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Tuesday, 20 August 2024

IS YOUR BODY AS OLD AS YOU? Chronological Age Vs Biological Age: Why Knowing The Difference Matters

 

Differentiating Between Chronological Age Vs Biological Age


OUR BIOLOGICAL AGE MIGHT NOT NECESSARILY BE THE SAME AS OUR CHRONOGICAL ADE -  DRSHIRLEY KOEH: 

Emagene Life & TruDiagnostic in Malaysia's first biological ...

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Differentiating Between Chronological Age Vs Biological Age


If you experience fear of growing old, you are not alone. A 2014 survey shows that nearly 90% of Americans are afraid of the implications of aging, from an increased risk of disease to declining physical ability. However, this fear often stems from two assumptions: that getting old is synonymous with disease and that you have no power over the aging process. These aren’t necessarily the truth.

There’s a lot that needs to be understood about the complex process that is aging. However, since the introduction of concepts such as biological aging and aging biomarkers in 1988, science has made significant advances. 

Today, we know that your true age is defined by more than the date on the calendar or the number of candles on your birthday cake. Instead, your biological age is a more accurate indicator of how old your body is, as well as of what disease risk profile you are facing at any point in life.

Unlike chronological age, biological age can be influenced and reduced with the right interventions. And, with RELATYV, you can also access a comprehensive tool to track your biological age and intervention progress in real-time. Let’s cover all you need to know below.

Understanding Chronological Age And Biological Age

American developmental biologist Scott F. Gilbert defined aging as “the time-related deterioration of the physiological functions necessary for survival and fertility.” More broadly, the term aging can be used to describe the biological processes associated with the passing of time, which lead to physical and cognitive decline. These changes, which are often permanent, affect any aspect of our body and mind, from cells and organs to the body’s own systems. 

Most theories link the beginning of the aging process with cellular senescence – or, in simpler terms, cellular retirement. This occurs when the cells in our body cease to divide, often in response to different triggers, including DNA damage and dysfunction of the telomeres (the protective caps at the ends of our chromosomes). 

In certain scenarios, this process is critical because it prevents damaged or stressed cells from propagating, aiding in tumor suppression and wound healing.

 

However, when cells stop dividing, they also stop acting as young, healthy cells – which can lead to a decline in the reserves of progenitor and stem cells, which are essential to replace damaged cells and tissues and to keep the body working properly. 

Additionally, the accumulation of waste materials from older cells can begin to accumulate and kickstart diseases commonly associated with aging.

Several theories have attempted to explain why cells, at some point in our lives, stop dividing. Some, like the Hayflick Limit, suggest a sort of biological countdown. Others link the accumulation of cell byproducts (known as free radicals) or damage to the energy-producing center of the cell (mitochondria) to aging. 

More recently, studies have begun to uncover the connection between aging and telomere shortening. Telomeres shorten at each cell division cycle. When they become too short, they can leave the chromosomes unprotected and cause genome instability, eventually leading to cellular retirement. 

We’ll look at the relationship between telomere length and aging in more detail below. 

Chronological age and biological age are two different measures that can be used to determine how your body is aging. Unlike chronological age – which simply tells you how much time has passed since your birth – biological age is a more accurate indicator of how old your body is, how long you can expect to live, and what your disease risk profile is. Recent research findings link biological aging with cellular retirement.

What Is Chronological Age?

Chronological age represents the exact amount of time a person or organism has existed, typically measured in units such as years, months, or days since birth. It’s a fixed, easily quantifiable measure, independent of health status, lifestyle choices, or genetic factors. In other words, you can always know how old you are based on your chronological age. 

Nonetheless, while this is a useful marker of time, it doesn’t necessarily reflect biological age, which may be influenced by a multitude of factors including genetics, environmental exposure, and lifestyle habits. Unlike biological age, chronological age cannot be modified.

What Is Biological Age?

Biological age refers to how well your body functions compared to your chronological age. It is a dynamic measure of one’s health and vitality. It determines how well your body’s cells and systems are functioning and how fit you are compared to the standard for your chronological age range. 

For instance, a person may be chronologically 50 years old but due to a healthy diet, regular exercise, and optimal stress management, their biological age may be measured as 40. This figure indicates that they have a health and risk disease profile akin to an average 40-year-old, showing that, biologically, they are aging at a slower rate. 

Similarly, two people with the same number of birthdays can have different biological ages, depending on how they are aging internally, due to genes and lifestyle choices. 

By telling you how old your body truly is compared to your chronological age, biological age also more accurately predicts your disease risk profile, lifespan, and expected healthspan (the number of years lived without chronic illness or disability)

Unlike chronological age, biological age can be modified by addressing the factors that influence this measure. These factors include:

  • How well you manage stress
  • How physically active you are
  • Your diet 
  • Exposure to toxins or pollutants
  • Genetics
  • Habits such as smoking and drinking alcohol 
  • Sleeping habits 
  • Environmental factors, such as where you live or work
  • Systemic inflammation, or low-grade, chronic inflammation that, over time, affects how your body functions. (Systemic inflammation is also considered to be the root cause of various chronic diseases, from diabetes to respiratory illnesses, metabolic dysfunction, and cardiovascular disease).

Having a “give up” mentality can also make you age faster. If you feel you’ll never be able to overcome medical conditions or improve your health, you are more likely to give up trying, which can lead to poor lifestyle choices that make you age faster. 

Over time, these factors can influence the rate of cellular retirement and telomere shortening, which accelerate the biological aging process.

Understanding The Difference Between Chronological Age And Biological Age

Your chronological age simply states how many days, months, or years you’ve lived – it does not provide any information regarding how well your body’s system functions, how old you are internally, or how likely you are to develop dementia or diabetes. It is truly just a number

On the other hand, you can think of biological age as depicting a comprehensive picture of your aging rate and body function, based on physiological evidence. According to studies, biological age can be used as a predictor of the onset of diseases associated with aging, including dementia, as well as other aging-related diseases.

How They Are Measured

Chronological age is very easy to calculate by looking at the passing of years and days – counting your biological age, on the other hand, can be more challenging and require specialized tests. 

Medical diagnostics today look at a wide range of indicators that describe several aspects of how your body is aging and may predict your disease risk. These “indicators” are known as biomarkers of aging, a concept initially introduced by Sprott et al in 1988

Over the past years, science has progressed in leaps and bounds and, today, doctors are able to use a wide range of more accurate predictors compared to the ones used in the 1980s. Thanks to advanced technologies, these indicators are also more accurately measured, offering precise estimations of a person’s biological age. 

Two of the main biological markers used today to determine internal age-related changes are telomere length and DNA methylation.

  • Telomere length

In simple terms, telomeres are cap-like structures at the end of our chromosomes that protect them against deterioration. They are composed of repetitive sequences of non-coding DNA that protect these chromosomes – just like the plastic tips on shoelaces protect from fraying. 

With each cell division, these telomeres get shorter. Once they become too short, the cell is unable to divide and becomes senescent (goes into cell retirement) or dies. Scientists have seen that telomeres get shorter as we age (i.e. as our chronological age increases). 

However, the rate at which they shorten is also determined by a wide range of factors, including lifestyle, environment, exposure to pollutants, stress, and inflammation. Because of this, telomeres are often considered to be our “biological clock.”

Over the past years, the global scientific community significantly focused on the implications of shortening telomeres. Some key research findings include:

  • 2019 study shows that short telomeres are linked to an increased risk of Alzheimer’s disease. 
  • 2021 systematic review shows that shortening telomeres are associated with increased disease duration, lower brain volumes (as per MRI scans), and a higher degree of disability among patients with multiple sclerosis. 
  • 2015 review shows that shorter telomeres significantly increase the risk of several psychiatric disorders. 
  • 2021 study shows that not only are shorter telomeres linked to an increased risk of cardiovascular disease, but in patients with coronary heart disease, they can also predict a higher risk of complications. 

The results of earlier studies are consistent in linking shorter telomeres with chronic illness, neurodegenerative disorders, shorter longevity, and earlier death. 

  • DNA methylation

To understand what DNA methylation is, it is important to consider DNA as something dynamic and able to change. In particular, not all genes in the DNA are “expressed” at any given time. Some of your genes may be switched “off,” while others are “on” (or are expressed) due to internal or external factors. 

For example, a certain gene that regulates inflammation in your body may have been functioning, or on, since your early days. Encountering chronic stress or adverse lifestyle changes later on in life can prompt the gene to shut down or turn off.

As a consequence, you may start to experience increased inflammation, which can make you suddenly more prone to frequent illness or even chronic diseases such as heart disease or diabetes. 

The process used by the DNA to turn genes on or off is known as methylation. This biological process involves the addition of a methyl group (CH3) to the DNA molecule. This modification doesn’t change the DNA sequence itself, but it may switch genes on or off, in a process known as gene regulation. 

Methylation patterns can change over time, and they are often influenced by age, lifestyle, environment, and disease state. It is estimated that the human genome contains 28 million methylation sites in the DNA, several of which change with age – making the DNA methylation rate an accurate predictor of biological age.

As we age, variations in DNA methylation become more frequent: the rate at which genes are regulated can increase in some areas of the body (e.g.: soft breast tissue, which has been seen to be as much as three years older compared to the rest of the body) while others decrease.

Connection to Health

Chronological age is commonly used as a risk factor to determine the level of risk for a range of diseases. For example, it’s widely accepted that adults aged 65 and older have a higher risk of diseases like cardiovascular disorders, diabetes, osteoarthritis, stroke, and cancer. 

It is easy to see why chronological age is used in determining disease risk instead of biological age: this figure is easily accessible to both patients and healthcare providers. For instance, when a patient turns 65, their doctor will encourage them to stick to routine screening tests and take preventative measures. 

However, there’s a caveat. 

Let’s look at a patient who is chronologically 55, but has a biological age of 65. Their risk of disease is much higher than their chronological age would suggest. 

As a result, they may not undergo screening tests or adopt lifestyle interventions that could modify their disease risk and protect them from complications. Left undetected, a higher biological age can make patients more prone to disease and disability as they age, which can kick-start a negative loop of chronic illness and add to the healthcare burden. 

Over time, this can lead to a snowball effect: not implementing the right lifestyle interventions can increase the rate at which you are aging, which can exponentially increase your disease risk, ultimately affecting your longevity and lifespan. 

It’s easier to think of biological age this way: your body doesn’t know how many birthdays you’ve celebrated, it only knows how well or badly your systems, organs, and tissues are aging internally. Consequently, it can act as the body of a younger or older person. 

If you are biologically 10 years younger than your chronological age, your body is likely to match the health and disease risk profile of your biological age, not your chronological age. This can impact how long you’ll live and, more importantly, how many years you can live without disability or chronic illness.

Does Chronological Aging Intersect With Biological Aging?

Chronological age does not directly impact biological processes – rather, it gives us an indication of how old we are at any given point in life and what to expect from our health. For example, according to the Centers for Disease Control and Prevention, most breast cancer cases are diagnosed after the age of 50. 

So, if you are approaching this milestone, you may wish to undergo screening tests for early detection. 

Nonetheless, as we have seen above, your chronological age does not paint the full picture. For example, due to poor lifestyle choices and environmental factors, you may be aged 40, but have the same breast cancer risk level as a 50-year-old. 

Chronological age intersects with biological age because, ultimately, as time passes, the state of our tissues, organs, and systems begins to decline. But the rate at which this happens is better outlined by biological age, which describes the rate of cellular retirement. 

In turn, by halting cell division, cellular retirement determines how well the body’s tissue, organs, and systems function, and at what rate their function declines. Functional decline can affect the internal part of your body – such as organs and tissues – but it can also manifest with visible signs, such as reduced energy and mobility, skin changes, and memory problems.

Do We Define Ourselves by Chronological or Biological Age?

Above, we’ve looked at the fact that chronological age is just a number, which doesn’t necessarily describe how well the body is doing internally. So, why do we let it define us? 

There are several reasons for this:

  • Mindset

Our mindset plays a vital role in helping us control the rate at which we age. When we have a positive mindset, we are able to find purpose in life and stick to healthy lifestyle choices. For example, if you feel more energized and determined to stay healthy, you will find it easier to exercise regularly, eat healthy meals, and socialize. 

On the other hand, if you are plagued by chronic illnesses and declining mental health, you are more likely to experience depression, social isolation, a sedentary life, and diseases like diabetes, obesity, and cardiovascular disorders – which further aggravate the picture. 

Our mindset can also be influenced by our assumptions. Some people get ill just after celebrating their 60th birthday, simply because they now believe they are “old.” 

Similarly, if you are in your 60s or 70s, experience declining health, and see yourself as old, you are more likely to think “I’m getting old, my health can only get worse – so, why try?” Think of this as a self-fulfilling prophecy.

These are boundaries that we set in place and dare not cross. But they are just that: self-limitations. Research confirms that even simply thinking that you are young and can improve your health can have a profound impact on your life. 

In a 1979 study by Ellen Langer – known as the “Counterclockwise” experiment – a group of older adults was asked to spend five days in a retreat and live as if they were 20 years younger. 

The results? Better hearing, memory, grip strength, vision, joint flexibility, manual dexterity, IQ, gait, and posture. The participants also experienced lower arthritis pain levels and appeared significantly younger after the retreat.

  • Ageism and societal views

Besides our own mindset, external factors such as societal views and stereotypes associated with aging can also cause us to define ourselves by our age. Ageism can negatively impact a person’s quality of life, self-esteem, and health outcomes. 

In practice, when people are perceived as old, they begin to act as old. They may begin to rely more and more on caretakers and cultivate feelings of hopelessness. This can cause them to take actions such as going into retirement or interrupting hobbies, which, in turn, inhibits their productivity, contribution to society, life purpose, social life, and mental and physical health. 

Not only does this place excessive strain on a person’s well-being, but it can also contribute to the burden placed on their families, healthcare system, and pension scheme.

Why Is Knowing Your Biological Age Important?

Knowing what your biological age is compared to your chronological age can help you plan interventions and lifestyle modifications to ultimately improve your disease risk profile, increase longevity and healthspan, and boost overall wellness. 

Knowing that you can modify your biological age is also important to rebuild your mindset and prevent your chronological age from defining you.

Early Detection Of Health Risks

Understanding your biological age provides invaluable health insights – it can work as a barometer that indicates your susceptibility to diseases before symptoms appear. 

Knowing your level of risk can help you seek early intervention and medical advice, reducing the severity or even preventing conditions commonly related to age, from dementia to diabetes. By tackling your risk of disease early on, you can extend your healthspan and longevity.

Targeted Anti-Aging Strategies

Consider your biological age as a starting point to seek effective anti-aging interventions that will, in time, help you control your biological age and rate of aging. The goals of these strategies are to:

  • Increase telomere length or reduce the rate at which they are shortening
  • Support DNA methylation
  • Support the healing and regeneration of damaged cells and tissues
  • Boost the body’s ability to heal naturally 
  • Improve mental and physical health 

Quantifiable Progress Tracking

Tracking your biological age offers objective measurements of health progress – more so than just tracking your chronological age. This data can help you better understand how different lifestyle modifications, medications, interventions, or therapies impact your health. 

Therefore, it helps to make informed decisions and adjustments, leading to better, more sustainable health outcomes.

Can Aging be Reversed?

Above, you’ve learned that biological age can be modified. With the right interventions, you can not only slow down the rate of aging but also reverse it. 

Although these interventions should be planned by a specialist around your unique goals and needs, some key anti-aging strategies include:

  • Exercise. Not only does exercise help improve physical strength, flexibility, pulmonary capacity, and cardiovascular health, but it has also been seen to help preserve telomere length as we age. 
  • Nutrition. Eating a Mediterranean diet has been seen to be the optimal choice to support telomere length and reduce mortality from age-related diseases. This is because it is rich in legumes, nuts, fruits, vegetables, mostly unrefined grains, and a high intake of unsaturated lipids (e.g.: olive oil). Oppositely, alcohol, red meat, or processed meat have been associated with telomere shortening. 
  • Sleep. A 2023 review of 22 studies shows a clear link between good sleep quality and duration and optimal telomere length. 
  • Stress management. A review published in 2022 shows that chronic psychological stress is a major contributor to aging. Stress is also linked to a range of age-related diseases, including cardiovascular disease, type 2 diabetes, metabolic syndrome, autoimmune diseases, and depression.
  • Environmental adjustments. Environmental contributors can impact aging in multiple ways. A stressful environment can lead to chronic stress and impact sleep and nutrition. Furthermore, in vitro clinical trials have shown that significant alterations take place in the length of the telomeres after exposure to pollutants and toxins. 
  • Anti-aging treatments. Anti-aging treatments span from caloric restriction to nutraceuticals and hormone replacement therapy (HRT). Certain stem cell and platelet-rich plasma therapies may also help replenish the reserves of stem cells and growth factors in aging adults, to support the ability of the body to heal naturally. These interventions can help re-establish balance in bodily systems affected by aging.
  • SupplementsSupplements such as those combined in the RELATYV formula – including NAD+, curcumin, resveratrol, glutathione, and NAC – can offer important anti-aging properties. 

For example, NAD+ (nicotinamide adenine dinucleotide) plays a critical role in energy metabolism and the reduction of oxidative stress. Polyphenol like resveratrol can help reduce the risk of cardiovascular diseases, while collagen provides support, elasticity, and strength to tissues and organs. 

Ultimately, getting to know and monitoring your biological age can help you make better-informed decisions about your health and allow you to extend the number of years lived – and the ones lived without disability and disease! 

What RELATYV does is put you back in control. Starting with an accurate biological age test, you’ll be able to better understand how your body is aging. Your RELATYV age is a measure obtained by comparing your biological age to your chronological age. This figure combines the best of both worlds: just like chronological age, it is very easy to quantify – but it is also as accurate and modifiable as your biological age. 

The RELATYV platform can calculate your RELATYV age using an advanced algorithm, which elaborates critical health data – from your medical records to performance indicators. Equipped with this knowledge, you’ll be able to start planning and introducing anti-aging interventions guided by a team of specialists. 

As you implement custom interventions and recommendations for longevity and wellness, you can monitor changes in your biological age, thus reducing your disease profile risk and increasing your healthspan.

Slow Down The Ticking Clock With Us

Too often, we let our chronological age define us, our achievements, our health, and our productivity. But the adage “age is just a number” could not be more true when we are talking about chronological age. 

Instead of surrendering to an aging mind and body, you can now take control of your health – starting by understanding what your biological age is. Monitoring this figure and taking steps to reduce your biological age can help you feel younger and act younger, while also reducing the risk of disability and boosting your longevity.

About the AuthorAbout the Author

Will is a healthcare executive, innovator, entrepreneur, inventor, and writer with a wide range of experience in the medical field. Will has multiple degrees in a wide range of subjects that give depth to his capability as an entrepreneur and capacity to operate as an innovative healthcare executive.

Will is a healthcare executive, innovator, entrepreneur, inventor, and writer with a wide range of experience in the medical field. Will has multiple degrees in a wide range of subjects that give depth to his capability as an entrepreneur and capacity to operate as an innovative healthcare executive.



Age: Why Knowing The Difference Matters

Monday, 19 August 2024

On high alert over mpox, Malaysia; Indonesia advises sick travellers to discontinue visit; China implements measures to prevent mpox at ports

 


Malaysian authorities are stepping up surveillance at international entry points. PHOTO: REUTERS



PETALING JAYA: Although no new mpox cases have been reported in Malaysia so far this year, the Health Ministry says it is ramping up surveillance and advocacy activities after the World Health Organisation (WHO) issued its highest alert.

The ministry said Malaysian authorities are stepping up surveillance at international entry points and all travellers from countries that have reported mpox cases are required to monitor their health status, including symptoms for 21 days after their arrival in Malaysia.

It also advised people with a history of risky activities or who have symptoms such as rashes and blisters to seek treatment at the nearest health facility immediately and avoid contact with other people to prevent the spread of the virus.

Healthcare personnel at public and private facilities are also required to notify suspected and confirmed cases to their nearest district health office to ensure that prevention and control measures can be implemented.

The ministry also assured the public that there are enough labs for testing and diagnostics.

There are 10 labs, including two private labs, with the capability to conduct PCR (polymerase chain reaction) tests to confirm any diagnosis.

The ministry is also increasing awareness activities by distributing materials to high-risk groups and locations, such as spas and saunas.

It said premises offering services that involve skin-to-skin contact with customers such as the aforementioned must always ensure that hygiene is maintained and their employees as well as customers are not experiencing symptoms such as blisters or rashes.

“If an employee or customer experiences symptoms, they should immediately seek medical attention,” the ministry said in a statement yesterday.

It added that it will continue to work with other government agencies and non-government agencies including public hospitals and private hospitals to monitor, detect and treat mpox cases.

It will also continue to monitor the situation within and outside the country.

WHO had declared mpox, previously known as monkeypox, a Public Health Emergency of International Concern (PHEIC) for the second time on Aug 14.

The first PHEIC was declared on July 23, 2022, and ended on May 11, 2023.

“The second declaration was made based on the advice of the IHR (International Health Regulations) Emergency Committee given the spread of the new mpox strain known as clade 1b, which is spreading fast in the Democratic Republic of Congo and neighbouring African countries,” it said.

“The increase in cases in Congo is quite significant with 15,600 cases and 537 deaths reported in 2024, which is higher than the year prior.

“Apart from that, four countries in East Africa, namely Burundi, Kenya, Rwanda and Uganda, reported mpox cases for the first time,” it added.

Malaysia has recorded nine mpox cases to date since the first case was detected on July 26, 2023, including a case recorded in November that year.

The Health Ministry said all the cases reported had a history of high-risk activities and had recovered with no deaths reported.

Commenting on the latest development, Prof Dr Sharifa Ezat Wan Puteh, a health economics and public health specialist with Universiti Kebangsaan Malaysia’s Faculty of Medicine, said those who had sexual encounters with partners from countries where there are mpox cases, including places where the disease is endemic, should be monitored.

“It can also spread from infected pregnant women to their unborn children.

“Those travelling out to infected countries, especially the United States and African countries, need to be mindful of the risk of contact and infection during sexual activities,” she said.

A total of 99,176 mpox cases, including 208 deaths, were reported worldwide from Jan 1, 2022 to June 30, 2024.- THE STAR/ASIA NEWS NETWORK

China implements measures to prevent mpox at ports

China's General Administration of Customs (GAC) has issued a notice that it will tighten surveillance at ports of entry to prevent the spread of mpox in China, after the World Health Organization (WHO) declared on Wednesday that the mpox outbreak constitutes a public health emergency of international concern.

People coming from countries and regions affected by mpox outbreak, who have been exposed to mpox or have symptoms such as fever, headache, back pain, muscle pain, swollen lymph nodes and rashes, should declare their conditions to customs upon entry. Customs officials will take medical measures and conduct sampling tests according to prescribed procedures, the GAC said.

Transport vehicles, containers, goods, and items from countries or regions affected by the outbreak and potentially contaminated should undergo sanitary treatment according to prescribed procedures, the GAC noted.

The measures took effect immediately upon announcement on Thursday, and will be valid for six months, according to the GAC.

According to the Africa centers for disease control and prevention data on August 9, 13 countries in Africa have reported 17,541 cases of mpox, with 517 deaths. 

China has effective capabilities to respond to the potential risks of the spread of mpox, Lu Hongzhou, head of the Third People's Hospital of Shenzhen, told the Global Times on Friday. 

To prevent the spread of mpox, Lu suggested that people should avoid sexual contact with individuals of unknown health status, and stay informed about mpox outbreaks in destination countries and regions when traveling. Lu added that people should avoid coming in contact with animals such as rodents and primates that may carry the virus

WHO calls for efforts to rein in mpox spread
Domestic vaccine undergoing clinical trials: experts
Monkeypox virus particles under a microscope made available by the Centers for Disease Control and Prevention  Photo: VCG

Monkeypox virus particles under a microscope Photo: VCG


Domestic mpox vaccines have not hit the market but research institutions in China have been carrying out clinical trials, Chinese experts said on Monday as the World Health Organization (WHO) declared the mpox surge a public health emergency of international concern - its highest alert level and urged manufacturers to ramp up vaccine production to rein in the spread of a more dangerous strain of the virus.

The WHO urged pharmaceutical firms to ramp up vaccine production on August 16 local time after it warned of the rapid spread of the new Clade 1b variant, a more deadly mpox strain, from the Democratic Republic of Congo (DRC) to other African countries. 

Meanwhile, the Stockholm-based European Centre for Disease Prevention and Control (ECDC) on Friday raised its risk level for mpox to "moderate" from "low," a day after global health officials confirmed the first infection caused by a new strain of the virus outside Africa, in Sweden, which was followed by more sporadic cases appearing in the EU, with the overall risk to the population having gone up from "very low" to "low," Reuters reported on Friday. 

WHO spokeswoman Margaret Harris urged manufacturers to scale up mpox production, according to a report from Agence France-Presse (AFP) on August 17. The WHO also asked countries with mpox vaccine stockpiles to donate them to countries with ongoing outbreaks, according to the AFP. 

According to Lu Hongzhou, head of the Third People's Hospital of Shenzhen, there is currently no domestic mpox vaccine available in the Chinese mainland, whereas research and preparations are underway, and relevant clinical trials have been promptly carried out. 

In July of 2023, the replication-deficient mpox vaccine developed by the China National Pharmaceutical Group Corporation (Sinopharm) and Chinese Center for Disease Control and Prevention passed the clinical trial application phase with the National Medical Products Administration, making it the earliest domestically developed mpox vaccine to enter the clinical research stage in China. 

However, due to the small number of mpox cases across the country and a dispersed population, it is difficult to conduct large-scale clinical studies on the vaccine's efficacy. Additionally, the risks and challenges of such studies are significant, making the development of an mpox vaccine face numerous challenges, Su Jinfeng, a senior biomedical engineer, said in an interview with the Global Times previously. 

During the last mpox epidemic on the Chinese mainland, the first imported mpox case was discovered in September 2022 and the first local infection was reported in June 2023. In the following three months between June and August, over 1,000 local confirmed cases were reported across more than 20 provinces across the country, which was triggered by local secondary outbreaks and covert transmission, according to The Beijing News. 

On September 20, 2023, mpox was classified as a Category B infectious disease under China's infectious disease control law while China's National Health Commission stated that the mpox epidemic would continue to exist within the country for a certain period of time. 

Since the beginning of this year, a total of 357 cases of mpox were reported nationwide as of this June, with no related deaths reported, according to the National Disease Control and Prevention Administration.

Lu said that based on the current prevention and control measures and the domestic epidemic monitoring situation, there is a relatively low possibility of a surge in mpox infections in the Chinese mainland. 

China's General Administration of Customs announced on Friday that it would begin screening people and goods entering the country for mpox over the next six months. People arriving from countries where outbreaks have occurred, who have been in contact with mpox cases, or display symptoms should declare this information to customs authorities when entering the country, adding that vehicles, containers, and items from areas with mpox cases should be sanitized. 

According to Lu, the mpox virus strain currently circulating on the Chinese mainland belongs to the lineage C.1.1 under the Clade IIb strain, which caused the global outbreak of mpox between 2022 and 2023. Considering peak travel season and the frequent international exchanges, the risk of cross-border transmission of the mpox virus may increase. 

However, the mpox virus is primarily transmitted through prolonged close contact, such as sexual activities, skin-to-skin contact, and close-distance breathing or conversations between people, Lu told the Global Times on Monday, noting that its ability to spread between people is relatively weak. 

Meanwhile, many people aged 40 and above in the Chinese mainland have already been inoculated with smallpox vaccines, the administration of which, Lu said, has an efficacy of 85 percent in preventing mpox. 

Given China's current strict border control and epidemic prevention measures, it is difficult for new cases to spread to the country from overseas. Therefore, the likelihood of a rapid increase in infections in the Chinese mainland like that back in 2023 is relatively low based on the current prevention and control measures and domestic epidemic monitoring, Lu said. 

Aside from vaccination, treatments of mpox mainly consist of supportive care and the treatment of complications. Currently, antiviral drugs used in the treatment of mpox include cidofovir, brincidofovir, and tecovirimat. Additionally, ongoing clinical trials of a series of small molecule drugs for mpox have also found that some medicines at lower doses can specifically inhibit the replication of the mpox virus. - By GT staff reporters

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