–from Star Base and Buchanan Hospitals
By Vaye Abel Lepolu
Monrovia — The National Public Health Institute of Liberia (NPHIL) has confirmed four fatalities linked to Mpox and other underlying conditions at two major health facilities in Liberia, sparking an investigation by the National Incident Management System (IMS). Officials reported that three of the deaths occurred at the Starbase Isolation Center in Monrovia, while the fourth was recorded at the Government Hospital in Buchanan, Grand Bassa County. Medical reports indicate that some of the deceased were also suffering from conditions such as HIV/AIDS and sepsis.
These are the first Mpox-associated deaths in Liberia since the outbreak was declared by the Africa CDC and WHO in August 2024. The National Public Health Institute of Liberia (NPHIL) says its reference laboratory will conduct genomic sequencing on the specimens to determine further details. Liberia’s public health surveillance remains on high alert amid a rise in Mpox cases across the region.
Mpox, though generally self-limiting, can be severe, particularly in patients with weakened immune systems. As of September 29, Liberia has reported 923 confirmed cases, including 169 active, 750 recoveries, and four fatalities. Health officials are urging the public to stay calm, observe sanitary measures, and report suspected cases promptly.
From Symptoms to Global Outbreaks
Mpox, formerly known as monkeypox, is a viral illness caused by the monkeypox virus, a relative of the now-eradicated smallpox virus. While the disease often resolves on its own, it can pose serious risks to vulnerable populations, and recent global developments have placed it at the forefront of public health concerns.
The illness typically presents in two phases. Initially, individuals may experience flu-like symptoms, including fever, intense headache, muscle and back aches, swollen lymph nodes, chills, and profound exhaustion. These symptoms generally appear within three weeks of exposure to the virus.
Following the initial symptoms, a distinctive rash usually emerges one to four days later, though for some individuals, the rash may be the first or only sign of infection. This rash progresses through several stages, beginning as flat, red marks that evolve into raised bumps, which then fill with fluid to become blisters. These blisters eventually pustulate, crust over into scabs, and fall off. The lesions can appear on almost any part of the body, including the hands, feet, chest, face, mouth, and genital or anal regions, and are often painful.
The transmission of mpox occurs primarily through close, personal contact. An infected person is contagious from the onset of their symptoms until their rash has completely healed and a fresh layer of skin has formed. The virus spreads person-to-person through direct contact with the infectious rash, scabs, or bodily fluids, which can happen during intimate activities like sex, hugging, or kissing. Indirect transmission is also possible through contact with contaminated objects, such as bedding, towels, or clothing, used by an infected person. In certain endemic regions of Central and West Africa, the virus can spread from infected animals to humans via bites, scratches, or contact with the animal’s fluids. Additionally, a pregnant person can transmit the virus to their fetus through the placenta.
Prevention remains the cornerstone of managing mpox. The most effective strategy is vaccination for those at risk. The JYNNEOS vaccine, administered in a two-dose series 28 days apart, is recommended for individuals with multiple sex partners and healthcare workers with potential occupational exposure. Beyond vaccination, avoiding close contact with anyone displaying an mpox-like rash and refraining from handling materials they have contaminated are crucial steps. For those who contract the virus, most mild cases resolve within two to four weeks with supportive care, such rest, hydration, and pain management. For severe cases or individuals at high risk for complications, such as the immunocompromised, antiviral medications may be considered, though research into their efficacy is ongoing.
The global landscape of mpox has shifted dramatically in recent years. Historically, the disease was largely contained to parts of Central and West Africa. However, a significant global outbreak from 2022 to 2023, driven by a less severe strain known as clade IIb, spread to over 100 countries, predominantly through sexual contact among men who have sex with men. Concurrently, a separate and more concerning outbreak of a more severe strain, clade I, has been escalating in the Democratic Republic of the Congo and neighboring African nations. Due to the virulence of this strain and its potential for international spread, the World Health Organization took the significant step in August 2024 of declaring the Central African mpox outbreak a Public Health Emergency of International Concern (PHEIC), highlighting the ongoing and evolving threat of this virus.
