Mpox cases rise in handful of Africa’s outbreak countries

Though cases are falling in two of the region’s high-burden countries, officials from the Africa Centres for Disease Control and Prevention (Africa CDC) are tracking rises in several other nations, including Burundi, Uganda, Ghana, Kenya, Liberia, and Guinea, a top official said today.

At the agency’s weekly briefing, Yap Boum, PhD, MPH, deputy incident manager for Africa CDC’s mpox response, said 23 African countries have reported outbreaks this year, and 18 of them are still active. He emphasized that outbreak dynamics vary by country, reflecting differences in clades, affected populations, outbreak measures, and health behaviors. 

Cases have been steadily declining in Sierra Leone—where community healthcare workers are making headway with contact tracing and vaccination—and in the Democratic Republic of the Congo (DRC). Boum added that health workers in several countries face the challenge of measles outbreaks occurring alongside mpox circulation, with diseases initially having similar symptoms. Infections in the DRC, Uganda, and Sierra Leone made up 74% of all cases in Africa last week, a proportion that has dropped as cases rise in other affected nations.

He said Sierra Leone has made strong progress with mpox vaccination, with more than 120,000 people immunized so far, but vaccine shortages now limit expansion to other high-burden countries.

Resurgence in Burundi, Uganda

Resurgence in Burundi, which saw early success after emerging as one of the continent’s hot spots, is partly related to public perception that the outbreak is over, Baum said, adding that more risk communication efforts are needed to counteract that message. He also said stepped-up surveillance is needed to track down all chains of transmission.

Circulation is occurring in 7 of Burundi’s 46 districts, especially in Bujumbura North.

Uganda, also experiencing resurgence, reported a 60% rise in cases last week. Kampala reported about half of the cases, which partly reflects increased active surveillance. Boum said outbreaks are also flaring in Wakiso and Masaka City. 

Rises in more recently affected countries

Elsewhere, Ghana reported a doubling of cases in the last reporting week, which he said is quite concerning. As in other West African countries, clade 2 is circulating. Ghana’s Western Region is most affected, making up 54.6% of all confirmed cases.

Kenya reported its highest weekly total since its outbreak began last summer, as responders face challenges in tracking cases in the community. Boum said circulation of the virus in Kenya has now moved beyond the northern transport corridor, where most of the infections involved truck drivers, sex workers, and businesspeople, which signifies wider community transmission. 

Elsewhere, Liberia has reported an upward trend over the past 2 weeks, with 43% of cases in Montserrado. Test positivity is up sharply, from 37% to 79% over the past 2 weeks. Similarly, Guinea has reported rising cases over the past 4 weeks, with most of the confirmed cases in Conakry and Kindia regions.