The Mpox epidemic, clade Ib, which began in September 2023 in the Democratic Republic of the Congo (DRC), “is recording a increasing number of cases of the so-called “monkeypox” in the country and is also spreading to neighboring countries. Burundi, Kenya, Rwanda and Uganda have each reported their first cases. Many of the patients have travel links to eastern parts of the DRC and each of these countries has identified clade Ib of the virus.
Transmission
The new strain, “based on available epidemiological data, has spread rapidly among adults through close physical contact, including sexual contact identified within networks of sex workers and their clients.” But “as the virus spreads further, the affected groups are changing” and this version of Mpox “It is also spreading within families and other contexts“. The World Health Organization (WHO) takes stock in an update on the situation in Africa, focusing in particular on what is happening in the countries neighboring Congo.
On the one hand there is the clade 1b racewhich is of international concern, given that infections intercepted outside the African continent are starting to be reported – yesterday Thailand reported the first confirmed case in Asia, a 66-year-old European who arrived in the country after traveling in Africa – in Africa there is no lack of contribution from the other clade of the virus: Ivory Coast, for example, is reporting cases of Mpox clade II for the first time since the beginning of the multinational epidemic that broke out in 2022.
As for the other affected African countries, in Burundi there have been 545 alerts for Mpox cases since the epidemic was declared as of August 17, 2024, of which 474 suspected cases (86.9%) have been examined and validated. Of the 358 cases tested, 142 (39.7%) have tested positive for Mpox and genomic sequencing analysis has confirmed clade Ib. Children under 5 years of age represent 60.3% of cases, followed by young people between 11 and 20 years of age (42.6%) and 21-30 year olds (38.2%). In Kenya, on August 13, out of 14 suspected cases identified, one tested positive for Clade Ib, the first case of Mpox ever identified in the country. Rwanda as of August 7 had reported 4 confirmed cases of Mpox and zero deaths. In Uganda, there were 2 cases, recorded in July.
THE’Mpox’s current expansion on the African continent “is unprecedented – notes the WHO in the report on the epidemic – At least 4 countries have identified cases for the first time and others, such as Côte d’Ivoire, are reporting resurfaced outbreaks. The modes of transmission are not yet fully described and probably include exclusively human-to-human transmission.“. Furthermore, “the expansion of the epidemic in Burundi suggests that in some settings there may already be sustained community transmission of clade 1”.
“In areas or environments where people gather with high population density, as well as in high-risk sexual networks, transmission could lead to explosive epidemics, further aggravated by population movements or insecurity – warns the UN health agency – Conversely, the virus can also spread silently along commercial travel routes, as symptoms may be less severe in some cases, access to health services in transit may be limited, and concerns about stigma may lead affected people to avoid seeking care”. Based on these elements, WHO has separately assessed the risk of Mpox in the eastern part, Democratic Republic of the Congo and neighboring countries, as high and in Côte d’Ivoire and other West African countries as moderate. This assessment applies to the general population, and in particular to those who have sexual contact with Mpox cases, and to health workers if they do not take appropriate precautions.
Currently no deaths were reported in the five countries examined in the report“but – warns the WHO – there is the potential for a greater health impact with greater spread among vulnerable groups: children, immunosuppressed people, including those with uncontrolled HIV infection or advanced HIV disease, and pregnant women (for whom Mpox can be more severe). “There is concern that the epidemic in Africa will continue to evolve”, concludes the UN agency, which as regards travellers, among the recommendations to countries indicates to “encourage authorities, health and care workers and community groups to provide information to protect themselves and others before, during and after travel to events or gatherings where Mpox may represent a risk”. In any case, the report specifies again that the WHO “does not recommend any restrictions on travel and trade with these countries or any other country affected by the virus“.
Kyriakides writes to EU health ministers to donate vaccines to Africa
Stella Kyriakides, European Commissioner for Health and Food Safety, said she had “written to Health Ministers about plans to donate vaccines and therapies for Mpox. Solidarity is key to addressing global health threats. We are counting on Member States” of the EU “to support our African partners in managing the outbreak. The European Commission stands ready to coordinate”.
“In the face of the Mpox outbreak in several African countries, we must act together in a coordinated and sustained manner, with the Africa Centers for Disease Control and Prevention (Africa CDC) and the affected countries, in a spirit of global solidarity and cooperation – wrote Kyriakides in the letter to EU ministers, posted on X – On 13 August, Africa CDC declared a public health emergency of continental security, calling on the global community to mobilize 2 million doses of vaccine. On 14 August, the WHO also took action, declaring “the 2024 outbreak a public health emergency of international concern under the International Health Regulations. In addition, on 15 August a first case of clade Ib was detected in the EU”, in Sweden.
“As a first response to the escalation in Africa of the epidemic” of the virus formerly known as monkeypox (before the name change ordered by the WHO in an anti-stigma function), “the Health Emergency Preparedness and Response Authority (Hera) has partnered with the pharmaceutical company Bavarian Nordic to secure and donate over 215,000 doses of Mva-Bn vaccine to the Africa CDC, which will distribute them based on an established vaccination strategy and regional needs”. But, Kyriakides noted, “the doses needed to address the current epidemic are obviously much higher. Several Member States and third countries have announced their intention to donate doses to affected countries and Africa. European donations will have a more immediate impact if they are coordinated and channeled with the proven Team Europe approach, as was successfully done during the Covid pandemic”. For this reason, the Commissioner’s offices have moved to “inquire about the intention” of the Member States “to donate vaccines and therapies against smallpox and the volumes available with a deadline by the end of August. As is known, a Joint Procurement Framework is in place with the Bavarian Nordic company and it is possible to purchase more vaccines also for donation purposes”.
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