Is India Really At Risk Of A Monkeypox Outbreak?

Is India Really At Risk Of A Monkeypox Outbreak?

                Although more than four years have lapsed since the World Health Organization declared COVID-19 in March 2020, there is always a lurking fear that another outbreak is around the corner. On August 14, the WHO declared that the latest wave of the disease had struck Central Africa under the previous name, Mpox (formerly Monkeypox), and was a global emergency that required the most immediate response possible. The virus, which was initially alarming African countries, now spreads beyond the continent to countries like Sweden and Pakistan. This rapid spread, with the deadly Clade 1b strain leading the way, has really sent alarm bells ringing in concerned global health organizations.

The virus has already killed more than 500 people around the globe, mainly in the Democratic Republic of Congo, accounting for over 96 percent of cases registered worldwide this year. No cases have been reported in India, but the Central government is on its guard. The pandemic exposed many weaknesses in the health infrastructure of India and claimed thousands of lives in the country. The memory of those challenges is still fresh, so there is an effort not to be caught dozing this time.

As global health concerns continue to evolve, India finds itself questioning the potential threat posed by Monkeypox, a rare viral disease that has recently garnered international attention. While the disease was historically confined to certain parts of Africa, recent outbreaks in non-endemic regions have raised alarms worldwide. With its vast population and dense urban areas, India must consider whether it is truly at risk of a Monkeypox outbreak and what measures can be taken to prevent and contain any possible spread. Understanding the nature of the virus, its transmission routes, and the country's preparedness are crucial in addressing the looming threat of a Monkeypox outbreak in India.

What is Monkey Pox (Mpox)

According to the World Health Organization, monkey pox is a zoonosis, which means that it transmits to humans from animals, with manifestations that are similar to but milder than those of smallpox. Having some renowned features as a presentation, this disease is characterized by fever, rash, and swollen lymph nodes, which may lead to several medical complications. In most cases, monkeypox is self-limiting and typically persists from two to four weeks.

As per the Government of India guidelines on management of Monkeypox Disease, 2022, human-to-human transfer occurs mainly through the large respiratory droplets, which generally requires prolonged close contact; bites or scratches from infected person may also cause infection, and contact with the body fluids or lesions of an infected person and items of clothing or linens contaminated with virus. Animal-to-human transmission can occur through bites or scratches from infected animals and through handling bush meat.

The incubation period for monkeypox is six to thirteen days, and the case fatality rate, over time, can reach as high as 11% in the general population and higher among children. Recent figures show a reduced fatality rate of about 3% to 6%. Lesions appear one to three days following the fever. The symptoms usually last two to four weeks. At the beginning, the lesions are painful and then become itchy as they heal. Of great interest is the fact that monkeypox has a predilection to the palms and soles.

The outbreak of the monkeypox disease, in its major spread to previously unaffected regions through sexual contact, made Public Health Emergency of International Concern be declared in July 2022. For this, the declaration was removed in May 2023 with reporting of continuous reduction of such cases globally.

Why Monkeypox Is So Scary This Year

There is a concern about Monkeypox this year because of a really dangerous strain going around in the Democratic Republic of Congo known as Clade 1b. This is really high in its virulence, with a linked mortality rate of 3%—way higher than the 0.1% rates associated with other strains.

Is monkeypox fatal?

 The Democratic Republic of Congo Health Minister, Roger Kamba, said so far this year, the DRC recorded 16,700 confirmed and suspected cases of Mpox, including over 570 deaths, from the 15,664 suspected cases and 548 deaths reported last week. Seventeen African countries and a couple of others populations, mainly children below the age of 15, Kamba told

Xinhua news agency characterized this as a "novelty" in the context of the outbreak. According to the health agency of the African Union, Mpox cases reported in 2024, where the upside of 160 percent compared to the same period of 2023.

 How many cases of monkeypox have been reported in India?

Since 2022, a total of 30 cases were detected in India with the last case in March 2024. India reported the first case of monkeypox in July 2022. Globally since 2022, WHO has reported 99,176 cases and 208 deaths due to Monkeypox from 116 countries.

To What Symptoms Does Monkeypox Lead?

Monkeypox usually starts with symptoms like fever, headache, muscle aches, back pain, swollen lymph nodes, and fatigue. Subsequently to these primary symptoms, a rash form in different parts of the body, including the face, the palm of the hands, sole of the feet, groin, or genital or anal regions. The rash becomes blistery or pockmarks and lasts for 2 to 4 weeks. Others can have pain so severe that it is due to the presence of inflammation inside the rectum (proctitis) or in the genitals, which can affect urination.

 Do Animals Carry the Monkeypox virus?

This is true. According to findings, the monkeypox virus can actually be carried by some animals, mainly monkeys and a few other ground-dwelling rodents, which include tree squirrels. The possibility of getting the virus from the animals is through physical direct contact with either the living and infected animal or its meat that is not cooked properly. It is basically transmitted through bites, scratches, or when the infected animal is handled during hunting activities. Common modes of transmission include

Is Mpox as Dangerous as Covid-19 Or Swine Flu?

Mpox, a zoonotic infection characterized by flu-like symptoms and skin lesions, has been a concern for public health. The World Health Organization (WHO) declared it a global emergency in 2022. The virus is categorized into two clades: Clade 1, found mainly in Central Africa and known for its higher severity and mortality rate, and Clade 2, which is milder and found in Western Africa. The current outbreak is driven by Clade 1b, which emerged in September of the previous year.

While Mpox can be fatal, it differs significantly from Covid-19 and swine flu in terms of transmission and impact. Covid-19 and swine flu were highly infectious due to their airborne nature, allowing them to spread rapidly across large populations. In contrast, Mpox is transmitted through close skin-to-skin contact, respiratory droplets, or contaminated clothing and bedding. This mode of transmission makes Mpox less likely to become a global pandemic like Covid-19, as it requires more direct physical contact for spread. Additionally, the visible symptoms of Mpox, such as skin blisters, facilitate easier identification and isolation of infected individuals, helping to contain its spread.

India's experience with Mpox began in 2022 when the first case was recorded in Kerala from a traveler from the UAE. The virus spread within the country, with 27 confirmed cases and one death reported that year. The most recent case was in March this year in Kerala, with no new cases reported since then. This localized and controlled spread highlights Mpox's differing epidemiological patterns compared to more rapidly transmissible viruses.

How to Stay Safe

Following the alert set by the World Health Organisation, the Central and state governments of India have initiated their response mechanism to deal with the Mpox threat. Public health advisories and measures are now in place, with the Indian Council of Medical Research and the National Centre for Disease Control now closely monitoring the situation and assessing trends internationally.

The Directorate of Public Health and Preventive Medicine has issued alerts in Tamil Nadu. Attempts are on to trace passengers arriving from Democratic Republic of Congo and other Central African nations through airport health officers and port health personnel. Cities like Hyderabad and New Delhi, which have a sizeable number of African students, have also been put on high alert.

The Need For Vaccines

In 2022, ICMR researchers isolated the first strain of Mpox. This led to calls for the development of vaccines and testing kits to be fast-tracked. The existing vaccines against smallpox and chickenpox are likely to provide protection against Mpox in India.

According to Rakesh K. Mishra, the former director of the Centre for Cellular and Molecular Biology, "There is a need to watch the spread of the disease globally and utilize all DNA-based diagnostic methods that are at our disposal." Though there is an effective vaccine against it, ensuring its supply may prove a challenge.

According to Mishra, simple preventive measures such as avoiding close physical contact with suspected cases, keeping away from those showing symptoms, and wearing masks can help control the spread of infection.

While in the developed countries of Europe, vaccines are already available for the more highly exposed people, and therefore the containment is easier. In comparison, underdeveloped African countries that lack both vaccines and resources remain the most at-risk and in great need of heavy international support.

              As the threat of Mpox continues to evolve globally, India’s proactive measures and heightened alert status reflect a serious commitment to safeguarding public health. Although the country has thus far avoided widespread outbreaks, the rising number of cases in other regions and the emergence of more severe strains underscore the need for vigilance. The comprehensive response, including monitoring, advisories, and potential vaccine development, is crucial in mitigating the risks.

While Mpox is not as highly transmissible as airborne diseases like Covid-19, its potential to cause localized outbreaks and complications remains significant. India’s emphasis on preventive strategies, early detection, and international collaboration will be key in managing and potentially averting a larger crisis. As global health dynamics continue to shift, maintaining preparedness and responsive actions will be vital in protecting both the nation's health and its future resilience against emerging infectious threats.