London School of Hygiene & Tropical Medicine

On 14 August 2024, the WHO Director-General declared that the upsurge of mpox in the Democratic Republic of the Congo (DRC), and a growing number of countries in Africa, constitutes a Public Health Emergency of International Concern (PHEIC). 

Since the news broke, experts from the London School of Hygiene & Tropical Medicine (LSHTM) have been working with the global media to provide accurate, up-to-date information on what mpox is, why the current outbreak is of concern, and what steps could help to prevent the spread of infection.

Read our experts commenting on the WHO announcement.

Michael Marks, Professor of Medicine at LSHTM and Honorary Consultant in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospital, provided extensive comment and briefing for The Guardian’s First Edition newsletter.

Professor Marks told The Guardian that the current outbreak “is far and away the biggest outbreak of mpox ever, with quite a high fatality rate… It’s not likely to lead to a COVID-19 style pandemic. There will be concerns about its spread in countries with more resources, but it’s chiefly going to be a problem in the region.”

He highlighted the vital importance of getting vaccines to where they are needed on the frontline: “There hasn’t been a release of adequate funding or vaccination to control this in the most affected countries… The teams in DRC are very experienced, and with the right resources, they can handle it. But what’s required is vaccine access.”

Speaking on the Evening Standard’s Tech & Daily Podcast, Professor Marks directly addressed the concerns people in the UK might have, he said:

“The risk to listeners, I suspect, is very small, unless they’re planning to travel to an area where there is an outbreak. They may be able to access vaccination before they travel. Really because transmission is predominantly through direct skin to skin contact with individuals with the rash, it’s about avoiding that direct contact with those individuals.”

While in an interview for The Independent’s ‘Debunked’ podcast he commented on false claims attempting to link mpox to other vaccines, such as those for COVID-19, he said:

“The outcome of disinformation will be pretty minimal, probably, for the people spreading the disinformation but could be catastrophic for the populations most at risk, who stand most to benefit from vaccination.”

Professor Marks commented for numerous other media outlets including Mail Online, FT, LA Times, Fortune, The Hindu, BBC Africa, ABC News, Al Jazeera, Mirror, and The Metro.

Much of the media coverage sought to explain the differences between the two main ‘clades’, or variants of mpox, with clade II responsible for the previous 2022 outbreak, which began circulating in West Africa, and clade I behind the current outbreak in DRC.

In an interview with Sky News, Emma Thomson, Clinical Professor of Emerging Viruses at LSHTM and The University of Glasgow, said:

“In 2022, we saw mpox in the UK and that occurred largely as a result of sexual transmission and also direct contact transmission. There were more than 3,000 cases in the UK in 2022.

“This Clade I virus is more concerning because it has been expanding very rapidly, it appears to be more transmissible and it’s associated with a higher mortality rate.”

In a live interview with the BBC News channel, Emeritus Professor Jimmy Whitworth from LSHTM said:

“There is a great danger that this can spread widely throughout Africa… It does seem that it has been able to evolve so that it can transmit from person to person than previous forms of the mpox virus. 

“In terms of what can be done on the ground at the moment, I think [we should be] engaging with the population so that they’re aware about this and what they can do in terms of reporting if they have any symptoms and avoiding unprotected sex, close contact with strangers and crowded places. It’s important that healthcare workers are also aware about what they need to provide good clinical care for people who are infected.”

In comments that were reported across a range of media outlets, including Newsweek, Professor Whitworth said:

“These declarations amount to a call for action, and should lead to the prompt mobilisation of money and resources, and a coordinated international response to the epidemic.

"The amount of vaccine required has been estimated by Africa CDC to be 10 million doses. The cost and availability of vaccine is going to be a great challenge, but it is really important that, unlike in the COVID-19 pandemic, there is global solidarity, that the vaccine reaches the people who need it most and that it is not stockpiled by rich countries."

Professor Whitworth also did a series of live interviews for BBC radio and was quoted in outlets including The i and Evening Standard.

In comments provided ahead of the WHO declaration, David Heymann, Professor of Infectious Disease Epidemiology at LSHTM, told Mail Online:

“Person-to-person transmission is now occurring and if persons with infection travel to other countries, the same situation regarding smallpox vaccination exists... outbreaks of person-to-person transmission could occur.

“Though the world joined together for mpox outside Africa, the situation in Africa continues to be neglected at a risk to persons in DRC.”

In a further comment alluded to in the article he shared his concerns about what will happen next: “The question post smallpox eradication remains: will mpox fill the epidemiological niche left by the eradication of smallpox?”