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65,000 More Mpox Vaccines in Congo Amid Cold Chain Challenges

The United States and European nations have delivered 65,000 additional doses of mpox vaccines to the Democratic Republic of the Congo (DRC), the center of a global outbreak that health officials are seeking to contain amid challenging deployment conditions.


USAID said 50,000 JYNNEOS vaccines arrived in the capital of Kinshasa on Tuesday, the same day GAVI, the Global Alliance for Vaccines and Immunisation, announced the delivery of 15,460 Bavarian Nordic vaccines. 


This follows the shipment of over 200,000 mpox vaccines last week from the European Union. Millions of doses are still needed to protect health workers and establish vaccine stockpiles especially in countries where the mpox virus is endemic and healthcare systems are underdeveloped. 


The DRC in Central Africa is rich in natural resources but one of the world's poorest nations, with a majority of its population earning an average of US$ 2 a day.


"We have also been supporting DRC and other countries to ensure the necessary cold chain systems are in place," Dr. Tedros Adhanom Ghebreyesus, World Health Organization (WHO) Director General, said in a press briefing on September 4. 


Cold chain systems refer to temperature-controlled supply chains that ensure proper storage, transportation, and distribution of vaccines.  According to the United States Centers for Disease Control and Prevention, JYNNEOS vaccines must be kept at temperatures between 2°C and 8°C (36°F and 46°F) and thawed for 10 minutes before use. Unpunctured vials may be kept at room temperature for a maximum of six hours. 


The Africa Centers for Disease Control and Prevention has launched a response plan for mpox clade I to run until February 2025 costing US$ 600 million. 


Mpox was first called monkeypox after its discovery in Denmark in 1958 in monkeys kept for research. It was first detected in humans in 1970.  Endemic to central and west Africa, mpox is transmitted through the bite or fluids of an infected animal, which can include squirrels and dormice. Human transmission is through contact with bodily fluids or contaminated objects.


There are two strains of mpox: clade I is the new and stronger strain, and clade IIb.


The DRC has had over 27,000 suspected clade I cases and 1,300 deaths since January 2023. The first case of the new strain outside the African continent was reported in Sweden last month.


WHO declared a global emergency on August 14 for clade I, calling the outbreak "very worrying."  The agency made a similar announcement in 2022 after the first strain infected people in 110 countries across Africa, Europe, and the Americas.  


WHO issued its alert in a week of rapidly evolving news about mpox, capped by a risk assessment from the European Centre for Disease Prevention and Control that there was "moderate" risk of an outbreak as more cases of the new strain are "highly likely" while the old strain "continues to circulate at low levels in Europe and globally."


Symptoms of mpox appear between six to 21 days after infection. These include fever, headaches, and skin eruptions that evolve over 2 to 4 weeks from a rash to raised lesions, to pustules then to scabs. The mortality rate is between 0 to 11 percent, with children, HIV-positive patients and people with compromised immune systems at a higher risk of getting infected and a more severe course of the virus. Infected individuals are advised to stay indoors, avoid contact with others, cover skin rashes with long sleeves and pants, and disinfect high-touch surfaces such as light switches and door knobs.




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