US confirms first case of more severe MPOX strain

California patient tests positive with new version of virus test Mpoxformerly known as monkeypox, was reported by the Centers for Disease Control and Prevention (CDC) last week. This is the first time that a mutant virus infection has been confirmed in the United States.

There are two distinct genotypes of mpox viruses: clade I and clade II. Clade II was responsible for mpox epidemic in the US in 2022and it's still in circulation, with about 3,000 cases reported across the country this year.

Clade I mpox is primarily prevalent in Central and East Africa, where more than 11,000 cases have been confirmed this year. In August, the World Health Organization declared: international public health emergency In response to the mpox outbreak in the Democratic Republic of Congo and other African countries.

The California patient had recently traveled to East Africa, according to the CDC. Their symptoms are reported to be improving.

“We are just a plane ride away from any infectious disease, but given that this disease has been around for months, we occasionally see infected people being transferred to other parts of the world. It's only a matter of time,” he said. David Weber, MD, MPHprofessor and medical director of the Department of Infection Prevention at the University of North Carolina Medical Center.

Historically, clade I has been more likely to cause severe disease and death than clade II. In previous outbreaks, clade I had a mortality rate of 3% to 11%, whereas clade II had a mortality rate of approximately 1% to 4%. In the current epidemic, the mortality rate for clade I is close to 1%.

The CDC said the latest cases of subclade Ib have been reported in Germany, India, Kenya, Sweden, Thailand, Zimbabwe and the United Kingdom.

How contagious is Clade I Mpox?

There is only one confirmed case of clade I mpox in the United States, so health officials cannot be sure exactly how this infection spreads in the community. The CDC says groups most at risk include men who have sex with men, people of diverse genders, sex workers, and some health care and testing workers.

Mpox does spread through skin-to-skin contact during sex. It is not entirely clear whether the mpox virus is transmitted through body fluids during sex. The Democratic Republic of the Congo has the largest outbreak of clade I, where the virus appears to be spread primarily through heterosexual contact.

Notably, two-thirds of mpox cases in the Democratic Republic of the Congo are children under the age of 15. But the CDC said it's unlikely the U.S. will see similar numbers of childhood infections. People in the United States tend to live in smaller households, have easier access to disinfecting products, and have easier access to medical and health information.

“We learn as we go.” Kelly Gebo, MD, MPHJohns Hopkins University School of Medicine professor told Berrywell.

“The modeled epidemics show that close contact transmission within and between households is unlikely in the United States. However, in general, the way people live in the United States is similar to that in Central and East Africa. “I think the risk for most Americans is very low,” Gebo added.

Gebo said the emergence of new virus variants means health care workers need to pay attention to signs of mpox not only in men and gender-diverse populations, but also in children and women.

Weber said it's important that health systems have access to faster tests than they currently have to monitor the virus. Most hospitals cannot test for mpox in-house. Samples must be sent to the state health department, which may send them to another lab. This could delay health care workers' ability to treat patients and impede surveillance efforts.

“There are other diseases that are similar to chickenpox. We need to know whether it's chickenpox, syphilis, herpes, chickenpox, so we need to make testing easier. Yes,” Weber said.

How can I reduce my risk of Mpox infection?

The risk of mpox infection in the United States is very low. Nevertheless, certain groups are at increased risk of infection, particularly with clade II mpox.

Mpox usually presents as a rash. Lesions may appear on the hands, chest, and genitals. Although less common in women, mpox also occurs in the transgender population.

Gebo said if someone in your household has Mpox or has been exposed to Mpox, you should avoid touching that person's sheets and other household items. Don't share toothbrushes, sex toys, or other materials that may have body fluids on them.

The CDC recommends that certain high-risk groups be vaccinated with Jynneos, the only vaccine approved to treat mpox. Two doses are required, at least 28 days apart. People who have recovered from mpox do not need vaccination, and the CDC does not recommend getting a “booster shot” for people who have already received two doses of the vaccine.

“There's no reason to think [the Jynneos vaccine] “Although it is not equally effective against all current clades, there is evidence that immunity is more durable than we thought, so it lasts at least two years,” Weber said. said.

The only antiviral treatment available for mpox is Tpoxx (Tecobilimato). a Research sponsored by the National Institute of Allergy and Infectious Diseases This indicates that people infected with clade I MPOX in the DRC who received tecobilimat did not recover faster than those who did not receive treatment.

There are no completed randomized controlled trials testing how well Tpoxx works in people in the United States, but a study of people who took Tpoxx between 2022 and 2023 found that the drug It was found to help most people recover and reduce the severity of their illness.

Mr. Weber recommends everyone who travels abroad to read this book. CDC travel page Learn how to protect yourself from MPO and other infections.

“Healthcare workers need to remember that any disease in the world is just a plane ride away,” Weber said. “All hospitals need to be aware of highly contagious diseases and be prepared to both diagnose and treat them.”