Mpox cases in the Democratic Republic of the Congo (DRC) have now topped 20,000 for the year, and Guinea has confirmed its first case, raising the number of affected countries to 14, the head of the Africa Centres for Disease Control and Prevention (Africa CDC) said at a briefing today.
Meanwhile, Africa CDC and the World Health Organization (WHO) launched a joint regional mpox preparedness and response plan, which coordinates actions based on countries most at risk.
As the virus triggers outbreaks in more African countries, posing a risk of exported cases in other parts of the world, researchers from the US Centers for Disease Control and Prevention (CDC) report findings from airline contact tracing that indicate the risk of disease spread in that setting is very low.
Kids bear heavy burden in both DRC, Burundi
At today’s Africa CDC briefing, Director-General Jean Kaseya, MD, MPH, said the rate of Africa's cases has climbed since May, but the case-fatality rate is going down owing to earlier recognition and care.
African countries reported 5,466 cases, 252 of them confirmed, from 14 member states over the past week, and 26 more people died from their infections. Of 24,851 cases reported in the African region this year, 22,091 were in Central Africa, which includes the outbreak's DRC epicenter.
The DRC had 2,662 cases over the past week, 25 of them fatal. Of cases this year, 58% occurred in children younger than 15, Kaseya said, noting the presence of numerous risk factors, including poor sanitation, insecurity and population mobility, malnutrition, interaction with wildlife, low public risk perception, unsafe sexual practices, and viral mutation.
Kaseya noted that Burundi, facing a new and escalating outbreak linked to the 1b mpox clade, is also seeing a shift in age distribution, with children younger than 15 now the most affected age-group. In both countries, the percentage of infections is slightly higher in males than in females.
Health officials also noted the first case in Guinea, which involves a 7-year-old girl from Macenta prefecture. He said genetic sequencing is under way, and if clade 1b is confirmed, it will be the first of that type reported from West Africa.
In other outbreak developments today, Kenya's health ministry reported the country's fifth case, involving a 29-year-old woman from Mombasa whose spouse is the country's fourth confirmed mpox patient. She has no recent travel history, but her spouse had recently traveled to Rwanda, another outbreak country.
Plan is important milestone between Africa CDC, WHO
At today's briefing, Africa CDC and WHO officials unveiled an mpox preparedness and response plan, which the agencies said marks a significant step to strengthen and speed up actions targeting the mpox threat in the region.
In a WHO statement, Kaseya said, "This unified strategy ensures that all partners are aligned on common objectives, eliminating duplication and maximizing impact." As complex as the outbreak is, the response is equally complex, as epidemiologists sort out outbreak dynamics in different countries and gauge the impact of different clades. Also, vaccine donations are arriving in the region amid diverse regulatory situations and varied capacities to receive and deploy doses.
This unified strategy ensures that all partners are aligned on common objectives.
The plan covers the next 6 months and has a budget of nearly $600 million, with 55% targeted for the response in 14 affected countries and 45% for operational and technical support through partners.
Matshidiso Moeti, MD, who directs the WHO's African regional office, said the plan represents an important milestone between Africa CDC and the WHO. "By coming together, we can achieve more, and our collective strength will carry us further, ensuring that communities and individuals are protected from the threat of this virus."
The plan classifies African counties based on their risk status, with those experiencing sustained human-to-human transmission at the top tier and those with sporadic cases since 2022 and endemic zoonotic reservoirs at the next highest level.
Very low risk during airline travel
In other mpox developments, traveling on a flight with a person with mpox doesn't appear to be an exposure risk, researchers from the CDC reported yesterday in Morbidity and Mortality Weekly Report.
They described contact tracing findings from 2021 through 2022 of 113 people who traveled on commercial flights while they were infectious with clade 2 mpox, the type involved in the global outbreak that peaked in 2022.
Of 1,046 traveler contacts who were identified by US public health agencies, no secondary cases were found. Investigators said the findings were similar to a 2022 study of airline exposure by Australian scientists.
Taken together, airline travel appears to pose a very low risk, because the type of contact involved in the spread of mpox is unlikely to occur on a plane. The authors said though clade 1 maybe be more transmissible, both clades spread in the same way—close or intimate physical contact with infected lesions or, less commonly, respiratory secretions and fomites.
Though mpox might not warrant routine contact-tracing activities among airline passengers, limited aircraft contact investigations could be considered for the first probable or confirmed clade 1 mpox identified in recent air travelers or to corroborate equivalent risk as with clade 2.
