Asia's Worrying Increase in the Spread of Mpox

Wednesday - August 2 2023, 10:02 UTC - 1 year ago

Asia is currently experiencing a surge of mpox (formerlky known as monkeypox) infections, with China surpassing all other countries in the world. While mpox is less contagious than Covid-19, vaccinatio rates remain low in some Asian countries, creating an increased risk for outbreaks. Chinese authorities are being urged to take a more active stance against the virus.

Hazmat suits, PCR tests, quarantines, and contact tracing—it was hard not to feel déjà vu last week when China’s Center for Disease Control and Prevention published new guidance on how to contain a disease outbreak.

But what was happening was not another covid wave. Rather, the Chinese government was addressing a potentially significant new public health concern: mpox. The World Health Organization reports China is currently experiencing the world’s fastest increase in cases of mpox (formerly known as monkeypox), and the country needs to act fast to contain the spread.

While the Americas and Europe have mostly contained the mpox outbreak that started in mid-2022, Asia has emerged as the disease’s new hot spot. Japan, South Korea, and Thailand, which all saw sporadic imported cases last year, have reported weekly new case numbers in the double digits in 2023, meaning the virus has been spreading in the domestic population. But according to the latest data reported to the WHO, China has surpassed all other countries in the world, with 315 confirmed cases in just the past three months—though irregular case reporting from Beijing means it’s impossible to know the true scale of the disease at this point.

Mpox is less contagious than covid, but since 2022, more than 88,000 people have contracted the disease, which can be painful and even debilitating for some. More than 150 people have died. Some countries have been more successful than others at containing domestic mpox outbreaks—and much of their success is arguably a result of proactive measures like vaccination campaigns.But the Chinese government has barely started to take action.

"Compared with the response to covid-19 … the [Chinese] response is certainly dramatically different," says Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. "Even though [mpox] is less likely to develop into a large outbreak in the country, the Pollyanna attitude may encourage the spread of the disease among the at-risk population—unless they take a more active campaign against the disease." .

How it’s spreading now .

In May, the WHO declared that mpox was no longer a public health emergency of international concern (PHEIC) because cases had gone down significantly in countries that had seen large outbreaks last year, mostly in the Americas and Europe. (Mpox has been endemic in West and Central Africa for decades and remains so.) .

"Overall, compared to where we were last year, we’re definitely in a different place," says Krutika Kuppalli, an infectious-disease physician and chair of the Infectious Disease Society of America’s Global Health Committee. "We have much fewer cases, but we are seeing sporadic outbreaks in different parts of the world." .

Indeed, by the time the WHO rescinded the PHEIC declaration, many Asian countries were already starting to see an uptick. Japan was the first Asian country to report a significant increase in mpox cases, in March. In May, a report by researchers in the country warned that the disease could surge across Asia, owing to the connectedness between Japan and other Asian countries and the low mpox vaccination rates in some of those countries.

In addition to low vaccination rates, the WHO has identified four key factors that can lead to outbreaks. These include high density populations, imported cases from affected countries, inadequate detection and response mechanisms, and poor public health awareness.

China, by far the most populous country in the world, has had a haphazard response at best. In May, the Chinese Center for Disease Control and Prevention issued guidance for managing an mpox outbreak, which included constructing a containment zone, engaging in contact tracing, establishing a 24-hour hotline, and conducting vaccinations. But the government has yet to implement these guidelines for the most part, and many of the measures that are being taken have been criticized as overly restrictive, particularly among younger people.

Well-known Chinese actor and singer Chen Kun was the target of widespread condemnation late last month after he posted an Instagram story showing a sign outside one of Beijing’s major train stations that stated that anyone born after 1995 must be tested for mpox before they can board the train. Although the post was quickly taken down, it highlighted the level of fear and panic about the virus.

The implications of China’s mpox outbreak remain to be seen. But for now, experts are urging Beijing to take the issue seriously and take proactive steps to prevent further spread of the virus.