The Africa Centres for Disease Control and Prevention (Africa CDC) has declared the Mpox outbreak a Public Health Emergency of Continental Security (PHECS). This declaration was made by the Director General, Dr Jean Kaseya, who spoke on the need to work with every African leader and partners of public health concern to contain the epidemic of Mpox. He called for the need to enact cross-border testing to contain the spread of the disease between neighbouring countries.
The first case of Mpox virus in Africa was identified in the Democratic Republic of Congo in 1970. Since then, cases of Mpox infection have continued to rise and is now a matter of continental security. In 2022 – 2023, the World Health Organisation (WHO) had declared Mpox outbreak a public health emergency of international concern (PHEIC). Following this recent outbreak of the virus caused by a strain, the WHO has again declared the disease a global health emergency.
Since 2022, there have been 38,465 cases of Mpox disease leading to 1,456 deaths. Between June of 2022 and August 2023, there was a 79% rise in the outbreak and a record 160% rise in the outbreak within the same period between 2023 and 2024. As at today, the reported weekly outbreak has risen from two (2) to almost three (3) new outbreaks per week.
Mpox affects the five (5) regions of Africa with presence in sixteen (16) countries. Six (6) new countries (like Kenya and Rwanda) have reported cases of Mpox outbreak, and eighteen (18) countries are at risk of infection. Countries with endemic cases include Benin, Cameroon, Central African Republic, DRC, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, Sierra Leone, and South Sudan.
The primary mode of transmission for Mpox is contact with infected person or animal with an incubation period of 5 – 21 days. Other risk factors for contracting the disease include having multiple sex partners, co-infections (like HIV), and malnutrition. Africa CDC has declared its position in creating awareness about Mpox while coordinating subcommittees on surveillance, diagnostics, communication, vaccine, and therapeutics. Adequate response to diagnosis of the Mpox virus will aid in better management of cases.
Challenges in addressing Mpox outbreak, a public health emergency
According to Dr Kaseya, some of the challenges that the CDC faces in managing the Mpox virus outbreak include:
- Insecurity and sociopolitical crisis
- Limitations in understanding the epidemiology and transmission dynamics of the disease.
E.g. Why people with HIV are more at risk of contracting the Mpox virus. Other epidemiologic data show that in DRC 60% of Mpox cases occur in children under 16 years of age and females while in other African countries, it occurs more in males and adults.
- Inadequate global attention and resource investment in the control of the disease
- Unavailability of counter measures like vaccines, therapeutics, and diagnosis
Dr Kaseya has said that to fight the Mpox virus, Africa must have access to new treatments and vaccines in addition to understanding the epidemiology of disease outbreak. Many African countries have established plans to access the Mpox vaccine, and based on these agreements, the continent needs 10 million doses. So far, Africa CDC has been able to source 200,000 doses from Bavarian Nordic, the manufacturers of the JYNNEOS vaccine used generally in mitigating the global 2022–2023 Mpox outbreak, however the vaccines are yet to arrive.
Epidemiology of Mpox
Mpox has an incubation period of 5 to 21 days, where the virus silently establishes itself in the body. Early symptoms are similar to those of the flu, presenting as fever, headache, muscle aches, and fatigue. Swollen lymph nodes may distinguish the disease from similar illnesses such as chickenpox or smallpox.
A rash typically appears within 1 to 3 days after the onset of fever, often starting on the face before spreading to other parts of the body. Progression stages of the rash include macules (flat lesions) → papules (raised lesions) → vesicles (fluid-filled blisters) → pustules. Within 2 to 4 weeks, the pustules will usually scab over and fall off, marking the end of the contagious period.
While the viral strain that is prevalent in West Africa has a mortality rate of less than 1%, the strain circulating from West Africa is said to have between 1% – 10% mortality rate. Other complications may include pneumonia, confusion, and eye infections which can lead to loss of vision. In addition, people with weakened immune systems or underlying health conditions (e.g. HIV) have a higher risk of infection.
Most people recover fully with supportive care, such as fluid intake and pain management. There is no specific cure for Mpox, but antiviral drugs may be used in severe cases. Prevention is key in managing Mpox.
- Avoid close contact with infected individuals
- Practice good hygiene and use personal protective equipment (PPE)
- Get vaccinated, where available
If you suspect exposure to Mpox, the first step is to isolate yourself to prevent potential spread. Contact a healthcare provider immediately for guidance and testing. Early detection and supportive care significantly improve outcomes, reducing the risk of complications and transmission.