Africa CDC Confirms Over 21,000 Mpox Cases, 591 Deaths In 13 African Countries

Addis Ababa, Ethiopia– The Africa Centres for Disease Control and Prevention (Africa CDC), a specialized health agency of the African Union, has confirmed a total of 21,466 Mpox cases and 591 deaths across 13 African countries since the beginning of 2024.

In a letter addressed to the Ministers of Health of African Union Member States, Africa CDC Director General, Dr. Jean Kaseya, provided the latest update on the Mpox outbreak.

Dr. Kaseya highlighted the urgent need for a unified and holistic approach to tackle the spread of the disease, emphasizing the importance of coordinated response efforts among Member States.

Amid a global shortage of Mpox vaccines, the Africa CDC has also advocated for the approval and distribution of available vaccines across all African Union Member States.

The push for vaccine approval is seen as a crucial step in mitigating the impact of the outbreak and safeguarding public health across the continent.

The recent surge in Mpox cases and fatalities has prompted health authorities to intensify surveillance, testing, and public awareness campaigns.

The Africa CDC continues to work closely with national health ministries and international partners to bolster response efforts and ensure that resources are available to manage the outbreak effectively.

Dr. Kaseya’s call for action stresses the need for enhanced collaboration, resource mobilization, and strategic planning to combat the ongoing health crisis.

“From 2023 to date, the Mpox viral zoonotic disease has been reported in 16 African Union (AU) Member States across all five AU regions, with a high case fatality rate above 3.9 percent.

“From 1st January 2024 to 23rd August 2024, a total of 21,466 cases (3,350 confirmed; 18,116 suspected) and 591 deaths, with a case fatality rate (CFR) of 2.9 percent, have been reported from 13 AU Member States.”

The affected countries are listed as Burundi, Cameroon, the Central African Republic, Congo, Côte d’Ivoire, the Democratic Republic of the Congo, Gabon, Liberia, Kenya, Rwanda, South Africa, Uganda, and Nigeria.

“Even as I write this letter, Gabon has confirmed its first case, while Sierra Leone and Malawi are now testing their suspected cases,” Kayesa stated.

On the confirmation of Mpox cases by Member States, Kayesa declared, “Some of you are reaching out to us, especially in contexts where lab results are negative for Mpox. To better advise you, Africa CDC has also consulted.

“I consulted our best African epidemiology and lab experts, as well as international experts and appropriate bodies like the US CDC, China CDC, Europe CDC, and WHO.

“I would like to draw Your Excellencies’ attention to the fact that a negative test result in the laboratory does not necessarily mean there is no Mpox epidemic.

“The conclusion is that relying solely on laboratory test results for diagnosing Mpox is not advisable. We need a holistic approach that integrates laboratory testing with clinical assessment and epidemiological data to accurately diagnose and manage Mpox,” he explained.

Kayesa said the diagnosis and management of Mpox should involve a comprehensive approach that considers multiple factors, including clinical presentation, epidemiological context, history, risk factors, and lab testing, among others.

“Regarding Mpox testing, it can sometimes yield a negative result in the laboratory even when the disease is present due to several factors. The accuracy of Mpox testing depends significantly on when the sample is collected.

“If the sample is taken too early or too late in the course of the infection, the viral load might be too low to be detected.

“The signs and symptoms of Mpox, such as fever, rash, swollen lymph nodes, and lesions, are critical in diagnosing the disease. A thorough clinical examination is essential, especially when laboratory results are inconclusive or negative.

“Understanding the patient’s exposure history, such as contact with known cases or travel to areas with ongoing Mpox outbreaks, is crucial. This context can provide strong evidence for a probable case, even in the absence of positive lab results,” he asserted.

In his view, while important, lab tests should be interpreted in conjunction with clinical and epidemiological data.

“False negatives are possible, and a negative test does not entirely rule out Mpox, especially if there is strong clinical suspicion. For all Mpox cases, countries should perform HIV and STI tests.

“No test is perfect, and some Mpox tests may have lower sensitivity, meaning they might not detect very low levels of the virus. This can result in a false negative if the viral load in the sample is below the test’s detection threshold.”

On viral variability, he said different strains or mutations of the Mpox virus might not be as easily detected by certain tests, especially if the tests were designed for a specific strain.

“In some cases, an individual’s immune system might clear the virus or suppress its replication to levels undetectable by laboratory tests, even though the disease was present.”

Noting that only Nigeria, South Africa, and the DRC have approved the use of Mpox vaccines, Kayesa said it is critical for other countries to approve the introduction of the vaccines.

“The tension of the increasing demand for vaccines by Western nations and the monopoly in vaccine manufacturing (BN is the only company currently manufacturing this vaccine) puts Africa at a disadvantage in securing the vaccines, given the limited market demand by African leaders.

“There is a serious risk that Africa will not be considered in the distribution of the vaccines and other medical countermeasures if African leaders don’t come together strongly to make their voices heard in the fight against this disease.

“There is also a risk, now openly mentioned in some Western countries, of imposing travel restrictions to Africa if our leaders and communities don’t take this outbreak seriously.

“Suboptimal communication activities to raise awareness among the population and sensitize them about vaccine use are evident. Support will be provided to affected countries with the donation of vaccines already secured,” he said.

On the complexities surrounding vaccines, the DG stated that while vaccine access is limited, the benefits of an expensive vaccine with limited clinical efficacy data need to be carefully assessed, and a plan developed to ensure vaccines are appropriately deployed to maximize benefit.

“We need to ensure that regulatory authorities agree to use the vaccines, that supply chain logistics are in place, and that communication activities are ongoing to ensure acceptance of the vaccines by the targeted population.”