MPOXED

Riverside County’s sharp rise in mpox cases, with more than half reported in just the last two months, underscores that the virus remains a pressing local health concern. As Pride celebrations begin, health officials are emphasizing prevention through vaccination and education. Completing the two-dose mpox vaccine series is key to reducing transmission, especially for those at higher risk. Free vaccination and testing at Palm Springs Pride and other county clinics make prevention accessible. The message is clear: vigilance, vaccination, and open communication are essential to protect community health and prevent a resurgence of mpox in Southern California.

A new study published in Clinical Infectious Diseases exposes troubling racial inequities and treatment delays among mpox patients who received tecovirimat during New York City’s 2022 outbreak. Black patients were significantly more likely to experience delayed access to treatment and hospitalization, even after accounting for HIV status and insurance. Although most patients improved with tecovirimat, systemic barriers in access and care persist. These findings underscore that public health responses must extend beyond antiviral distribution to address structural inequities in healthcare delivery. Ensuring equitable access to diagnostics, timely treatment, and follow-up care is essential for achieving true outbreak preparedness.

The World Health Organization’s latest global mpox assessment highlights both progress and peril. Although global infections have declined, clade Ib transmission is now established outside Africa, raising concerns about undetected spread. Africa remains the epicenter, with over 39,000 confirmed cases and 178 deaths, while new outbreaks in Kenya and Liberia show ongoing vulnerability. WHO warns that waning immunity, funding cuts, and stigma could reverse hard-won gains. Sustained surveillance, targeted vaccination, and integration with HIV and STI services are essential to containing the evolving virus. The decline in cases must not breed complacency as mpox adapts and expands its global reach.

As mpox continues to affect 26 African countries, home-based care has emerged as a pragmatic solution for managing mild cases amid limited hospital capacity. Adapted from COVID-19 strategies, the approach balances practicality with risk, relying on community health workers, infection prevention kits, and nutrition support to prevent household transmission. Countries such as Sierra Leone have shifted between home and institutional care depending on outbreak intensity. While over one million people have been vaccinated, vaccine access and logistics remain significant barriers. The Africa CDC’s coordinated response underscores how innovation, community engagement, and cross-sector partnerships can strengthen resilience against evolving epidemics.

The World Health Organization’s 59th situation report confirms that all clades of monkeypox virus continue to circulate globally, with Africa remaining the epicenter of infections. More than 80% of September’s 3,135 confirmed cases and 12 deaths occurred on the continent. While community transmission of clade Ib is expanding, WHO assesses the global risk as moderate for men who have sex with men and low for the general population. Ongoing vaccination campaigns in the Democratic Republic of the Congo have delivered more than 684,000 JYNNEOS and 118,000 LC16 doses. Sustained funding, dose-sparing strategies, and equitable vaccine access remain critical to control.

The emergence of community transmission of the new Clade Ib mpox variant in California and parts of Europe is a warning that global vigilance cannot wane. Though the general risk remains low, these cases—unlinked and locally acquired—suggest silent spread. The variant, first detected in the Democratic Republic of the Congo, appears to infect both men and women equally, unlike earlier outbreaks. Experts stress that vaccines reduce severity but may obscure detection as symptoms become milder. With weakened public health systems and reduced international aid, proactive surveillance, wastewater monitoring, and equitable vaccine access are essential to prevent another uncontrolled outbreak.

Bavarian Nordic’s new four-year contract with the European Commission marks a critical step in reinforcing Europe’s pandemic and biosecurity preparedness. The deal allows EU, EEA, and Western Balkan countries to purchase up to eight million doses of the company’s smallpox and mpox vaccine, with 1.1 million already secured. By including provisions for low-income country donations, the agreement strengthens both regional and global solidarity against infectious threats. As mpox cases decline worldwide, the continued investment in vaccine access highlights the EU’s strategic recognition that public health security is inseparable from resilience, ensuring readiness for future outbreaks and biological emergencies.

Recent detections of clade I mpox in California, all requiring hospitalization and unlinked to travel, highlight the growing threat of more severe infections amid shrinking federal public health funding. Former Centers for Disease Control and Prevention official Dr. Demetre Daskalakis and Human Rights Campaign policy advocate Matthew Rose warn that budget cuts and a potential government shutdown could undermine testing, surveillance, and vaccine access. Both emphasize the importance of maintaining vaccination efforts among at-risk groups, including men who have sex with men and sex workers. Without sustained resources and coordination, the United States risks losing ground in preventing future mpox outbreaks.

The ODIN-Mpox initiative demonstrates how environmental surveillance can revolutionize epidemic preparedness in Africa. By integrating wastewater genomics with real-time public health response, the project identifies mpox outbreaks—even in remote, non-sewered communities—days or weeks before clinical cases emerge. African-led, EU-supported, and One Health–oriented, ODIN-Mpox strengthens laboratory capacity, trains local scientists, and links surveillance directly to policy and outbreak response. Its success underscores that genomic early warning is not optional but essential infrastructure. To prevent future zoonotic crises, governments and donors must embed environmental surveillance into national preparedness plans, ensuring sustainable, equitable, and actionable epidemic intelligence across the continent.