New Delhi, August 2024 It has come to neighboring Pakistan, can India be far away? A deadly new strain of Mpox (formerly known as Monkey Pox) that emerged in Central Africa has made its way across the continent and beyond, posing a significant threat to global public health. The virus, once confined to remote regions, is now knocking on India's doorsteps, with Pakistan recently reporting its first cases. The question that looms large: Is India prepared to face yet another potential pandemic? Experts called for full preparedness to deal with a possibility of another pandemic that is looming large.

Originating from Congo, the strain behind this outbreak, Clade 1B, is highly infectious and has rapidly spread across Central and East Africa, with cases now being reported in Sweden and Pakistan. The World Health Organization (WHO) has declared this outbreak a global health emergency, the highest level of alarm under international health law, underscoring the severity of the situation. According to experts, India having barely emerged from the devastating effects of the COVID-19 pandemic, cannot afford to let its guard down. With Mpox cases creeping closer, experts are sounding the alarm and calling for immediate preventive measures to avert a potential health crisis.

“Mpox begins with symptoms like fever, body aches and followed by emergence of rashes across the body. These rashes develop through various stages macules, papules, vesicles, and pustules—over a period of 2 to 4 weeks. The virus has two main strains, known as Clade I and Clade II, with the former being more severe and associated with higher mortality rates. The current Clade 1B strain is highly infectious and possibly a high mortality rate too. Immediate action is required to prevent the virus from gaining a foothold in India," said Dr. Rakesh Pandit, Senior Consultant & HOD -Internal Medicine, Aakash Healthcare.  

Human-to-human transmission occurs through respiratory droplets, direct contact with body fluids, or exposure to contaminated materials. The virus can also spread during intimate contact, making it particularly concerning in densely populated or close-knit communities.

"So far, it is evident that Mpox is highly transmissible through close human contact, particularly during intimacy or through sexual fluids. This includes actions such as touching, hugging, kissing, or even sharing utensils or clothing of an infected person. Furthermore, the virus can also spread through contact with contaminated materials like bedding, towels, or surfaces that have been exposed to the virus. We need to be highly alert in terms of coming close to an infected person or a potential carrier who has history of travel particularly to any African nation,” warned Dr. Prashant Sinha, Head- Emergency, PSRI Hospital.

The potential for transmission through various routes highlights the need for stringent preventive measures.  Dr. Pranjit Bhowmik, Chairman- Asian Hospital said, "The reason for the Mpox epidemic is declining immunity due to the cessation of smallpox vaccination, deforestation, and encroachment of animal reserves, as well as risky and promiscuous sexual behavior. Preventive measures, including proper hygiene, avoiding contact with potentially infected animals, and practicing safe sex, are crucial in preventing the spread of the virus."

“The JYNNEOS vaccine, although not available in India at present, is recommended for the prevention of Mpox.  Getting vaccinated, especially for those at high risk, provides the best protection. In the absence of a vaccine, we must focus on other preventive measures such as avoiding contact with wild animals, practicing good hygiene, and wearing protective gear when dealing with potentially infected individuals," added Dr. Bhowmik.

One of the lesser-known but significant concerns about Mpox is its potential impact on the neurological system. The virus can affect the brain, leading to symptoms such as severe headaches and, in some cases, more severe neurological complications.

Dr. Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital, explained, "Mpox affects the functioning of the brain, and a headache is just one manifestation of that. The virus can cause inflammation in brain tissues, leading to more serious conditions such as encephalitis. We need to be vigilant and monitor patients closely, particularly those who present with neurological symptoms, to ensure timely intervention. The neurological impact of Mpox calls for the need for a multidisciplinary approach in managing the disease. "

Given the current situation, experts are calling for a multi-pronged approach to prevent the spread of Mpox in India. This includes public awareness campaigns, vaccination drives, and strengthening the country's healthcare infrastructure to handle a potential outbreak. India needs to act swiftly to set up isolation wards, train healthcare workers, and stockpile essential supplies such as personal protective equipment (PPE) and antiviral medications. The experts emphasized that early detection and isolation of cases will be key to preventing the virus from spreading.

The WHO has also recommended the implementation of contact tracing and quarantine measures for individuals who have been exposed to the virus. These measures, combined with public awareness campaigns, can help contain the spread of Mpox and prevent it from becoming a widespread epidemic in India.

As Mpox cases continue to spread across the globe, the threat to India becomes more imminent. The lessons learned from the COVID-19 pandemic should serve as a wake-up call for the nation. Experts called for preparedness, vigilance, and a proactive approach are essential to preventing Mpox from becoming the next public health crisis.