In August 2024 WHO shared a disease outbreak update on the mpox situation in Africa, presenting information on the latest countries that are reporting cases. The outbreak was declared a PHEIC by WHO and PHECS by Africa CDC, prompting efforts to secure vaccines for the continent. In the update, WHO states that epidemiological data reveal that clade Ib has been spreading “rapidly” through close physical contact; this includes sexual contact identified within “networks of sex workers and their clients”. However, the affected groups are changing as the virus spreads.
Newly affected countries
The following countries are the latest in the African Region to report cases of mpox, either clade I or clade II, since the multi-country outbreak began in 2022.
- Burundi – an outbreak was declared on 25th July 2024 after confirmation of three cases. These are the first confirmed mpox cases identified in Burundi. By 17th August, there were 545 alerts of mpox cases, of which 474 suspected cases were investigated and validated. Of 358 suspected cases tested, 142 tested positive for MPXV and genomic sequencing analysis has confirmed clade Ib. No deaths had been reported as of 17th August. Confirmed cases were reported from 26 of 49 districts. Males account for 55.6% of cases and females 44.4%. Children under 5 years were 60.3% of cases, followed by those aged 11 to 20 (42.6%) and those aged 21 to 30 (38.2%).
- Kenya – on 29th July a confirmed case of mpox was identified in Taita Taveta County; the patient is a 42-year-old male with a history of travel from Uganda to Kenya. At the time of identification, he was travelling to Rwanda through Tanzania. By 13th August, a total of 14 suspected cases had been identified; one case tested positive for MPXV clade Ib. 12 of the suspected cases tested negative with one outstanding result. No deaths had been reported as of 13th August. This is the first mpox case identified in Kenya.
- Rwanda – on 24th July WHO was notified of two laboratory-confirmed mpox cases and an outbreak was declared on 27th July. The cases included a 33-year-old female and a 34-year-old male, both with travel history to the Democratic Republic of the Congo. They are the first confirmed mpox cases identified in Rwanda. By 7th August, four confirmed mpox cases and zero deaths had been reported with close contacts of the cases under follow up. Sequencing analysis confirmed MPXV clade Ib.
- Uganda – after enhanced surveillance for mpox disease was initiated in June and early July in response to reported cases in the Democratic Republic of the Congo, six suspected cases were identified on 11th July. Two samples tested positive for MPXV clade Ib on 15th July. These are the first mpox cases identified in the country, but investigations suggest that transmission occurred outside Uganda. By 12th August, 39 suspected cases had been reported. No deaths have been reported.
- Côte d’Ivoire – in July 2024, Côte d’Ivoire confirmed two non-fatal cases of mpox with no epidemiological link. By 7th August, seven mpox cases had been confirmed in three health districts. Four of the confirmed cases (57%) are male, and all seven cases are above 15 years old. Forty contacts are being followed up. Although the country has previously reported mpox, no cases had been notified since the start of the multi-country outbreak in 2022. The latest cases belong to clade II.
Risk of outbreak evolution
WHO assessed the risk of mpox separately; the risk in the eastern Democratic Republic of the Congo and neighbouring countries is “high” and in Côte d’Ivoire and other West African countries it is “moderate”. However, there is “concern” that the outbreak in Africa will continue to evolve as:
- There is evidence of possible under-detection and under-reporting.
- Although governments have activated emergency responses, resources to respond remain limited in some countries.
- Measures to support adequate patient care and introduce vaccines for people at risk are not currently in place in most countries. Acquisition and roll-out will require time before implementation.
- Some of the countries have not reported mpox before, which means public awareness and knowledge and capacity for identifying the disease remains limited.
- The global multi-country outbreak of mpox is ongoing. Countries outside Africa are still detecting sporadic cases and the unprecedented increase of cases in the African Region increases the risk of further transmission.
To join colleagues in considering the role of vaccines in better outbreak preparedness and response at the Congress in Barcelona, get your tickets here, and don’t forget to subscribe to our weekly newsletters for the latest infectious disease updates.
