Mpox Symptoms in India: What You Must Know About Clade I, Ib, II, and IIb Variants

Mpox symptoms in India: Mpox (formerly known as monkeypox) has been a rising concern in India, with cases emerging across different regions. The virus, which belongs to the Orthopoxvirus genus, has multiple clades or variants, each presenting unique challenges. In this blog, we explore the differences in symptoms between Clade I, Clade Ib, Clade II, and Clade IIb, and what you need to know to stay safe.

Mpox is classified into two main clades: Clade I and Clade II. According to Dr. Tayal, Clade I is recognized as the more severe and lethal variant, while Clade II is associated with the 2022 global outbreak.

Mpox cases are rapidly increasing worldwide. On Monday, a 38-year-old man from Kerala tested positive for the Clade Ib variant of the virus. India has reported at least 32 mpox cases and one death since 2022, but this is the first confirmed Clade Ib case in the country.

As mpox cases continue to rise, understanding the symptoms of its variants is crucial. Dr. Tushar Tayal, Consultant in Internal Medicine at CK Birla Hospital, Gurugram, explained the differences in symptoms between Clade I, Clade II, Clade Ib, and Clade IIb variants of mpox.

What is Mpox?

Mpox is a zoonotic disease caused by the monkeypox virus, closely related to the smallpox virus. Though historically confined to certain regions in Africa, Mpox is now spreading globally, including in India. The virus spreads through direct contact with bodily fluids, skin lesions, respiratory droplets, or contaminated objects.

Clade Variants: Key Differences

Mpox consists of several clades, each with slightly different symptoms and characteristics. Below are the differences between Clade I, Clade Ib, Clade II, and Clade IIb:(10)

Clade I Symptoms: The Most Severe Variant

Clade I, also known as the Central African variant, is the most dangerous variant historically. Its symptoms include:

• Severe rash: A widespread, intense rash that usually begins on the face and spreads across the body.
• High fever: Body temperatures can exceed 39°C, lasting for days.
• Lymphadenopathy: Significant swelling of the lymph nodes is common.
• Fatigue: Extreme tiredness is often reported.
• Mortality rate: Clade I has the highest mortality rate, making early detection and isolation critical.

Clade Ib Symptoms: A Milder Version of Clade I

Clade Ib is a variant closely related to Clade I, but with milder symptoms:

• Rash distribution: The rash is still extensive but less intense than in Clade I.
• Moderate fever: Fevers are common but lower compared to Clade I.
• Lymphadenopathy: Swollen lymph nodes are present but less severe.
• Fatigue: Patients experience fatigue, but it is generally less debilitating.

Though Clade Ib is milder than Clade I, timely medical attention is still essential to prevent complications.

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Clade II Symptoms: The West African Variant

Clade II, commonly known as the West African variant, is globally widespread and less severe than Clade I:

• Milder rash: The rash is more localized and affects fewer areas of the body.
• Low-grade fever: Fevers are present but milder compared to Clade I and Ib.
• Swollen lymph nodes: Lymphadenopathy is common but not as pronounced.
• Fatigue and headaches: These symptoms occur but are less severe than in the Central African variants.

Clade II is generally less fatal, and symptoms tend to resolve faster than those of Clade I.

Clade IIb Symptoms: The Newest Variant

Clade IIb is a recently identified variant and a subclade of Clade II:

• Localized rash: The rash often affects a specific area, such as the face or extremities.
• Mild fever: Fevers are low-grade or sometimes absent.
• Lymphadenopathy: This symptom is less common than in other clades.
• Mild overall symptoms: Fatigue, muscle aches, and general discomfort are mild, and patients recover faster.

Clade IIb, though detected in several cases in India, is considered the mildest of all the clades.

How to Protect Yourself from Mpox

With multiple Mpox variants in circulation, especially in India, you can protect yourself by:

• Avoiding close contact with anyone showing symptoms like rashes or fever.
• Practicing good hygiene by washing your hands regularly and disinfecting surfaces.
• Wearing masks in crowded or high-risk areas to reduce exposure.
• Seeking medical help if you experience Mpox symptoms or have been in contact with a diagnosed person.

The growing number of Mpox cases in India highlights the importance of recognizing the differences in symptoms between Clade I, Clade Ib, Clade II, and Clade IIb. Each variant presents unique challenges, but with the right awareness and precautions, you can safeguard yourself and those around you. Stay alert, seek timely medical advice, and stay updated on the evolving Mpox situation in India.