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As the Mpox virus continues to cause concern worldwide, questions have arisen about its mode of transmission, particularly whether it can spread through the air as efficiently as Covid-19. Infectious disease experts have clarified that while respiratory droplets may play a role in the spread of Mpox, it is not as contagious through the air as Covid-19 or even the flu.
Mpox, a viral zoonotic disease primarily found in the tropical rainforest regions of Central and West Africa, has recently seen a significant outbreak. Over 14,000 cases and 524 deaths have been reported, leading the World Health Organization (WHO) to declare it a global health emergency.
The disease typically causes fevers, headaches, muscle aches, and painful boils on the skin. It is known to spread from person to person through close, skin-to-skin contact. However, there is growing concern about the potential for airborne transmission.
According to the US Centers for Disease Control and Prevention (CDC), prolonged face-to-face interactions, such as talking or breathing, may increase the risk of Mpox transmission. The WHO also maintains that respiratory droplets, and possibly short-range aerosols, can result in Mpox transmission.
“This suggests that respiratory droplets might play a role in transmission. That being said, it’s considered to play a lesser role in transmission dynamics as compared to direct intimate contact and sexual contact, which are the primary modes of transmission,” said Dr. Dipu T S, Professor and Unit Chief, Infectious Diseases Department, Amrita Hospital, Kochi.
A recent study by the University of New South Wales in Australia highlighted that the current outbreak, caused by the Clade 1 strain, has resulted in 70% of cases and 88% of deaths among children in the Democratic Republic of Congo (DRC). The researchers noted that the predominance of children in this outbreak suggests that respiratory transmission may be significant. They also pointed out that Mpox, like smallpox, is a respiratory virus and has been detected in ambient air.
Another study by Spanish researchers, published in the journal The Lancet Microbe in 2023, showed that Mpox transmission risk increases indoors in poorly ventilated rooms. This finding reinforces the importance of proper ventilation and protective measures in environments where prolonged close contact occurs.
Dr. Lancelot Mark Pinto, Consultant Pulmonologist and Epidemiologist at P. D. Hinduja Hospital & Medical Research Centre, emphasized that the keywords to note are “prolonged” and “face-to-face.” “Unlike highly transmissible airborne viruses such as influenza and SARS-CoV-2, Mpox isn’t likely to spread during casual short encounters. Family transmission, sexual partner transmission, and caregiver transmission are much more likely, and therefore such encounters would need added protection,” he said.
The global Mpox outbreak of 2022-2023, caused by the Clade IIb strain, has seen 99,176 cases and 208 deaths reported across 116 countries. While India has recorded 30 cases, with the last one detected in March 2024, global health experts remain vigilant.
Some scientists have warned that if the more pathogenic Clade I Mpox becomes highly transmissible between humans, it could pose a greater pandemic threat than Clade IIb. However, Hans Kluge, WHO Regional Director for Europe, reassured the public that Mpox, regardless of the strain, is not “the new Covid” as some have speculated. He emphasized that health authorities are well-equipped to control its spread.
Currently, there is no proven treatment against Mpox. However, vaccines are available, including Bavarian Nordic’s MVA-BN vaccine (Jynneos/Imvanex), which is approved in the US, Europe, and Canada. In Japan, KM Biologics’ LC16 vaccine is available, and Emergent BioSolutions’ ACAM2000 is under regulatory review in the US.
The Serum Institute of India (SII), the world’s largest vaccine maker, has also announced plans to develop a vaccine for Mpox. “Serum Institute of India is currently working on developing a vaccine for Mpox,” said CEO Adar Poonawalla, adding that the company will share “positive news within a year’s time.”
To prevent the spread of Mpox, experts recommend avoiding close contact with infected individuals and practicing good hygiene, such as regular hand washing and disinfecting surfaces. These measures, along with the development of vaccines, are crucial in controlling the ongoing outbreak and preventing further transmission.
