Mpox: How deadly is the virus and what treatments are available?

Monkeypox, formerly known as monkeypox, is driving an ongoing outbreak in the Democratic Republic of the Congo (DRC) and neighboring countries. The surge in cases is due in part to a new variant that is believed to be more deadly than the version of the virus behind the 2022 global monkeypox outbreak. But there are treatments that may help.

How deadly is mpox?

Studies have shown that the mortality rate for people infected with the MPox clade I variant causing the current outbreak is about 1 to 11%Differences in reported mortality rates may be due to differences in the affected populations and problems with disease surveillance. Lilith Whittles at Imperial College London.

For example, infants and children with less developed immune systems are more susceptible to severe and potentially fatal infections than adults. People with suppressed immune systems, such as those with HIV, are also more susceptible, she said.

Additionally, people in some areas have little access to health care, so surveillance for MPOX is limited. As a result, only the most severe cases are detected in medical clinics, while milder cases are missed, making the death rate appear higher than it actually is. More frequent misdiagnosis of MPOX symptoms as other illnesses, such as measles or chickenpox, also allows more cases to go undetected, Whittles said.

Some people have died from the MPOX virus due to complications such as sepsis, where the infection eventually enters the bloodstream and causes organ failure, or lung damage due to inflammation caused by the MPOX virus. Piero Auliaro At Oxford University.

What treatments do we have for mpox?

In the Democratic Republic of Congo and nearby countries at the epicenter of the outbreak, specific treatment for MPOX is largely unavailable. Instead, doctors focus on treating symptoms, which typically last two to four weeks. This includes using paracetamol (acetaminophen) to relieve fever and headache, or cleaning skin lesions to prevent bacterial infection. Jean-Claude Houdahemka at the University of Rwanda.

In the UK and US, doctors can treat severely ill vaccinia patients with the antiviral drug tecoviridad. Originally developed to treat smallpox, its use in treating vaccinia was based on animal studies that showed it improved survival compared with a placebo. Tecoviridad works by binding to a protein on the surface of vaccinia and smallpox that the viruses exploit to Released from infected cells and spread to other cells.

Doctors in the United States and the United Kingdom can also treat MPOX with other antiviral drugs, such as cidofovir, which has been shown to Protecting mice from lethal doses mpox virus. This drug interferes with the enzyme that the virus uses to replicate its genome.

Another treatment, VIGIV, involves injecting anti-smallpox antibodies (collected from people who have been vaccinated against smallpox) into a person infected with the smallpox virus. This can boost the immune response to the virus.

How does mpox treatment work in humans?

While animal studies have shown these treatments to be effective for mpox, their effectiveness in humans is unclear. Preliminary results from a recent randomized controlled trial in the Democratic Republic of the Congo suggest that tecovirimat does not accelerate Healing painful lesions Children and adults infected with mpox clade I variants.

Still, the researchers found that the MPOX mortality rate for participants who received antiviral treatment was 1.7%, an improvement over the 3.6% mortality rate typically seen in the DRC. However, Oliyaro said that could be explained in part by the fact that the trial participants received close care in the hospital.

Ultimately, better treatments and a better understanding of how lethal MPox is will be critical to protecting people, especially those in the Democratic Republic of Congo, from the ongoing outbreak, he said. Lucille Bloomberg at the University of Pretoria in South Africa.“There is still a lot of work to be done,” she said.