People travelling to Kenya have been warned “take extra precautions” amid an outbreak of a particularly deadly strain of mpox. The country has reported eight cases of mpox clade Ib, Travel Health Pro said in an update.
This strain is more deadly than clade II and is “associated with a higher risk of people with the infection developing severe illness or dying.” It is part of a wider outbreak in Africa, which was thought to originate in the Democratic Republic of Congo (DRC) last year and attributed to 610 deaths.
In August this year, the World Health Organisation (WHO) declared this outbreak a public health emergency of international concern. Formerly known as monkeypox, mpox can be transmitted when a person comes into close contact with an infected, human, animal or contaminated material.
Initial symptoms can be flu-like and include a fever, muscle aches and exhaustion. A distinctive rash or pus-filled lesions then usually appear one to five days after the first symptoms.
Travel Health Pro explains: “The rash (spots, blisters or ulcers) often begins on the face, then spreads to other parts of the body. This can include the mouth, genitals and anus. The number of sores can range from one to several thousand.”
Most people will recover within three weeks – however, severe illness can occur and sometimes results in death. Those most vulnerable to more severe outcomes include children, pregnant women and the immunocompromised.
Why is clade I so dangerous?
Mpox is an infection caused by the virus MPXV. There are two distinct clades of the virus: clade I and clade II. In 2022/23, there was a global outbreak of clade II mpox, including in the UK.
This is a less severe strain compared to clade I, which has been found in several countries in Africa this year. “Historically, clade I mpox has been associated with a higher risk of people with the infection developing severe illness or dying, compared to clade II,” Travel Health Pro explains.
“Prior to 2024, clade I mpox had only been reported in five countries in central Africa. However, recent cases in additional countries within Central and East Africa mark the first known expansion of its geographical range, heightening the risk of spread beyond the region.”
No clade I mpox cases have been reported in the UK to date. As of September 18, the countries in central and east Africa where clade I cases have been reported are:
- DRC
- Republic of the Congo
- Central African Republic
- Burundi
- Rwanda
- Uganda
- Kenya
- Cameroon
- Gabon.
Precautions to take
Before travelling you should check Foreign Commonwealth and Development Office (FCDO) advice on whether it is advised to travel to your intended destination. This also includes information on entry requirements, safety and security.
The risk of mpox is currently low for most travellers, Travel Health Pro says. But you can reduce your risk while travelling by taking sensible precautions to protect yourself from infection:
- Avoid contact (including sexual contact) with anyone who is unwell or has an unusual rash
- Wash hands often with soap and water or an alcohol-based hand sanitiser containing at least 60 percent alcohol
- Keep your hands away from your eyes, nose, and mouth. If you touch your face, make sure your hands are clean
- Talk to sexual partners about their sexual and general health and ask if they have any symptoms
- Before you have sex, go to a party or event, check yourself for mpox symptoms, including rashes and blisters. If you have mpox symptoms, take a break from attending events or having sex until you’ve been assessed by a health professional
- It can take up to three weeks for symptoms to appear after having contact with someone with mpox, so stay alert for symptoms after you have skin to skin or sexual contact with someone new
- Everyone is encouraged to exchange contact details with sexual partners, to help stop further mpox spread when cases occur
- Avoid touching items such as bedding/clothing and do not share eating utensils/cups, food or drink with anyone who has symptoms or has mpox
- Avoid contact with animals, especially rodents.
- Do not eat, cook or prepare any type of raw or wild meat (bushmeat) or any meat from unknown sources.
The first symptoms of mpox to look for include:
- A high temperature
- A headache
- Muscle aches
- Backache
- Swollen glands
- Shivering (chills)
- Exhaustion
- Joint pain.
A rash or pus-filled lesions then usually appear one to five days after the first symptoms. UK travellers experiencing symptoms abroad should:
- Limit their contact with other people
- Get medical advice locally, calling ahead before going to a healthcare facility. If they are not able to call ahead, they should inform a staff member as soon as they arrive that they are concerned about mpox
- Check with a health professional that they are fit to travel
- Anyone diagnosed with mpox should not have sex while they have symptoms, including lesions, and must use condoms for 12 weeks after infection. This is to reduce the risk of spreading MPXV to partners
- Follow local public health advice.
If you have just arrived at a UK airport or port of entry having recently travelled to any of the mpox affected countries, and have any new spots, blisters or ulcers, you should speak to a member of port or border staff to get advice.
If you have visited one of the affected countries and develop symptoms within 21 days of returning to the UK, you should isolate at home and call NHS 111 for advice, letting them know your travel history.