Three different mpox epidemics happening at the same time with each their own mpox strain. Updated.
There has been confusion and Science magazine published an article to explain the situation.
Subscriptions are free.
Explaining the current situation of three different mpox epidemics happening at the same time.
Science magazine has a really good explanation of the three epidemics involving Clade 1, 1b, and 2. Each is impacting different populations.
Clade 1 epidemic, also called clade 1a, is primarily in the Western Congo. It spread to humans from small rodents, it impacts primarily children. It has limited human to human spreading.
Clade 1b epidemic is primarily in the Eastern Congo. It isn’t from animal reservoirs. It spreads primarily by sexual contact and is primarily in adolescents and young adults.
Clade 1b is a variant that clearly is a danger to the Gay community as clade 2 was and is. Yes, Gays got vaccinated, but there is a risk of break through infections.
Genetic analysis indicates that Clade 1 and 1b diverged centuries ago, but 1b wasn’t detected before. Clade 1b is the mpox that is spreading all over Africa and is the mpox resulting in alerts by the African Center for Disease Control and the WHO.
It is the mpox that has been detect so far in one traveler to Sweden and one traveler to Thailand.
The third epidemic of Clade 2 started in Nigeria, perhaps starting as early as 2014, but wasn’t recognized until 2017 and then lead to the world wide epidemic. The number of cases has gone way down, but it is still happening in Europe and the United States.
It really isn’t known whether Clade 1 is more deadly than Clade 2. The different health systems tend to capture data differently, and people in Africa often only go to the doctor when they are severely ill, so the data is extremely skewed. The people mildly impacted don’t see a doctor.
The article says that clade 1a and 1b have been around for a long time, and have “spilled over” into humans at different times and then ceased to be a problem.
The primary cause of the current situation is the cessation of smallpox vaccination. Smallpox vaccination also protects against mpox. Other factors are the expansion of people into forests to conduct agriculture and eating “bushmeat.”
As for deadliness of 1b, there is this result for an experimental drug that failed and where the patients got good care is 1.7%. That is out of a 1000 patients 17 will die.
One intriguing data point comes from an unpublished study of the antiviral drug tecovirimat to treat mpox patients in the DRC, carried out by the National Institute of Allergy and Infectious Diseases and INRB. The drug did not work, but a 15 August press release summarizing the outcomes notes that the mortality rate was 1.7% in both the treatment and placebo groups, likely because study participants received better care than people in the DRC usually do.
What are the possibility of it spreading to places outside Africa? What are the chances the Gay community gets it.
So far only two cases of clade 1b have been detected outside Africa, one traveler to Sweden and one traveler to Thailand. In both cases they were detected and quarantined and persons possibility exposed tracked down.
The case in Argentina wasn’t mpox but something else. The Philippine case detected was clade 2. There have been two reported cases of mpox in Pakistan. The first wasn’t clade 1b, but clade 2. For the 2nd case, in Pakistan, I haven’t tracked don a good source to know if the 2nd case even exists.
So far it seems to be getting caught at the airport and with the alert cases are being isolated. This is good so 1b doesn’t spread to the general community.
However, as more people get it in Africa while they are waiting for vaccines and it spreads across Africa there will be more opportunities for travelers to get it and bring it to a nation outside Africa.
As long as cases are detected at entry points to a nation and follow up tracing is done, it should be contained.
The risk though is that an infection is early and not observable as lesions, and the person enters a populous nation and then spreads there. Then that nation with an epidemic and outside Africa is a source for possible transmission to another nation.
Maybe the scenario will be the current containment works for a while, and then something slips through and that nation is now a new source for carriers to another nation. .
The one thing that will help is that after people do get mpox they will have immunity and maybe scars, and after awhile the population will either have been vaccinated or infected. This is a really bad way for immunity to be acquired by a population, but the vaccines are still promised at this time, and not delivered to Africa.
We will need to monitor the situation and see what happens. Since vaccines haven’t arrived yet, and it will take a while to get enough vaccines to get the epidemics in Africa under control, we likely will be needing to keep a close watch for some time.
Also, the chances of it not reaching nations outside Africa depends on it not developing new forms of transmission that are more contagious, like coughing or other respiratory transmissions.
Don’t get alarmed, but do get vaccinated.
Violence against Gays
At least one local religious right homophobe wanted to make an issue of mpox and Gays.
There was an Islamic activist in Dallas County who called the Dallas Police and tried to get Gay events shutdown. This is my report on it.
If clade 1 reaches the United States or clade 1b impacts a lot of straight people, there might be panic and hysteria and blaming Gays.
Should have never happened. Could have been avoided with action multiple times before.
In May 12, 2023, Nature magazine had this article, “The disease will be neglected: scientists react to WHO ending mpox emergency.” This is the fear that after the Clade 2 mpox epidemic in the Western world ending, it would be neglected.
And it was neglected, hence the current emergency in 2024.
https://www.nature.com/articles/d41586-023-01581-1
Previous to the Clade 2 epidemic which impacted the Gay community, there had been warnings also which were ignored.
Unfortunately, this article in Nature, Nov. 30, 2022, “These monkeypox researchers warned that the disease would go global,” is now behind a paywall.
They had warned that there was a developing risk as they observed that mpox was becoming an STD. The epidemic in 2022 could have been prevented.
https://www.nature.com/articles/d41586-022-04155-9
This is Science magazines article on the history of bungling and slow response to Clade 2 in Nigeria.
Obviously after the 2022 epidemic, we needed to have a program of vaccinations in Africa, but it never happened.
When they stopped vaccinating for smallpox did anyone think about what other diseases were being prevented by the vaccine? Apparently not.
So now we have articles like this, Time, “It’s Time to Start Taking Mpox and Bird Flu seriously.”
We should.
https://time.com/7012269/take-mpox-bird-flu-seriously-essay
Associated Press story, “Africa’s mpox outbreaks result from neglect and world’s inability to stop epdemics, experts say.”
https://apnews.com/article/africa-mpox-outbreak-who-f1c5d501223ccf3b53c6d9a2727d5c8a
Vaccination programs in Africa would have been cheap and should have started at least a year ago.
We will have neglect of African diseases and evidently a disease impacting Gays isn’t considered a priority for the Biden government to effectively deal with.
Instead we have articles taking about plans to start vaccination programs and nations waiting for vaccines.
Reuters, “Why mpox vaccines are only just arriving in Africa after two year.”
CNN, “African health officials hopeful mpox shots will start within days as WHO says outbreak is ‘not the new Covid’”
https://www.cnn.com/2024/08/20/africa/argentina-quarantines-mpox-ship-intl-latam/index.html
The four major failures.
1. Vaccinations needed to continue even after smallpox was eliminated.
2. Tropical diseases in general shouldn’t be neglected. With global transportation systems, a disease is just a jet flight way.
3. There should have been vaccinations going on prior to the Clade 2 outbreak that west to the West and impacted the Gay community.
4. There should have been vaccinations going after the Clade 2 pandemic.
But instead African American nations are crying out for vaccine deliveries.
How many tropical diseases will reach the Gay community.
The Gay community in the United States has been slammed by two African diseases, HIV and mpox so far, and the way the health establishment currently is neglecting tropical diseases, we shouldn’t be surprised if the Gay community gets hit with a 3rd or 4th or 5th tropical disease.
I wrote to my congressional rep. Jasmine Crockett and never got a reply.
As for the so-called leadership of the LGBT, obviously don’t care about STDs that impact Gay men.
Summary
1. We will need to continue to monitor mpox.
2. This was entirely avoidable as well as the previous mpox pandemic.
3. We need to start pressuring the Democrats to be more effective on tropical diseases.
We don’t need a 3rd tropical disease after HIV and mpox to be hitting the Gay community.
The real root cause of this mess is that Gays have to invest a large portion of their political efforts fighting homophobia, and also the LGBT leadership doesn’t care much about STDs that Gay men are of risk of.
Of course, if you haven’t gotten vaccinated, get vaccinated. If 1b reaches the United States and impacts straight people there will be a huge rush for it.
