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Following the World Health Organization’s alert regarding the MPOX epidemic, the French Society of Dermatology is responding. Professor Nicolas Dupin, a dermatologist at Cochin Hospital, takes stock of what we know and what we don’t know yet about this virus.
Mpox: an epidemic to watch
On August 14, the WHO recently warned of a resurgence of monkeypox, mpox, in the Democratic Republic of Congo (DRC) and other African countries. At the origin of this epidemic, we find a different clade of the virus, clade 1B, which is spreading in the general population and mainly affects children.This epidemic differs from the one we experienced in Europe in 2022, the mpox clade 2, which mainly affected men who have sex with other men.” explains Professor Nicolas Dupin, dermatologist.
Does this mean that the modes of transmission have changed?The modes of transmission of mpox are similar regardless of the clade. The virus is transmitted mainly by direct contact with vesicular lesions, but also by saliva droplets. Intimate contacts, such as those observed during the 2022 epidemic, are also important vectors for the spread of the virus. Currently, human-to-human and intra-family transmissions are of particular concern in the DRC” specifies the expert.
Populations to be vaccinated are more difficult to identify
This is not the first time that a mpox epidemic has threatened Europe. “In 2022, Europe faced an outbreak of MPOX linked to clade 2, a virus originating from West Africa. This outbreak was quite specific because it was mainly transmitted sexually and mainly affected men who have sex with men.” says the expert. The epidemic was then quickly controlled, even if the expert specifies that France continues “to see some sporadic cases in specialized centers such as CeGIDD (Free Information, Screening and Diagnostic Centers) or infectious disease departments“.
But this time, the target populations for vaccination are less identifiable.”The initial risk groups (transgender people with multiple partners, as well as sex workers) remain today the priority targets for preventive vaccination. However, for the current epidemic in the DRC, we have not yet identified a specific target population outside the geographical area concerned. For the moment, only people traveling to endemic areas could be considered at risk but there is no recommendation for vaccination in this context.” admits the expert.
On September 2, the High Authority of Health recommended two complementary strategies: one preventive for unvaccinated or incompletely vaccinated people presenting a high risk of exposure to the virus; and the other reactive for people in contact with identified cases.
“To date, we have not yet identified any cases of clade 1B in France. However, we remain vigilant about the evolution of this epidemic, especially if it begins to spread outside the countries currently affected. We must remain ready to adapt our responses according to the situation.” concludes the expert.