within three weeks of being in affected areas.

As the mpox outbreak continues to evolve, it is crucial for travelers to stay informed and take appropriate precautions. The WHO’s declaration of a PHEIC serves as a reminder of the seriousness of this situation and the need for coordinated global action. By adhering to official health guidelines, travelers can better protect themselves and others in this evolving situation. Keep abreast of developments via the WHO’s dedicated mpox page.