Situation Report: Mpox Spreads in Africa

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Clade I Mpox Outbreak in the DRC

The Democratic Republic of the Congo (DRC) is currently facing its largest outbreak of clade I monkeypox virus (MPXV) on record. Since January 2023, over 22,000 suspected cases and more than 1,200 suspected deaths have been reported, marking a significant increase compared to previous years. The outbreak has affected all provinces of the DRC, including regions like the capital city Kinshasa, where clade I mpox cases are not typically seen.

Outbreak Spread to Neighboring Countries

The outbreak has spread to neighboring countries, including the Republic of the Congo, Central African Republic, Burundi, Rwanda, and Uganda, with confirmed or presumed cases linked to the DRC. While clade I MPXV is endemic to the DRC, the widespread transmission occurring in this outbreak and spread to neighboring countries is unusual and highlights the need for heightened surveillance and preparedness.

Clade I MPXV More Transmissible and Severe

Clade I MPXV, endemic to the DRC, is known for being more transmissible and causing more severe infections compared to clade II MPXV, which led to the global mpox outbreak in 2022. Transmission can occur through contact with infected individuals, animals, or contaminated materials, with high rates of infection observed among children, as well as individuals involved in sexual contact or patient care without appropriate protective measures.

Guidance for Health Care Providers

Health care providers should remain vigilant for mpox in patients with signs symptoms and symptoms consistent with mpox and recent travel history to the DRC or neighboring countries. Clinicians are advised to follow CDC guidelines on infection prevention and control, including appropriate specimen collection and coordination with local public health departments for testing. Though no cases of clade I mpox have been reported outside central and eastern Africa, the CDC emphasizes the importance of preparedness and early detection to prevent further spread.

The CDC continues to monitor the situation and recommends mpox vaccination for those at risk, particularly travelers to affected areas. The United States has robust testing capabilities for MPXV, including clade-specific testing, to support ongoing surveillance efforts. The CDC also advises public health departments and laboratories to follow specific guidelines for reporting and testing mpox cases, ensuring timely and accurate identification of the virus.

This update was drawn from the Centers for Disease Control and Prevention (CDC) Health Alert Network (HAN) Health Update (CDC, https://emergency.cdc.gov/han/2024/han00513.asp, Accessed 8/8/2024) about the outbreak of MPXV in the DRC issued on August 7, 2024.

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