Onne Vegter: Mpox hysteria is overblown and hurting SA tourism

Misplaced fear over the mpox outbreak in the Democratic Republic of Congo (DRC) is causing a decline in African tourism, echoing the Ebola crisis of 2014. Despite media headlines suggesting widespread risk, the outbreak is concentrated in the DRC, with minimal impact elsewhere. Tourists to unaffected regions face nearly zero risk. It’s crucial to combat misinformation and avoid unnecessary travel disruptions that could devastate Africa’s tourism industry.

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By Onne Vegter

Lack of understanding and misplaced fear about the current mpox outbreak in the Democratic Republic of Congo (DRC) is harming tourism to Africa. Ordinary travellers to the rest of Africa are at almost zero risk of infection, yet tourists are cancelling their holidays even to unaffected parts of Africa. Is this going to be a repeat of the Ebola crisis in 2014, when all of Africa saw tourist arrivals plummet because of an Ebola outbreak in a few west African countries?

Immediately after the World Health Organization declared the current mpox outbreak in the DRC a Public Health Emergency of International Concern (PHEIC), we started seeing media headlines like “Mpox cases are soaring in Africa” and “WHO declares mpox outbreak in Africa a global emergency.”

Why refer to “Africa” when the outbreak is concentrated in the DRC? Africa is a huge continent with 54 different countries. Most of them (including South Africa) have no cases of the clade Ib MPXV variant that is driving this outbreak. Can media editors not be more specific? 

Of course they can. But fear sells. Hysteria generates more traffic than a measured, factual approach.

For the sake of Africa’s tourist economy, let’s examine the facts of this outbreak.

The current mpox outbreak in the DRC is not merely a continuation of the previous global outbreak which started in 2022 and saw a total of about 100,000 cases and 208 deaths reported worldwide. The new outbreak is based on a different clade of the virus.

A new strain

The current outbreak in the DRC is driven by a different, more virulent strain known as clade Ib. There are two known strains or clades of MPXV, clade I and clade II. Clade Ib seems to be a more dangerous variant than clade II, but the primary mode of transmission remains the same — sexual contact. The new variant was first identified among sex workers in the town of Kamituga, where prostitution is common.

Outside of the DRC, the only other country with more than single digit numbers of clade Ib mpox is Burundi, a very small country adjacent to the DRC. A full list of countries with confirmed cases of clade Ib mpox shows that the tourism hotspots in southern Africa and east Africa remain unaffected and are not dealing with any clade Ib mpox outbreak. 

The handful of affected individuals in other countries are mainly those with a travel history to the DRC, and people who have engaged in risky sexual behaviour. 

Mpox is a sexually transmitted disease

During the 2022 outbreak, a study published in the New England Journal of Medicine found that “98% of the persons with infection were gay or bisexual men.” 

A position paper published in the journal Clinical Infectious Diseases, volume 76, concluded that mpox is sexually transmitted disease (STD) which is spread primarily through sexual contact, and that labelling it as such would help to focus public health interventions.

Labelling it as an STD would also help to assuage the misplaced fear and hysteria about the current outbreak, which was first noticed among sex workers.

Who is at risk?

Mpox spreads via exchange of bodily fluids. Infection usually occurs via sexual contact or other forms of very close personal contact. The people most at risk of infection are sex workers and their clients, gay and bisexual men who have sex with men, immediate family members of infected patients who share bedding and eating utensils, and health workers in close contact with infected patients, particularly if they lack personal protective equipment or fail to follow stringent hygiene protocols.

People suffering from HIV and children with weakened immune systems are most at risk of more serious outcomes. An mpox vaccine is available, and people who are at higher risk are encouraged to get vaccinated.

Is it safe to travel to Africa?

There is an incorrect perception that it might not be safe to visit Africa right now. Despite the scary headlines, the current mpox outbreak should be of little concern to most people. It is not accurate to suggest that everyone is at equal risk from mpox. Ordinary tourists to Africa (who are not visiting DRC) are at almost zero risk of contracting mpox, and there is no reason for them to alter or cancel their travel plans. 

Apart from misplaced fears about the risk of infection, there are fears that the WHO and governments might overreact again and ban air travel or close borders. This would be completely unnecessary and a huge disaster for Africa’s tourism economy. Even tourists who understand that they are not at risk from contracting mpox might be hesitant to book travel to Africa while there is any risk of border closures or travel bans. It is critical that the WHO and governments around the world carefully measure their response and reassure travellers, to avoid the kind of damage that the Ebola and Covid pandemics did to African tourism.

Most African countries are not facing any mpox outbreak, but we are at risk of facing yet another outbreak of media-fuelled hysteria and government overreaction. I sincerely hope that common sense will prevail as we combat this mpox outbreak in the DRC.

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