Monkeypox hits India: First case of fast-spreading Mpox clade 1 reported in Kerala

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There has been a global outbreak of monkeypox in many countries, including India. The viral infection caused by the monkeypox virus can affect anyone, and this new strain is believed to spread more rapidly than other strains. India has reported its first case of the monkeypox strain that led WHO to declare a public health emergency – Mpox clade 1. It has affected a 38-year-old man in the Malappuram district of Kerala. He tested positive for Mpox last week after returning from the United Arab Emirates, however he is now in a stable condition.

Mpox clade 1 detected in a 38 year old man in Kerala

A 38-year-old man from the Malappuram district of Kerala was infected by Mpox clade 1. It was reported that the patient developed a fever and chickenpox-like rash. Doctors found that the patient was infected with Mpox clade 1 upon testing. The rapid spread of this strain in the Democratic Republic of the Congo led WHO to declare it a public health emergency in August, 2024.

The previous monkeypox case reported in the national capital was a 26-year-old resident of Haryana's Hisar who tested positive for the before West African clade 2 strain earlier this month. The WHO declared mpox a public health emergency of International Concern in 2022, and 30 cases have been reported in India since then, according to a report by the Ministry of Health and Family Welfare. Here is what you need to know about Mpox and how to prevent it.

What is monkeypox and mpox clade 1?

Mpox, formerly known as monkeypox virus, is a rare viral disease similar to smallpox. Mpox is caused by the monkeypox virus (MPXV). It is an enclosed double-stranded DNA virus from the Orthopoxvirus genus of the Poxviridae family, which contains variola, cowpox, vaccinia, and other viruses. There are two distinct clades of the virus: clade 1 (with subclades 1a and 1b) and clade 2 (with subclades 2a and 2b). It can spread from person to person through close contact, including skin-to-skin contact, respiratory droplets, or contact with contaminated materials, according to the World Health Organization.

Symptoms of monkeypox

Mpox causes signs and symptoms that typically appear within a week, but can appear 1-21 days after exposure. Symptoms usually last 2-4 weeks, however they may last longer in people with weak immunity, as found in WHO. Common symptoms of mpox include:

Rash

Fever

Sore throat

Headache

Muscle aches

Back pain

Low energy

Swollen lymph nodes

The symptoms may differ from one person to another. For some people, the first symptom of mpox is a rash, while others may have fever, muscle aches or sore throat first.

Is mpox clade 1 more dangerous than clade 2?

In biology, clade is a group of organisms with a common ancestor. Mpox clade 1 (with subclades 1a and 1b) and clade 2 (with subclades 2a and 2b) are two distinct genetic variants of the monkeypox virus, each with unique characteristics that influence their geographic distribution, severity of illness, and transmission patterns, as confirmed by WHO.

“Clade 1 is associated with more severe symptoms and higher fatality rates compared to clade 2. Infections caused by clade 1 often result in a more severe illness with a higher likelihood of hospitalisation and death. The virus can spread through close contact with an infected person or animal, as well as through contaminated material,” explains internal medicine Dr Tushar Tayal.

“Clade 2 is more prevalent and has a more global distribution. It generally causes milder illness and has a lower mortality rate compared to clade 1. Infections caused by clade 2 often result in milder symptoms, with a lower likelihood of hospitalisation and death,” says the expert. However, it is important to note that even clade 2 infections can be severe in some individuals. The virus can spread through similar means as clade 1, including close contact with an infected person or animal, and through contaminated material.

The recent global outbreak of mpox was primarily caused by a variant of clade 2. While this variant typically causes milder illness, it is important to note that the virus can still spread rapidly and cause significant public health concerns. The emergence of clade 1 in certain regions has raised concerns about its potential spread and the possibility of more severe outbreak.

Mpox clade 1 cases reported in India Rashes are one of the most common signs of monkeypox. Image Courtesy: Shutterstock.

How to prevent mpox?

Mpox is primarily spread through close contact with an infected person or animal. Here are some effective ways to prevent the spread of the virus, as recommended by the expert.

Avoid close contact: Limit contact with people who have a rash or other symptoms of mpox. Avoid sharing bedding, towels, or other personal items with infected individuals.

Practise good hygiene: Wash your hands frequently with soap and water, especially after coming into contact with an infected person or animal.

Avoid contact with animals: If you live in an area where mpox is prevalent in animals, avoid contact with wild animals, especially those that are sick or dead.