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2022–2024 mpox outbreak in New Zealand

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2022–2024 mpox outbreak in New Zealand
DiseaseMpox
Virus strainMonkeypox virus
(West African clade)
LocationNew Zealand
Index caseAuckland
Arrival dateJuly 9, 2022 (2022-07-09)–present (2 years, 4 months, 1 week and 4 days)[1]

The 2022–2024 mpox outbreak in New Zealand is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus.[2] The outbreak reached New Zealand on 9 July 2022.[1] By 15 August 2024, there had been 53 local cases of confirmed mpox in New Zealand since July 2022; with four occurring in Auckland in 2024.[2] In mid-September 2024, a local outbreak linked to the Queenstown Winter Pride festival in late August 2024 had been reported.[3]

Background

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Mpox (/ˈɛmpɒks/, EM-poks; formerly known as monkeypox)[4] is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most infected individuals recover within a few weeks without treatment. The time from exposure to the onset of symptoms ranges from three to seventeen days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.[5][6][7]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus. The variola virus, which causes smallpox, is also in this genus.[8] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[8] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[5] The virus may spread from infected animals through handling infected meat or via bites or scratches.[5] Diagnosis can be confirmed by polymerase chain reaction (PCR) testing a lesion for the virus's DNA.[8]

Vaccination is recommended for those at high risk of infection.[8] No vaccine has been developed specifically against mpox, but smallpox vaccines have been found to be effective.[9] There is no specific treatment for the disease, so the aim of treatment is to manage the symptoms and prevent complications.[8][10] Antiviral drugs such as tecovirimat can be used to treat mpox,[8] although their effectiveness has not been proved.[11]

In May 2022, the World Health Organization (WHO) made an emergency announcement of the existence of a multi-country outbreak of mpox, a viral disease then commonly known as "monkeypox".[12] The initial cluster of cases was found in the United Kingdom,[13] where the first case was detected in London on 6 May 2022[14] in a patient with a recent travel history from Nigeria where the disease has been endemic.[15] On 16 May, the UK Health Security Agency (UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic.[14] Subsequently, cases have been reported from many countries and regions.[16] The outbreak marked the first time mpox had spread widely outside Central and West Africa. The disease had been circulating and evolving in human hosts over several years before the outbreak and was caused by the clade IIb variant of the virus.[17]

On 23 July 2022, the Director-General of WHO, Tedros Adhanom Ghebreyesus, declared the outbreak a public health emergency of international concern (PHEIC), stating that "we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little".[18] A global response to the outbreak included public awareness campaigns in order to reduce spread of the disease, and repurposing of smallpox vaccines.[19][20]

Transmission

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Stages of lesion development. Picture taken by Dr O.O. Afuye on 15 September 2019.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[21]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[22]

History

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On 9 July 2022, the Ministry of Health confirmed New Zealand's first case of mpox. The individual was an Auckland resident in their 20s who had recently returned from overseas travel in a country with reported cases of mpox.[23][24]

On 12 July 2022, New Zealand reported its second case of mpox. The Health Ministry confirmed that the individual had no links to the first case and had also returned from overseas travel.[25]

By 9 January 2023, the country had reported a total 41 cases of mpox. That same day, Associate Health Minister Ayesha Verrall confirmed that the New Zealand Government purchased 5,000 vials of mpox vaccines, enough for 20,000 people. A further shipment of vaccine vials was ordered for the later half of 2023. Individuals eligible for the mpox vaccine included close physical contacts of people with mpox including sexual partners and household contacts; gay, bisexual, and other men who have sex with multiple partners, transgender and cisgender women who are in sexual relationships with these men; and those recommended to have the vaccine by medical specialists.[26]

By 15 August 2024, Health New Zealand (Te Whatu Ora) had confirmed that there had been a total 53 local cases of mpox since July 2022; with four being reported in 2024 in Auckland.[27]

On 9 September 2024, a new mpox case was reported. The individual had attended the Winter Pride festival in Queenstown in August 2024.[28] On 11 September, a second mpox case was linked to the Queenstown Winter Pride festival.[29]

By 20 September, a total of 11 cases of mpox had been linked to the Winter Pride festival. The Queenstown outbreak also included several cases of mpox clade II.[30][31]

See also

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References

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  1. ^ a b "New Zealand's first Monkeypox case in isolation at home". Ministry of Health NZ. Archived from the original on 2022-07-09. Retrieved 2022-07-09.
  2. ^ a b Murray, Anna (15 August 2024). "Global mpox emergency: What New Zealanders need to know". 1News. TVNZ. Archived from the original on 13 September 2024. Retrieved 23 September 2024.
  3. ^ Whitworth, Ava (20 September 2024). "11 cases of mpox linked to Winter Pride, and separate case confirmed". Stuff. Archived from the original on 21 September 2024. Retrieved 23 September 2024.
  4. ^ "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). 28 November 2022. Archived from the original on 1 December 2022. Retrieved 29 November 2022.
  5. ^ a b c "Mpox". World Health Organization (WHO). 17 August 2024. Archived from the original on 19 August 2024. Retrieved 22 August 2024.
  6. ^ "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  7. ^ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). 15 March 2024. Archived from the original on 2 April 2024. Retrieved 22 August 2024.
  8. ^ a b c d e f "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  9. ^ Christodoulidou MM, Mabbott NA (1 January 2023). "Efficacy of smallpox vaccines against Mpox infections in humans". Immunotherapy Advances. 3 (1): ltad020. doi:10.1093/immadv/ltad020. PMC 10598838. PMID 37886620.
  10. ^ "Mpox (formerly Monkeypox)". NIH: National Institute of Allergy and Infectious Diseases. 6 December 2022. Archived from the original on 23 May 2023. Retrieved 24 May 2023.
  11. ^ "Patient's Guide to Mpox Treatment with Tecovirimat (TPOXX)". U.S. Centers for Disease Control and Prevention (CDC). 28 November 2022. Archived from the original on 24 May 2023. Retrieved 24 May 2023.
  12. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. 21 May 2022. Archived from the original on 22 May 2022. Retrieved 25 May 2022.
  13. ^ "So, Have You Heard About Monkeypox?". The Atlantic. 19 May 2022. Archived from the original on 23 June 2022. Retrieved 2 June 2022.
  14. ^ a b "Monkeypox cases confirmed in England – latest updates". GOV.UK. 6 September 2022. Archived from the original on 16 May 2022. Retrieved 2022-09-25.
  15. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  16. ^ "2022 Mpox Outbreak Global Map | Mpox | Poxvirus | CDC". www.cdc.gov. 2023-09-12. Archived from the original on 1 December 2023. Retrieved 2023-12-01.
  17. ^ Sample, Ian (2 November 2023). "Mpox circulated for five years before global explosion in 2022, research finds". The Guardian. ISSN 0261-3077. Archived from the original on 1 July 2024. Retrieved 1 December 2023.
  18. ^ "WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern". World Health Organization (WHO). 2022-07-23. Archived from the original on 25 July 2022. Retrieved 2022-08-04.
  19. ^ "Monkeypox – Campaign details". Department of Health and Social Care – Campaign Resource Centre. Archived from the original on 28 May 2023. Retrieved 2023-05-28.
  20. ^ "Protecting you from mpox (monkeypox): information on the smallpox vaccination". GOV.UK. Archived from the original on 28 May 2023. Retrieved 2023-05-28.
  21. ^ Vargas, Ramon Antonio (2022-06-07). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 2022-06-09.
  22. ^ "Monkeypox update: Where the outbreak stands now".
  23. ^ "New Zealand's first Monkeypox case in isolation at home". Ministry of Health NZ. Archived from the original on 2022-07-09. Retrieved 2022-07-09.
  24. ^ Bremner, Nicole (10 July 2022). "Experts weigh in as first monkeypox case arrives in NZ". 1News. Archived from the original on 11 September 2024. Retrieved 23 September 2024.
  25. ^ "Second case of monkeypox confirmed in NZ, Ministry of Health says". Radio New Zealand. 12 July 2022. Archived from the original on 13 July 2022. Retrieved 25 July 2022.
  26. ^ "Monkeypox vaccination available to eligible people from next week". Beehive.govt.nz. New Zealand Government. 9 January 2024. Archived from the original on 11 September 2024. Retrieved 23 September 2024.
  27. ^ Murray, Anna (15 August 2024). "Global mpox emergency: What New Zealanders need to know". 1News. TVNZ. Archived from the original on 13 September 2024. Retrieved 23 September 2024.
  28. ^ "New mpox case linked to Winter Pride in Queenstown". 1News. TVNZ. 9 September 2024. Archived from the original on 13 September 2024. Retrieved 23 September 2024.
  29. ^ "Second mpox case linked to Queenstown Winter Pride Festival". RNZ. 11 September 2024. Archived from the original on 12 September 2024. Retrieved 23 September 2024.
  30. ^ Whitworth, Ava (20 September 2024). "11 cases of mpox linked to Winter Pride, and separate case confirmed". Stuff. Archived from the original on 21 September 2024. Retrieved 23 September 2024.
  31. ^ "Mpox cases linked to Queenstown festival double". Otago Daily Times. 20 September 2024. Archived from the original on 21 September 2024. Retrieved 23 September 2024.