This is the 42nd situation report for the multi-country outbreak of mpox, which provides an update on the epidemiological situation of mpox in Africa (including countries in the WHO African Region and some countries in the WHO Eastern Mediterranean Region), with data as of 3 November 2024.
Mpox is a zoonotic disease caused by a double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family. The disease presents with symptoms similar to smallpox but with a lesser severity. It was first discovered in 1958 when two outbreaks of a poxlike disease occurred in co...lonies of monkeys kept for research, hence the name ‘mpox. The first human case of mpox was recorded in 1970 in the Democratic Republic of the Congo (DRC), which has subsequently spread to other central and western African countries. There are two known clades of the virus: clade I and clade II. Clade I, which is most frequently reported from countries in Central Africa, tends to be more severe than clade II. Cameroon is the only country known to harbour both clades.
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On August 13, 2024, the Africa CDC declared the mpox outbreak a Public Health Emergency of Continental Security (PHECS). The following day, the WHO declared it a Public Health Emergency of International Concern (PHEIC). A coordinated, continent-wide response is essential, co-led by the African Union... (AU) through the Africa CDC and the World Health Organization (WHO), in close collaboration with global partners working under a unified plan, budget, and monitoring framework.
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The Global Strategic Preparedness and Response Plan (SPRP) for mpox, covering the six-month period from September 2024 to February 2025, provides a framework for public health preparedness and response to the mpox emergency. The current draft, subject to Member State input, outlines the urgent actio...ns needed at global, regional, and national levels.
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WHO Director-General Dr Tedros Adhanom Ghebreyesus has determined that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005...) (IHR). Dr Tedros’s declaration came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data presented by experts from WHO and affected countries. The Committee informed the Director-General that it considers the upsurge of mpox to be a PHEIC, with potential to spread further across countries in Africa and possibly outside the continent.
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The monkeypox virus (MPXV) clade I epidemic that has been affecting the Democratic Republic of the Congo
(DRC) since November 2023 has recently spread to several other African countries including Burundi, Rwanda,
Uganda and Kenya. The size of these outbreaks could be larger than reported due to un...der-ascertainment and
under-reporting.
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WHO needs US$ 87.4 million over 6 months, from September 2024 to February 2025, to work with countries, partners and other stakeholders to stop and contain the current outbreak of mpox.
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On 14 August 2024, the Director-General of the World Health Organization (WHO) determined that the resurgence of Mpox in the Democratic Republic of Congo (DRC) and a growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC). Te...mporary recommendations are being developed with input from the International Health Regulations Emergency Committee and will be available in the coming days.
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Le Directeur général de l’OMS, le Dr Tedros Adhanom Ghebreyesus, a estimé que la recrudescence de variole simienne (mpox) en République démocratique du Congo (RDC) et dans un nombre croissant de pays d’Afrique constituait une urgence de santé publique de portée internationale (USPPI) au t...itre du Règlement sanitaire international (2005) (RSI).
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Given the circulation of the variant of clade I of mpox virus (MPXV) in the African Region, which is associated in the African Region with sustained transmission and the occurrence of cases in a wider range of age groups, including children, the Pan American Health Organization/World Health Organiza...tion (PAHO/WHO) encourages Member States to remain vigilant to the possibility of introduction of this variant in the Americas, and to continue their surveillance efforts, including genomic sequencing of detected cases, with special emphasis on high-risk groups.
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On 13 August 2024, Africa Centres for Disease Control and Prevention (Africa CDC) declared the ongoing Mpox outbreak a Public Health Emergency of Continental Security (PHECS). This was followed the next day by the World Health Organization (WHO), which extended the alert internationally as a public ...health emergency of international concern (PHEIC). After these declarations, many countries have made efforts to mobilize resources to introduce or expand laboratory testing, surveillance, and response activities. In particular, as the number of suspected cases surges in the Democratic Republic of Congo (DRC), Burundi, and the Central African Republic, and an increasing number of new countries report cases, there is an urgent need to implement testing to strengthen the Mpox response. However, access to appropriate quality assured diagnostics is a challenge. There is limited information on important characteristics, such as available test kits’ performance and ability to detect relevant clades.
To address the challenge of mpox access in the continent, the Africa CDC Diagnostic Advisory Committee (DAC) met in Kigali from 19-23 August 2024 to review the available evidence on molecular tests for Mpox and to shortlist tests that may be useful for Mpox testing in countries. The shortlist aims to provide guidance to Africa CDC, countries and partners on appropriate high-quality molecular tests to procure and use for the mpox response.
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En décembre 2022, la République démocratique du Congo a déclaré une flambée nationale de variole simienne. Un système de gestion des incidents est en place depuis février 2023, compte tenu du nombre croissant de cas signalés. Depuis septembre 2023, l’épidémie de variole simienne continu...e de se propager dans la province du Sud-Kivu, ainsi que, plus récemment, dans la province voisine du Nord-Kivu, du fait de la transmission par contact sexuel
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i. A person who is a contact of a probable or confirmed mpox case in the 21 days before the onset of signs or symptoms, and who presents with any of the following: acute onset of fever (>38.5°C), headache, myalgia (muscle pain/body aches), back pain, profound weakness or fatigue.
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ii. A per...son presenting since 01 January 2022 with an unexplained acute skin rash, mucosal lesions or lymphadenopathy (swollen lymph nodes). The skin rash may include single or multiple lesions in the ano-genital region or elsewhere on the body. Mucosal lesions may include single or multiple oral, conjunctival, urethral, penile, vaginal, or ano-rectal lesions. Ano-rectal lesions can also manifest as ano-rectal inflammation (proctitis), pain and/or bleeding.
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for which the following common causes of acute rash or skin lesions do not fully explain the clinical picture: varicella zoster, herpes zoster, measles, herpes simplex, bacterial skin infections, disseminated gonococcus infection, primary or secondary syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, allergic reaction (e.g., to plants); and any other locally relevant common causes of papular or vesicular rash.
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