Enhanced control measures helping to control mpox outbreak in Africa

 

More than 13 000 laboratory-confirmed mpox cases have been reported in the African region since the start of 2024, as of 17 November. Three countries – Burundi, the Democratic Republic of Congo and Uganda – account for approximately 97% of all reported cases so far this year.

From reinforcing outbreak control measures including health worker training, to the delivery of medical supplies and equipment, and to the development of vaccine deployment plans, World Health Organization (WHO) is providing critical technical and financial support to countries to effectively respond to and end the mpox outbreaks in the region.

While much of the focus has been on those countries whose populations are at higher risk of exposure to mpox due to larger outbreaks, WHO is also supporting countries experiencing sporadic cases. With WHO support most countries in the region that have been affected by mpox this year have successfully prevented a small number of isolated cases from spreading more widely among their populations and taking on epidemic proportions. 

By the time Ghana reported its first mpox case of the year on 1 October 2024 – a junior high school student in the Western North region – public awareness of the virus was already elevated due to weeks of risk communication and community engagement through WHO-sponsored social media campaigns. 

Recognition of the symptoms meant that both the student and his mother, who was subsequently infected, were promptly taken to medical facilities for treatment and made full recoveries without infecting other members of the community. Rapid contact tracing and testing were conducted to ensure that the virus had not spread beyond the household, early actions that helped contain the disease. 

To strengthen the response, WHO is working closely with the Ghana Health Service to increase public awareness even further. Police and immigration officials at key points of entry have also received training on how to recognize the signs of mpox to prevent the virus being imported into the country. 

“Mobilizing resources to support risk communication and community engagement is just one pillar of our mpox response, but it has so far proven critical; Ghana has registered just two cases in 2024. Without informed populations there is a risk that infected people will carry on as normal, passing the virus on to those around them,” said Dr Frank Lule, Acting WHO Representative in Ghana. 

Gabon—which alongside South Africa, Guinea, Cameroon and Congo is assessed to no longer be experiencing active community transmission of mpox—provides another example of how early interventions can yield significant benefits. The country reported its first laboratory-confirmed mpox case on 22 August. A 30-year-old man who had travelled to Uganda and returned with fever, fatigue and a skin rash. After seeking medical attention, he was isolated until full recovery and an extensive contact tracing operation was launched by WHO-trained health workers. One of the contacts identified was a 25-year-old IT worker living to the north of Libreville.

“As a contact, rigorous protocol was put in place to ensure my safety and the safety of those around me. I was told to watch out for symptoms like fever, fatigue or lesions and to immediately contact the surveillance teams should these symptoms develop. They also asked me to limit social interactions and close physical contact,” explained Axel Mouketou. 

“The surveillance teams remained in close contact with me, conducting visits and calling me on the phone to evaluate my health. This regular contact helped me feel supported and gave me the chance to ask any questions to better understand what actions I should take,” he said. 

WHO has also provided personal protective equipment and other medical supplies to the Ministry of Health; installed thermal cameras at multiple points of entry to Gabon; trained 72 officials at points of entry—including police officers, customs workers and health workers—to recognise mpox symptoms and isolate patients; and provided technical guidance to key ministerial officials. These measures have helped limit the number of lab-confirmed mpox cases in 2024 to just two.

“Our main focus is to maintain surveillance, health training and community engagement once this epidemic is over,” said Dr Narcisse Tounaikok, WHO’s interim mpox Incident Manager in Gabon. 

Similar contact tracing efforts were initiated in Guinea, after a seven-year-old child was confirmed to have been infected with the clade 2b subvariant of mpox on 2 September. Almost all the 91 identified contacts were fully followed up, with diagnostic tests revealing no further transmission of the virus.

Within days of the first mpox case being declared, Guinea’s national health authorities published a response plan with technical input from WHO. In Macenta, where the case was discovered, WHO provided training to staff in 18 health centres and two hospitals, to emphasize appropriate infection prevention and control measures that can be used to limit the spread of infection within health facilities. WHO is also continuously supporting laboratories across the country with training and equipment necessary to monitor mpox and a host of other diseases. 

The successful containment of mpox has not been limited to Cameroon, Congo, Gabon, Ghana, Guinea and South Africa. With WHO support, in 2024, Angola Mauritius, Morocco, Zambia and Zimbabwe have so far all prevented one or two identified cases from spreading further. 

“These countries are evidence of the value, both human and financial, of rapid detection, response and containment. With a timely push of reactive funds and technical assistance from WHO, they were able to stop the virus from spreading on a scale that would ultimately be much more challenging to manage, said Dr Samuel Boland, Mpox Incident Manager at WHO Regional Office for Africa. 

Across the African region, 14 countries—the Democratic Republic of the Congo, Burundi, Uganda, Nigeria, Côte d’Ivoire, Central African Republic, Ghana, Liberia, Rwanda, Kenya, Zimbabwe, Mauritius, Zambia, and Angola—are still assessed to have active transmission of mpox, a viral disease endemic to Central and West Africa. All require further enhancement of disease surveillance measures. High levels of mobility on the continent, the emergence of the particularly infectious clade 1b subvariant in 2023 and the persistent risk of zoonotic transmission are all causes for continued vigilance, even in countries where cases have been successfully contained.

Distributed by APO Group on behalf of WHO Regional Office for Africa.