Smallpox was declared a global health emergency on the eve of the August Bank Holiday after the rapid increase in infections of a new variant (Clade I) more aggressive than the 2022 variant (Clade II) in the Democratic Republic of the Congo. In that year several cases were diagnosed and treated at Cotugno in Naples without problems. Clade II was transmitted primarily sexually and by contact and had a mortality rate of 1%. For most patients, the result was uneventful and the disease resolved itself within two to four weeks.

This new version, however, is also transmitted through the respiratory tract and the mortality rate is 10 times higher, especially among children under 5 years of age.. In Campania the few and occasional cases recorded in 2022 and 2023 and also in 2024 are all of the old strain and have not caused any hospitalization: “Even the most recent cases are going on back to the last few weeks always the infections caused by the Clade II strain of 2022 – the warning Alessandro Perrella director of infectious diseases at Cotugno – although we have not yet had cases of this new variant. However, we are ready to face any eventuality. We expect new infections of the new strain at the end of this holiday season marked by travel to all parts of the world but we are still in the observation phase. Multiplication occurs in Africa where there is no good distribution of the vaccine.” Those who contracted the 2022 strain, known as Clade II, or who received the vaccine against mumps and human pox, given until the late 1980s , to be protected from severe disease even from the current version of the virus.

What is certain is that the new strain, Clade I, is endemic in Central Africa and has been more persistent and deadly than the 2022 Clade II strain. WHO lifted the state of emergency in May 2023after a sharp decline in cases as awareness of the disease and use of vaccines increased. But now the new variant is a cause for concern and the alert level has been raised to the highest level due to its spread in remote villages and among children. But we are still at a very early stage in a potential new crisis. Perrella himself wrote the path to the diagnosis and treatment of peat moss and also published in international journals data from the first case in Campania in 2022 with a manual on how to identify cases and how to make a differential diagnosis

« many Covid has taught us many things and especially that viral diseases are now transferred from one part of the world to another very easily and quickly – he said Luigi Atripaldicontact for the Higher Institute of Health for virus series and former head of the laboratory Monaldi–Cotugno – the new strain is characterized by its virulence with death 10 times higher than the strain 2022 Study 2023 by a group of Stockholm of the Karolinska The institution However, it has clearly proven that those vaccinated with the old human smallpox vaccine still retain reasonable protection and therefore have mild symptoms or do not get the disease”.

In Campania the reference laboratory of Cotugno capable of sequencing and molecular diagnosis of disease Mpox (mottled virus). In this regard, the Ministry of Health has asked the departments to get more commitment from the local information laboratories by organizing special funding.

“After some occasional issues in 2022 – it ends Ivan Gentilefull professor in Infectious Diseases at Federico II – we currently have no cases at the polyclinic. However, we are equipped for vaccination but these epidemics that seem far away should not be underestimated. Sooner or later the disease with the new strain will come to us considering the large flow of tourism with the African continent. “