Mpox: What are clades and how do they affect you?


The Department of Health (DOH) on Wednesday, Aug. 21, confirmed that the latest mpox case detected in the country has been classified as a clade II variant.

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(Photo from Unsplash)

Unlike the severe strain that has sparked global concern, the first mpox case reported in the Philippines this year has been classified as a "mild variant" since it belongs to clade II.

Amid concerns about the latest detection of a new mpox case following the World Health Organization (WHO) declaration that the viral disease has become a Public Health Emergency of International Concern (PHEIC), the DOH underscored the importance of understanding mpox and how to prevent it.

Clade I vs clade II

In a statement, the DOH explained that mpox, the disease, is caused by the Monkeypox virus, abbreviated as "MPXV," a species of the Orthopoxvirus genus.

READ:

https://mb.com.ph/2024/8/17/mpox-what-is-it-and-how-concerned-should-you-be

The virus was first discovered among laboratory primates in Denmark in 1958 and was later observed in humans in 1970, according to the DOH.

The disease was originally called monkeypox until the WHO renamed it "mpox" in 2022 to minimize stigma and its association with monkeys, as the disease can also infect rodents and humans.

“The disease was renamed, but the virus was not,” the DOH explained.

The DOH noted there are two major groups of MPXV called “clades.”

MPXV clade I, the DOH said, has been observed mainly in the Congo Basin (Central Africa) and was described in the 1980s as having a mortality rate ranging from one to 10 percent.

“Clade I is more likely to cause severe illness and death, especially in the immunocompromised,” the DOH said.

The DOH further noted that clade I has two subclades: Ia and Ib.

“Clade Ia is endemic in the Democratic Republic of Congo (DRC), with a case fatality rate (CFR) of 3.6 percent,” the DOH said.

“Meanwhile, clade Ib is a new strain of MPXV responsible for the current (2024) outbreak in the DRC and nearby countries,” it added.

Citing the WHO, the DOH noted that “there is, as yet, insufficient information available to fully characterize mpox severity due to clade Ib, as data are emerging and, so far, few deaths have been recorded, precluding age-stratified analyses."

Meanwhile, the DOH explained that MPXV clade II has been observed mainly in West Africa.

“It is milder than clade I, with a mortality rate reported from less than one to four percent,” the DOH added.

Before the recent declaration of mpox as a PHEIC by the WHO, the first warning was issued in 2022. 

“Clade II caused the 2022 mpox global outbreak,” the DOH said.

‘Milder’ variant in the Philippines

In the Philippines, the DOH stressed that the recent cases of mpox detected thus far are of MPXV clade II, with zero deaths.

READ:

https://mb.com.ph/2024/6/9/doh-reports-no-mpox-deaths-in-the-philippines

The most recent mpox case in the Philippines, reported to the DOH on Aug. 18, was identified as a clade II variant.

READ:

https://mb.com.ph/2024/8/19/doh-detects-new-mpox-case-in-the-philippines

On Aug. 21, the DOH said that the RITM reported to Health Secretary Teodoro Herbosa that sequencing of MPXV deoxyribonucleic acid (DNA) samples from the 10th mpox case in the Philippines showed it to be of MPXV clade II.

READ:

https://mb.com.ph/2024/8/21/doh-confirms-mpox-case-10-as-clade-ii-variant-why-it-matters

"We found the milder MPXV clade II in the 10th mpox case in the Philippines,” Herbosa said.

While the clade II variant is considered milder, Herbosa called for the public to stay vigilant.

“Let us continue to be alert but not alarmed,” Herbosa said.

He also pointed out that preventing mpox spread is possible by avoiding close and intimate physical contact, cleaning hands often with soap and water or alcohol-based sanitizers, and avoiding skin-to-skin contact.

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https://mb.com.ph/2024/8/15/tamang-praning-lang-doh-urges-caution-without-panic-amid-mpox-emergency