Figure 4: Transmission properties of different clades of MPXV and their virulence in humans and mice. Source: Alcamí A. Pathogenesis of the circulating MPXV virus and its adaptation to humans. Proc Natl Acad Sci U S A. 2023 Mar 28;120(13).
Mpox, the disease caused by infection with the MPVX, has become an increasing epidemic and pandemic threat. Of concern is the ongoing clade I mpox epidemic in Kamituga, Democratic Republic of Congo (DRC), and some of its neighboring countries which has infected almost 20,000 people and killed 975 (4.9 percent), both numbers almost certainly represent a significant undercounting of cases and deaths.[1]
The MPVX threat and its transmission dynamics are not yet fully understood. As noted by C. Raina MacIntyre, an Australian epidemiologist and Professor of Global Biosecurity, “the predominance of children in the DRC epidemic suggests transmission may be respiratory. In fact, smallpox and mpox are respiratory viruses, and mpox has been identified in ambient air […]. If the more pathogenic clade I mpox becomes highly transmissible between humans, it may pose a greater pandemic threat than clade IIb.”[2] MacIntyre later added, “If an emerging orthopoxvirus such as clade I mpox has an R0 of >1, it has epidemic and therefore pandemic potential.”[3]
- ↑ Stephanie Soucheray, DR Congo Mpox Outbreak Poses Global Threat of Deadlier Clade, Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota (May 20, 2024), https://www.cidrap.umn.edu/mpox/dr-congo-mpox-outbreak-poses-global-threat-deadlier-clade.
- ↑ C. Raina MacIntyre, Mpox, Smallpox and the Increasing Threat of Orthopoxvirus Epidemics, Global Biosecurity (Apr. 18, 2024). https://jglobalbiosecurity.com/articles/10.31646/gbio.268. CDC subject matter experts in a May 3, 2024, briefing with Majority committee staff said they did not agree that mpox is established as primarily a respiratory virus and that mpox routes of transmission are being studied. See Lauren Vogel, Is Monkeypox Airborne? Can. Med. Ass’n J. (Aug. 22, 2022), https://doi.org/10.1503/cmaj.1096013 (“According to WHO, monkeypox is transmitted through close contact with an infected person or animal, or contaminated material like bedding. That includes contact with the respiratory droplets that people spray when they talk, cough, or sneeze – although scientists are still studying how commonly the virus spreads this way.”).
- ↑ Id.
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