How dangerous is the mpox virus? We asked a Boehringer expert what you need to know about the pathogen formerly called "monkeypox".

We first reported on mpox, formerly known as “monkeypox”, in 2022. At the time, the virus had spread outside the mpox endemic areas, especially in Europe and North America. Now, two years later, there are reports of a new, possibly more dangerous, virus variant. What exactly is this virus, how is it transmitted, and what are the most noticeable symptoms? Dr. Christoph Keller, Senior Medical Advisor at Boehringer Ingelheim, explains.

Many pustules on human palms.
Painful skin pustules are typical symptoms of an mpox infection.

Christoph, the World Health Organization (WHO) declared the spread of mpox a "public health emergency of international reach" (PHEIC) on Wednesday, August 14. Did that surprise you?

Naturally, the WHO continuously monitors developments and regularly assesses the epidemiological situation. The assessment announced on Tuesday is purely a precautionary step. It's meant to alert national authorities in particular, and prepare them for possible outbreaks. Even though the number of mpox infections has fortunately continued to decline globally since the wave of infections in 2022 and 2023, we've seen rising infection rates in the past six months, especially in the Democratic Republic of Congo and neighboring countries. The viruses found primarily belong to the variant "Clade I", which is considered more infectious and dangerous than the "Clade II" variant that prevailed during the outbreak two years ago.

Although we don't have a vaccine or therapy against this disease, we monitoring the development of infectious diseases worldwide very closely. After all, we're always looking for ways to improve the health of humans and animals.

Where was the current mpox outbreak first observed? 

Both the virus strains mentioned have been known for a long time and are endemic in some areas of Africa, which means that they are constantly occurring there. In the current outbreaks, a subvariant called “Clade Ib” is now being observed, which apparently formed as part of the natural development of the virus. This variant could be characterized by higher infectivity. Children are particularly affected, for whom mpox infections have unfortunately always caused many deaths. A final assessment is currently not possible.

How is the virus transmitted and which groups of people are considered high-risk patients?  

In principle, everyone can become infected with mpox; the infections occur mainly through close skin-to-skin contact. Transmissions from pregnant women to their unborn children are also possible. Children, pregnant women, the elderly and immunocompromised people are particularly at risk of a serious disease progression.

What are typical symptoms? 

The infections often manifest themselves as a rash with painful pustules, especially where the infection has taken place. That might be on the face or genital area, for example. Additional symptoms include fever, fatigue or swelling of the lymph nodes.

How can you protect yourself from mpox? Is there a vaccine? 

There's no specific vaccine against the virus. However, the vaccines to protect against classic human smallpox offer good protection of about 85 percent due to the similarity of the viruses. Vaccination can still lead to a milder course of the infection, even after contact with the virus.

Anyone who has had contact with an infected person during the incubation period or observes the first symptoms should contact the local health authorities. Staff in doctors' offices, health departments or clinics should be informed of the suspicion of mpox when you arrive there or already when arranging an appointment.

Infected persons should avoid any kind of close contact or exchanging possibly contaminated objects with other people until the rash has completely healed and the last scab has fallen off – this can take up to four weeks. Outside the African endemic areas, however, the risk of infection appears to be low at the moment.

 

Copyright teaser image: stock.adobe.com - dottedyeti

Copyright image within the article: stock.adobe.com - Marina Demidiuk

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Mpox is a viral disease caused by the mpox virus (MPV). The virus is related to the classic human smallpox virus (eradicated worldwide for about 40 years) and the cowpox virus. Like COVID-19, mpox is a zoonosis, i.e. a disease that can be transmitted from animals to humans and vice versa.

Mpox was first discovered in 1958 in monkeys in a laboratory animal husbandry. It was first detected in humans in the Democratic Republic of Congo in 1970.

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Boehringer Ingelheim's VPH department works to combat contagious diseases that can be dangerous not only for the animals themselves, but also for humans and agriculture.

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