Mpox a Growing Concern for the Maritime Industry

Mpox (formerly monkeypox) is a viral illness first identified in research monkeys in 1958, with the first human case documented in 1970 in the Democratic Republic of Congo (DRC). It is endemic in parts of Central and West Africa and has now evolved to primarily spread through human-to-human transmission, as seen in the outbreaks of 2022 and 2024.

Current Status: Public Health Emergency of International Concern (PHEIC)

The World Health Organization (WHO) has declared mpox a PHEIC following outbreaks in the DRC and neighboring regions, along with the emergence of a new clade. This status emphasizes global coordination to control the spread and highlights the importance of awareness in industries such as maritime, where international travel and close quarters can pose heightened risks.

How Mpox Spreads

Human-to-Human Transmission:

• Close contact with the rash or body fluids of an infected person.
• Touching virus-contaminated objects like bedding or clothing.
• Inhalation of respiratory droplets during prolonged face-to-face interactions.
• Breaches in infection control in healthcare settings.
• Transmission during pregnancy via the placenta.

Animal-to-Human Transmission:

• Bites or direct contact with fluids from infected animals.
• Touching the rash of an infected animal.

Signs and Symptoms

• Incubation: Symptoms typically appear 5-21 days after exposure.
• Initial Symptoms: Fever, headache, body aches, fatigue, and swollen lymph nodes.
• Progression: A rash develops, often painful, starting as red spots, progressing to blisters and pustules, and eventually crusting over and falling off.
• Severity: Most cases are mild and resolve in 2-4 weeks, but severe cases can lead to hospitalization or death, particularly in children and immunocompromised individuals.

Infectious Period:
A person is infectious until all lesions have crusted over and fallen off. The virus may also be sexually transmitted for up to 12 weeks post-recovery.

Diagnosis and Treatment

• Diagnosis: Requires laboratory testing of blood and rash swabs, which may not be widely available.
• Treatment: Supportive care (e.g., managing fever and pain) and limited antiviral medications. Availability varies by country.

Vaccination

• Available Vaccines: Jynneos, Imvamune, and Imvanex, requiring two doses, 28 days apart.
• Eligibility: Varies by location; priority is given to high-risk groups.
• Research: Additional vaccines are under development.
• Chickenpox Vaccine: While not protective against mpox, vaccinating crew against chickenpox can reduce confusion in diagnosing similar-looking rashes and prevent unnecessary quarantines.

Recommendations for the Maritime Industry

1. Educate Crew Members:
   • Recognize symptoms.
   • Understand prevention methods.
   • Follow reporting protocols.
2. Promote Hygiene Practices:
   • Regular handwashing.
   • Avoiding skin-to-skin contact in outbreak areas.
3. Early Reporting and Medical Preparation:
   • Encourage prompt illness reporting.
   • Maintain up-to-date medical kits with supportive treatments.
4. Follow Vaccination Guidelines:
   • Provide mpox vaccines when available and as per local regulations.
5. Remain Informed:
   • Stay updated through reliable sources like MedSea, an International SOS Company.

Mpox represents a significant risk to global health, and the maritime sector must remain vigilant. Educating crews, implementing preventative measures, and adhering to vaccination protocols are essential steps to minimize the impact of the virus on operations and public health.