Credit Africa CDC
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Earlier this week, in ECDC Risk Statement On Mpox As Cases Continue to Spread In Africa, we looked at the increasing spread of (both clade I & clade II) Mpox across endemic regions of central Africa (see map above), and feared incursions into neighboring countries.
In the past few days both Kenya in east Africa, and Côte d'Ivoire in west Africa, have reported cases, raising further concerns that the virus is gaining territory.
The Central African Republic (CAR) has also declared an outbreak after cases - which are normally reported from more rural regions - have been reported in their capital; Bangui.
Complicating matters even further, we've seen reports for the better part of a year on a new variant of the virus - dubbed clade Ib - which is spreading in the DRC (see Preprint: Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo).
While this new clade has not been confirmed outside of central Africa, it appears to be more easily transmissible and more severe, sparking a number of recent risk assessments, including:
CDC HAN Advisory #00501: Mpox Caused by H-2-H Transmission with Geographic Spread in the Democratic Republic of the Congo
Current Situation
Mpox in Africa: Since the beginning of 2022 and as of 28 July 2024, a total of 37,583 cases and 1,451 deaths (case fatality rate [CFR]: 3.9%) of mpox have been reported from 15 African Union Member States (AU MS): Benin, Burundi, Cameroon, Central Africa Republic (CAR), Congo, Democratic Republic of Congo (DRC), Egypt, Ghana, Liberia, Morocco, Mozambique, Nigeria, Rwanda, Sudan and South Africa (see table 1).
In 2023 alone, 14,957 cases and 739 deaths (CFR: 4.9%) were reported from seven AUMS. This is a 78.5% increase in the number of new cases compared to 2022.
Since the beginning of this year and as of 28 July 2024 a total of 14,250 cases (2,745 confirmed; 11,505 suspected) and 456 deaths (CFR: 3.2%) of mpox have been reported from 10 AU MS: Burundi (8 cases; 0 deaths), Cameroon (35; 2), CAR (213; 0), Congo (146; 1), DRC (13,791; 450), Ghana (4; 0), Liberia (5; 0), Nigeria (24; 0), Rwanda (2; 0) and South Africa (22; 3).
This represents a 160% and 19% increase in the number of cases and deaths respectively in 2024 compared to the same period in 2023. DRC accounts for 96.3% of all cases and 97% of all deaths reported this year. In addition, Chad has reported 24 suspected cases and no confirmed case this year.
Two days ago the Health Ministry of Côte d'Ivoire issued the following communique announcing 2 recent cases of Mpox. Since the the local press is reporting 4 more (n=6).
COMMUNICATED
SUBJECT: DETECTION OF CONFIRMED CASES OF MONKEYPOX IN IVORY COAST
Two confirmed non-fatal cases of Monkeypox or Monkeypox were recorded in July 2024 respectively in the districts of Tabou and Koumassi in Abidjan.
The first case is a 46-year-old patient, a farm worker resident in Lboké in Tabou who consulted the Lboké V2 health center on July 1, 2024 for fever, headache and rash. The second case, a 20-year-old student living in Koumassi Campement in Abidjan, presented skin and oral mucosa rashes on July 14. The diagnosis of Monkey Pox was established after the analysis of biological samples carried out by the Pasteur Institutes of Abidjan and Dakar.
In accordance with the International Health Regulations, notification was made to the Organization World Health. Monkeypox or monkeypox virus infection is a viral infectious disease. It is transmitted by contact with the blood or bodily fluids of people or
of infected animals. The detection of confirmed cases of Monkeypox in Côte d'Ivoire requires the implementation of rigorous public health measures to prevent the spread of the disease. It is why the government has taken the following measures:
- Activation of the Public Health Emergency Operations Center (COUSP);
- Strengthening epidemiological surveillance in all health establishments for the early detection of suspected cases;
- Information and awareness of populations on disease prevention measures;
- Free care for patients;
- Strengthening infection prevention and control measures in health establishments;
- Development of a multi-sectoral plan to combat monkeypox.
(Continue . . . )
Yesterday, Agence Ivoirenne de Press (and others) reported 4 more cases in Yopougon health district in Abidjan. Meanwhile Kenya has gone on alert after a passenger - transiting Kenya while traveling from Uganda to Rwanda - was detected with Mpox.
But as our collective immunity from the smallpox vaccine - which was discontinued in the late 1970s - dwindles, there are increased opportunities for pox viruses to make a comeback.
As they spread from host-to-host, additional evolutionary changes seem likely (see Evolution of monkeypox virus from 2017 to 2022: In the light of point mutations).
