#18,298
A month ago the WHO declared the Mpox outbreak in Central Africa to constitute a PHEIC (Public Health Emergency of International Concern) after reports that a recently emerged clade (Ib) of the virus began to spread outside of the DRC (see More African Nations Reporting Mpox - Africa CDC Mpox Update (Jul 30th)).
Complicating matters, there are now 4 distinct clades of Mpox circulating in Africa (see map below), with Clade II and IIb considered the mildest, and Clade I and Ib considered more severe. Laboratory testing, however, remains quite limited in many of these regions.
Disappointingly, last month another pharmaceutical option, the Tecovirimat (TPOXX) Mpox Antiviral - was found to be ineffective against clade I mpox in an NIH Trial.
Yesterday the WHO released their first SitRep (#36) since the declaration of a PHEIC (see below). The highlights from this 18-page document follow, but you'll want to download and read the full report.
Mpox Multi-country External Situation Report n. 36, published 14 September 2024
Highlights
• On 14 August 2024, the WHO Director-General declared the resurgence of mpox to be a public health emergency of international concern (PHEIC), requiring a coordinated international response.
• This report focuses on the reporting period 1 January – 8 September 2024, as the latest complete epidemiological week, for the African continent. Global updates will be included once a month.
• The number of suspected and confirmed mpox cases reported in Africa in 2024 continues to increase. The most affected countries currently are the Democratic Republic of the Congo and Burundi.
• Testing coverage in the Democratic Republic of the Congo remains low, due to limited testing capacity, and the number of suspected cases is around five times the number of laboratory-confirmed ones.
• Mpox case fatality ratio in the Democratic Republic of the Congo in 2024 is 0.5% among confirmed cases (25 deaths out of 5160 cases) and 3.3% among suspected cases (717 deaths among 21 835 cases).
• In Africa, the two monkeypox virus (MPXV) clades and their subclades circulate in different geographic areas and affecting different populations, therefore need tailored and locally-adapted outbreak responses.
• Clade Ib, in circulation for approximately one year, has been associated with sustained human-to-human transmission and a rising trend in reported cases in eastern Democratic Republic of the Congo. Clade Ib is also causing an ongoing outbreak in Burundi.
• Although genomic sequencing capacity is limited, clade Ib appears to be the predominant strain in the North and South Kivu provinces of the Democratic Republic of the Congo, Burundi, Rwanda, Kenya, and Uganda, and has been confirmed in imported cases in Sweden and Thailand, one case in each county.
• This report presents an overview of the epidemiological situation in three countries that have national declarations of mpox outbreaks (Democratic Republic of the Congo, Burundi and Central African Republic). Future reports will include overviews from more countries.
• Comprehensive global, continental and national planning to address the mpox situation are underway.
• This report also includes two brief special focus sections providing updates on laboratory testing for clade Ib MPXV and the current global situation regarding vaccine availability and distribution.
• WHO has announced on 13 September the prequalification of MVA-BN vaccine, the first vaccine against mpox to be prequalified.
1 The slight differences in case counts, deaths and countries affected between this report and the regional mpox bulletin produced by the WHO Regional Office for Africa are explained by the different reporting periods of each report. Please find the latest regional mpox bulletin in the following link: Regional Mpox Bulletin: 6 September 2024 | WHO | Regional Office for Africa
2 In some countries, suspected cases that undergo testing are not removed from the overall count of suspected cases, regardless of whether the test result is positive (confirmed case) or negative (discarded case).
