Uganda to Start Mpox Vaccination

According to Health Minister Dr Jane Ruth Aceng, Uganda has recorded 10 confirmed cases of Mpox across several districts, including Kasese, Mayuge, and Kampala. Of these, four individuals have recovered, while six are receiving care at the National Isolation Facility in Entebbe. The minister also noted that 49 close contacts are under monitoring to prevent further transmission.

Mpox, a zoonotic disease transmitted from animals to humans, can also spread through human-to-human contact, contaminated materials, or respiratory droplets. While the disease is typically self-limiting, it can lead to severe outcomes, particularly among children, pregnant women, and individuals with compromised immune systems. The recent cases in Uganda highlight the need for both public health interventions and the upcoming vaccination program.

Vaccination Rollout

Uganda’s vaccination strategy will involve two vaccines: MVA-BN and LC16. The MVA-BN vaccine, approved by the U.S. FDA, is recommended for adults, while LC16, produced in Japan, is suitable for both adults and children. Both vaccines are currently undergoing Emergency Use Licensure by WHO and Uganda’s National Drug Authority (NDA).

The Africa CDC has allocated 2,000 doses of the MVA-BN vaccine to Uganda, which will be sufficient for 1,000 individuals. Minister Aceng confirmed that the government is working closely with international partners to secure additional vaccine doses to ensure broader coverage. The Ministry of Health is also developing a distribution plan based on the severity of cases and epidemiological data.

Public Health Measures

To complement the vaccination efforts, Uganda’s Ministry of Health has implemented several other interventions. Regional referral hospitals and national isolation facilities have been designated to manage suspected and confirmed Mpox cases. Additionally, home-based care guidelines for mild cases have been developed and are being widely disseminated.

The Ministry has also urged the public to avoid close contact with individuals displaying Mpox symptoms, refrain from sharing personal items, and regularly wash their hands. Health workers are reminded to use appropriate personal protective equipment (PPE) when attending to suspected cases.

What you need to know about Mpox

HOW IT SPREADS

Mpox can be transmitted in the following ways: Human-to-Human contact: Through direct physical contact, kissing, or sexual intercourse with an infected person. Contact with contaminated materials: Such as bedding, clothing, or needles that have been used by an infected person.

Studies show that the Mpox virus lasts up to 5 days on dry surfaces like stainless steel and glass, 3 days on plastic surfaces and up to 2 days on wooden, cardboard and absorbent surfaces.

It should be noted that absorbent surfaces like beddings and clothing pose a higher risk of infection even though the virus lasts for a short period of time (2 days).

Mother-to-Child transmission: Infected pregnant women can pass the virus to their unborn babies or to the newborn babies by close contact during and after birth.

Inhalation of droplets from infected individuals with nasal involvement or exposure to respiratory droplets from an infected person.

Contact with Infected Animals: Handling or consuming infected animals, such as squirrels, rats, mice, or monkeys.

Signs and Symptoms of Mpox

The clinical presentation of mpox runs in two phases.

a. The first phase is characterized with common symptoms like fever, body ache and runny nose.

b. The second phase is characterized with a skin rash, and swollen glands in the neck, armpits, and the groin.

Overall, the signs and symptoms of Mpox include:

i. Skin rash (this varies according to clinical phase of the illness) At the beginning, there are pastules (with pus) which are highly infectious and can take from 2-4 weeks to heal.

ii. Fever

iii. Sore throat

iv. Headache

v. Body aches

vi. Backpain

vii. Low energy (General body weakness)

viii. Swollen lymph nodes

WHO IS AT RISK OF MPOX?

Everyone is at risk of getting Mpox. The following groups are at a higher risk;

i. People in close interaction with Mpox patients e.g. household members and sexual partners (including commercial sex workers).

ii. People taking care of Mpox patients without the correct use of Personal Protective Equipment.

iii. Individuals with multiple/frequent unknown sexual partners are at the highest risk of exposure.

Children, pregnant women, elderly (60 years and above), individuals with weakened immune systems such as People Living with HIV/AIDS, are at high risk of severe Mpox disease and death.

DISEASE PROGRESSION AND OUTCOMES

Mpox is not a disproportionately fatal disease, and is largely self-limiting in nature. It begins with fever that later progresses into a skin rash (as described above). The skin rash which lasts up to four weeks has two possible outcomes; it may heal or may get secondary bacterial infection which may lead to blood infection or pneumonia leading to death.

An individual with the skin rash is highly infectious and continues to contaminate surfaces including beddings, clothing and furniture.

Fatal cases are among; children under 15 years (but more in those <5 years), pregnant women may lose their unborn babies or may get other undesirable pregnancy outcomes, and individuals with weakened immunity (people living with HIV/AIDS).

In addition, the public health implications can be dire to the communities and individuals affected.

The facial and body lesions among immunocompromised individuals can be disfiguring, where the quality of life of individuals is severely affected. In some cases, patients have been reported to have suffered eye complications including permanent blindness.

In addition to the above, long distance truck drivers plying the region in the interconnected routes and resting areas within East Africa may be among the most at risk and could act as a quick way of transmitting the virus.

Some of the behaviors that may be exhibited by the long truck drivers such as engaging in sexual activities with commercial sex workers could become drivers of Mpox transmission