Is mpox the next COVID? Infectious disease experts address pandemic potential

As mpox (formerly monkeypox) has been declared a global public health emergency, some are wondering whether the virus poses the risk of a COVID-like pandemic.

The World Health Organization (WHO) officially declared the mpox outbreak a "public health emergency of international concern" on Aug. 14, based on a surge of cases in the Democratic Republic of the Congo (DRC) and multiple African countries.

As of Aug. 17, there were 545 reports of mpox cases since the outbreak was declared, 474 of which were confirmed, according to data from WHO.

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Symptoms include a sometimes painful rash on various parts of the body, fever, chills, exhaustion, muscle aches, headache, swollen lymph nodes and respiratory symptoms, according to the U.S. Centers for Disease Control and Prevention (CDC).

There are two types of mpox: Clade 1 and Clade 2.

Clade 2 was the strain that caused the 2022 global outbreak, the CDC noted. Survival rates for this type are more than 99.9%.

Clade 1, which is responsible for the current outbreak in the DRC and Africa, causes more severe illness and deaths. 

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"Some outbreaks have killed up to 10% of the people who get sick, although more recent outbreaks have had lower death rates," the CDC noted. 

"The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries are very worrying," said WHO Director-General Dr Tedros Adhanom Ghebreyesus when announcing the public health emergency. 

"On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives."

While health officials have expressed concern about the spread of a new strain of the potentially deadly virus, the consensus is that mpox is not likely to become a pandemic like COVID — primarily because it doesn't spread in the same way.

"Certainly not," said Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital in Boston, during a conversation with Fox News Digital.

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"What made COVID so contagious is that it is a respiratory virus spread by aerosols, so that even casual contact — being in the same room with someone for a reasonable period of time — meant you could catch [the virus]" from that person.

Another difference is that COVID is contagious starting from a day or so before someone develops symptoms, Kuritzkes pointed out. 

"By contrast, mpox requires close contact (skin-to-skin) for transmission in the vast majority of cases," he said.

"Rarely, heavily contaminated material such as bedding can be infectious, but people are not going to catch mpox by being on the same bus or running into someone at the grocery store."

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While mpox is far less contagious than COVID, it could potentially cause a "widely distributed epidemic" through sexual contact, according to Kuritzkes.

"HIV is now pandemic (found in all countries across the globe), but as high as the numbers are, it is not transmitted by casual contact," he said. "The same is true of mpox."

Dr. Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, echoed that mpox is "not the new COVID."

"It spreads via direct contact or sex, and kissing, and very close respiratory droplets, but not over longer distances by respiratory spread," he told Fox News Digital.  

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"Clade 1 is currently in DRC and neighboring African countries," Siegel said. 

"The U.S. has increased surveillance, including wastewater analysis, but there have been no cases [of Clade 1] found here yet." 

Dr. Brad Perkins, chief medical officer at Karius, a California life sciences company focused on saving lives from infectious diseases, reiterated that mpox is "considerably less infectious" for person-to-person spread than COVID-19. 

"Mpox is primarily spread from person-to-person, usually through direct contact, including intimate contact — but on average, there are fewer people who become infected as a result of contact with a mpox case compared to COVID-19," he told Fox News Digital.

"While mpox can affect anyone, data has shown that men who have sex with men are disproportionately impacted, with a notable disease burden among Black and Hispanic men," Perkins noted.

"This highlights the importance of early recognition and diagnosis, in addition to awareness and targeted vaccination of those who are at highest risk."

As with other viral infections, those who are immunocompromised or very young are at the greatest risk of severe infection, according to Kuritzkes.   

"For mpox, the main concern is for people with HIV who are not currently receiving effective antiretroviral therapy," he added.

Even after the infection has cleared, survivors can face long-term effects and complications, Perkins warned.

"Conditions like vision impairment, encephalitis and scarring have been reported," he told Fox News Digital. 

"We need deeper research into characterizing and addressing these long-term sequelae."

To prevent transmission of mpox, the U.S. Centers for Disease Control and Prevention (CDC) recommends vaccination for men who are gay, bisexual or have sex with men, are age 18 or older, and have other specific risks.

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Those risks include new diagnoses of sexually transmitted diseases and a recent history of multiple sex partners, among others.

"Second, and most obviously, would be to avoid close contact with people who have mpox lesions," said Kuritzkes.

"The big issue is getting the vaccine to the people who need it in Central and West Africa to end the current outbreak."

The United States Agency for International Development (USAID) has sent 50,000 doses of the JYNNEOS mpox vaccine to DRC, Siegel noted — "but there is still a worldwide shortage of this vaccine, which will prove crucial to stop the spread, especially if the outbreak widens."

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In addition to the current vaccines and antiviral treatments that are available, Perkins stressed the need for new innovations in mpox diagnostics, therapeutics and preventive measures.