Deaths top 1,000 in Africa’s mpox outbreak

African funeral

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Over the past week, Africa’s surge of new mpox cases continued, and the region passed a grim marker, with fatal cases passing 1,000 for the year amid several worrying developments, including spread to new countries and in crowded settings that include prisons and refugee camps.

At a weekly briefing today with the Africa Centres for Disease Control and Prevention (Africa CDC), Director-General Jean Kaseya, MD, MPH, reiterated that the outbreak isn’t under control. “We still believe cross-border transmission is a major issue,” he said, adding that rapid tests are needed to help identify travel-related spread more quickly.

Countries in the region reported 3,051 new cases over the past week, along with 50 more deaths, pushing the totals since the first of the year to 42,438 cases, 1,100 of them fatal. Kenya this week reported the first death in its outbreak, a 46-year-old man who worked as a truck driver. Zambia’s first case, announced on October 8, also involved a truck driver, who is from Tanzania.

With the report of the first two cases from Zimbabwe earlier this week, 18 countries in the region are now reporting mpox cases.

In another new development, Ghana—a recently affected country—reported its second case, a household contact of its first case.

Spread at prisons and displaced-person camps

Kaseya said new outbreaks have been detected in two prisons in Uganda and involve patients who didn’t have a history of travel outside Uganda. So far, three cases have been confirmed at two different prisons, where 1,874 contacts have been identified.

Health officials initially though the patients had chickenpox, given that one of the facilities had reported a chickenpox outbreak in June. 

Meanwhile, cases continue to rise at internally displaced person camps in the Democratic Republic of the Congo (DRC) North Kivu province, which house 2.5 million people at 13 sites. So far, 697 mpox infections have been reported from the camps, 333 of them lab confirmed. Just more than half are male, and adults ages 20 to 40 are the most affected group.

He said aside from the crowded conditions in both settings, prisons and camps have other challenges in stemming the spread of mpox, including a lack of hygiene facilities and lack of access to infection prevention and control tools.

Vaccine rollout continues, with Nigeria to launch next

So far, vaccination has started in the DRC and Rwanda, Kaseya said. Nigeria expects to begin its campaign on October 22.

In the DRC, nearly 21,000 people from three provinces (South Kivu, North Kivu, and Tshopo) have been vaccinated so far, starting with the contacts of mpox cases and frontline health workers. Vaccination is expected to begin in November in Kinshasa, where cases started to rise after school resumed, Kaseya said.

Across the broader region, only four countries have vaccination plans, a step that paves the way for countries to receive doses, he said. They include the DRC, Nigeria, Rwanda, and the Central African Republic. South Africa has a draft vaccination plan, and Ivory Coast’s plan is in the development stage.

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