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Geneva, August 27, 2024 — The World Health Organization (WHO) has clarified that droplets represent a minor route of transmission for mpox compared to physical contact. The WHO’s latest update, shared on Tuesday, emphasizes that while droplets from close face-to-face interactions may contribute to the spread of mpox, physical contact remains the primary transmission route.
Since declaring an international emergency on August 14, the WHO has been monitoring the surge in mpox cases, particularly the Clade 1b strain, in the Democratic Republic of Congo (DRC) and neighboring countries. This recent alert is driven by the rapid spread of Clade 1b, which was first identified in September of the previous year.
According to the WHO’s website, mpox primarily spreads through close physical contact, which includes skin-to-skin contact such as touching or sexual activity, as well as mouth-to-mouth or mouth-to-skin contact, such as kissing. The agency notes that while infectious respiratory particles can be generated through close talking or breathing, this form of transmission is considered secondary to direct physical contact.
WHO spokeswoman Margaret Harris stated at a briefing in Geneva, “If a person with mpox has visible lesions and is in close proximity, there is a possibility of transmission through breathing or talking, but this is a minor source compared to direct skin-to-skin contact.”
Harris further clarified that while droplets from talking or breathing can potentially spread the virus, this mode of transmission is not a major concern and does not involve long-distance airborne spread. She emphasized that understanding the full transmission dynamics of mpox requires further research.
In response to the outbreak, the WHO has recommended the use of facemasks for individuals with mpox, their close contacts, and healthcare workers. This precaution aims to mitigate the risk of transmission, particularly in settings where close contact is unavoidable.
The current mpox outbreak involves two main subtypes: Clade 1, which is endemic to the Congo Basin, and Clade 2, found in West Africa. The DRC is experiencing a surge in two Clade 1 strains: Clade 1a and the newly emerging Clade 1b. The latter, known for its rapid spread, has significantly contributed to the recent escalation.
While Clade 1 mpox is known to be more virulent than Clade 2, the WHO has yet to determine if Clade 1b is more dangerous than Clade 1a. Harris mentioned, “We don’t have data suggesting that Clade 1b causes more severe cases or fatalities compared to Clade 1a.”
To address the outbreak, the WHO is seeking $87.4 million from September to February to implement containment measures. The UN refugee agency has expressed concerns that displacement camps in affected regions could face severe impacts, stressing the urgent need for additional support to prevent a devastating crisis among refugees and displaced populations.
Allen Maina, UNHCR’s public health chief, highlighted the challenges of implementing mpox prevention in overcrowded shelters with poor sanitation and limited humanitarian assistance, emphasizing the need for immediate action to protect vulnerable communities.
