Dutch Cabinet monitoring worsening mpox outbreak in Africa; No new travel warnings yet

The Dutch government is closely monitoring developments related to the outbreak of the mpox virus in some African countries, but has not yet issued any new travel advisories or warnings to citizens abroad. The dangerous clade 1 strain of the virus formerly known as monkeypox was diagnosed in an individual in Stockholm, Sweden, that country's Public Health Agency announced on Thursday. A day earlier, the World Health Organization (WHO) issued the most serious warning it can with regards to the mpox outbreak, declaring it to be a public health emergency of international concern.

Patients are likely to develop far more severe symptoms when infected with mpox from the clade 1 strain. It is also linked to a higher mortality rate than the clade 2b strain that spread in the Netherlands during a 2022 outbreak that infected over 1,200 people.

"The previous global outbreak of clade 2b has mainly been spread through sexual contact, while clade 1 is more commonly spread through other contact routes, mainly close contacts within the household and often to children," the Public Health Agency of Sweden said.

No current entry bans, but Dutch government is keeping outbreak under observation

There are no current plans to ban people travelling from the affected region in Africa from entering the Netherlands, a spokesperson for the Ministry of Justice and Security told NL Times. She said that the Ministry of Health is coordinating policy on the matter, which requires the efforts of at least five different ministries.

The Democratic Republic of Congo (DRC) is the primary focus of the mpox outbreak, which has also spread to Burundi, Kenya, Rwanda and Uganda, the WHO said. For now, measures like a ban on travel between the Netherlands and those countries is not planned, but that could change as the situation develops, the ministry spokesperson noted.

Dutch airline KLM currently runs nonstop service between Schiphol Airport and Kigali, Rwanda, and Nairobi, Kenya. The largest passenger airline operating from the airport near Amsterdam also has connecting services, making it possible to fly between the Netherlands and all five of the countries named in the WHO warning. An airline spokesperson also said they are keeping close watch on the situation.

"We are closely monitoring the situation regarding mpox and are in the process of reporting it in the travel advice for the countries concerned," a spokesperson for the Dutch Ministry of Foreign Affairs told NL Times shortly before Swedish authorities provided their update. So far, only the travel advice for Burundi describes the concern for the mpox outbreak.

"We will also adjust the travel advice for other countries concerned in the same way in the coming days," he added.

Mpox outbreak "very worrying," and requires international cooperation, says WHO

"The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. 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,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus on Thursday.

Those infected with mpox can suffer from a rash that presents as blisters, bumps, or red spots, and it can be painful for the individual. The rash can take up to three weeks to clear up, and can leave scarring. Symptoms of the disease include fever, headache, muscle pain, swollen lymph nodes, shivers, fatigue, and a painful inflammation of the rectal lining, according to Dutch public health institute RIVM.

"The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself," said Professor Dimie Ogoina, who chairs the WHO's committee responsible for evaluating emergencies.

Current travel alerts mostly do not mention mpox

Dutch Ministry of Foreign Affairs advisories are color-coded as green when there is no security risk, yellow when there are some risks, or orange when the risk level is more serious. The most severe red warning level indicates individuals should avoid the region entirely.

The northern and eastern regions of the DRC are already under a red alert due to an ongoing conflict between the country's military and different armed groups, and the rest of the country is under an orange alert. The area of red bleeds into parts of western Burundi, and extends along the Rwanda border. Otherwise, a yellow advisory is in effect for those two countries.

The Ministry of Foreign Affairs has also advised people to avoid eastern Kenya at all costs due to the prospect of "terrorist attacks, robberies and kidnappings." Five regions, including parts of Nairobi and Mombasa, are also under an orange advisory because of criminality and violence, but also fighting between different factions in more rural areas. The rest of the country is under a yellow caution level.

Of the travel advisories for the five countries, there is only one mention of the new viral outbreak. "In Burundi, several cases of the monkeypox virus have been reported at the end of July 2024," the advisory states. The Ministry of Foreign Affairs also refers individuals to the RIVM for advice if they are infected, or if they want information about how they can prevent infection.