Uganda has reported two new cases of the clade 1b strain of the mpox virus.

The health ministry has announced that one of the patients is a truck driver and that both are in isolation at a hospital in Entebbe, about an hour south of the capital.

As mpox spreads, concerns are rising about the confirmed cases of 1b, a new and potentially deadlier strain.

Where has mpox spread?

Burundi, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Ghana, Ivory Coast, Kenya, Liberia, Mozambique, Nigeria, Pakistan, the Philippines, the Republic of the Congo, Rwanda, South Africa, Sweden, Thailand and Uganda have reported cases – a total of 18.

The World Health Organization (WHO) declared the virus a “public health emergency of international concern” while emphasising that mpox is “not the new COVID“.

This is the second emergency alert relating to mpox from the global health agency in two years.

The current outbreak is triggered by Clade 1, believed to be a more serious variant that can spread through skin-to-skin contact.

Mpox has been identified in Africa since 2022, originally traced to the Democratic Republic of the Congo (DRC).

In 2023, a new strain of Clade 1 was discovered in DRC – Clade 1b.

A different outbreak of the virus’s earlier Clade 2 variant is also spreading, although at lower levels, with more than 100 countries reporting infections by last month.

Clade 2 is believed to cause milder infections and has a fatality rate of 0.2 percent compared with 3.9 percent for Clade 1.

Here’s where mpox disease has spread from January to August this year:

Africa

According to data from the Africa Centres for Disease Control and Prevention (Africa CDC) and the governments of Kenya, Mozambique, Uganda and the Ivory Coast, the Clade 1 variant of mpox has been detected in the following countries this year:

• Burundi (eight cases, zero deaths)
• Cameroon (35, two)
• Central African Republic (213, zero)
• Ivory Coast (28, one)
• Republic of Congo (146, one)
• DRC (13,791, 450)
• Ghana (four, zero)
• Liberia (five, zero)
• Nigeria (24, zero)
• Rwanda (two, zero)
• South Africa (22, three)
• Uganda (four, zero)
• Kenya (one, zero)
• Mozambique (one, zero)

The DRC is experiencing the biggest outbreak of the disease ever recorded with thousands of people infected as of August 21. The government declared an epidemic in December 2022.

Nearly all reported cases – 96 percent – across Africa are in the DRC, where children younger than 15 account for 60 percent of the cases, Africa CDC said.

The new Clade 1b strain has been detected in countries neighbouring the DRC: Kenya, Rwanda and Uganda, which had not previously reported any cases since the outbreak began in 2022.

So far, 541 deaths have been recorded from mpox, with 535 in the DRC (97 percent). The Africa CDC does not classify deaths according to strain.

In Ivory Coast, authorities said, the outbreak is linked to the 2022 Clade 2 variant.

Asia

The Philippines, Thailand and Pakistan reported new mpox cases this month.

In Thailand, authorities confirmed a new case of Clade 1b on Thursday, Asia’s first case of the new strain.

The individual, identified as a 66-year-old European male, reportedly returned from an unnamed African country currently experiencing a “large” outbreak of the Clade 1 variant.

He reportedly does not have serious symptoms and was believed to have transited through a Middle Eastern country en route to Thailand.

In the Philippines, authorities said the milder Clade 2 variant has been confirmed in the most recent case there – a 33-year-old Filipino male with no travel history.

The patient is the country’s 10th confirmed case since 2022 and authorities say mpox has likely been spreading quietly for a while.

Pakistani authorities said its first patient reported this year is a male infected with Clade 2.

However, authorities said last week they are trying to trace the patient, who is believed to have travelled to another province before the test results were released.

Europe

•  Sweden (one case, zero deaths)

Sweden reported an mpox case on August 15 which was confirmed to be the more serious Clade 1 variant.

It is “highly likely” that Europe will record more cases of Clade 1 because of frequent air travel between Europe and Africa, according to the European Centre for Disease Prevention and Control.

However, sustained transmission might be low in Europe if cases are quickly diagnosed and if testing, surveillance and contact tracing are used, the agency said. The European Union has ruled out closing its borders to hard-hit countries.

Americas, Middle East, Oceania and Antarctica

No countries in North or South America have reported new Clade 1 cases so far.

However, they should be “alert” to possible Clade 1 and Clade 2 cases, the Pan American Health Organization said on August 9.

The region reported more than 62,000 cases of the Clade 2 virus from 2022 to July 2024, including 141 deaths.

There are no confirmed cases of Clade 1 in Oceania or the Middle East.