Epidemiological update, week 37/2024: Mpox due to monkeypox virus clade I

Global background 

Since the beginning of mpox monitoring in 2022 and up to 31 July 2024, over 100 000 confirmed cases of mpox due to MPXV clade I and clade II, including over 200 deaths, were reported by more than 120 countries globally, according to WHO (2022-24 Mpox (Monkeypox) Outbreak: Global Trends). All cases of mpox due to MPXV clade I were reported by African countries, except for one case reported by Sweden and one by Thailand. No secondary transmission of MPXV clade I has been reported outside of the affected African countries. 

Epidemiological situation in Africa

In 2024, over 24 000 confirmed or suspected mpox cases due to MPXV clade I and clade II, including over 600 deaths, have been reported from Africa Union Member States, including over 5 000 confirmed cases, according to the Africa CDC Epidemic Intelligence Report issued on 10 September 2024 and the WHO AFRO weekly report of 6 September. The reporting countries are Burundi, Cameroon, Central African Republic, Congo, Cote d’Ivoire, Democratic Republic of the Congo (DRC), Gabon, Guinea, Liberia, Kenya, Nigeria, Rwanda, South Africa and Uganda. Additionally, a case was reported by Morocco on 12 September 2024 (no information on the clade).

The epidemiological situation remains similar to the previous week.

The two countries reporting the largest numbers of cases in recent weeks are still the DRC and Burundi: 

• DRC has reported over 800 confirmed cases the past four weeks and Burundi over 300, according to the WHO Global report on mpox (data as of 8 September). Deaths have been reported only in DRC among suspected cases (over 100 according to WHO the past four weeks). Clade Ib has been detected in both countries, while clade Ia is co-circulating in DRC. 
• The DRC continues to report the highest number of mpox cases in Africa and a continuous increase in the total reported number of cases. The cumulative number of cases in 2024 is over 20 000 (over 5 000 confirmed), including over 600 deaths, while testing rates increased reaching over 40% (Africa CDC Epidemic Intelligence Report issued on 10 September 2024 and WHO AFRO weekly report of 6 September). The majority of cases and deaths reported are among <15-year-olds (66% of cases and 82% of deaths), while males accounted for 73% of all people with mpox, according to Africa CDC.
• In Burundi, as of 8 September 2024, 385 confirmed cases have been reported according to the WHO report (2022-24 Mpox (Monkeypox) Outbreak: Global Trends). According to the WHO AFRO weekly report of 6 September, cases were reported from 29 of 49 districts and both confirmed and suspected cases keep increasing. Over a third of cases (37.5%) were reported among children under 10 years. There is a slightly higher percentage of males among cases (56%).

No new cases have been reported in the past week from Uganda, Rwanda or Kenya, countries that had previously reported detection of MPXV clade Ib and mpox circulation for the first time in 2024. Overall, 10 cases have been reported in Uganda, four in Rwanda and five in Kenya. In Gabon (two cases), Guinea (one case) and Liberia (nine cases), where cases were also reported recently, information on the clade is not yet available (2022-24 Mpox (Monkeypox) Outbreak: Global Trends as of 8 September 2024). 

Epidemiological situation in the EU/EEA for MPXV clade I

On 15 August 2024, Sweden reported the first imported case of mpox due to MPXV clade Ib in EU/EEA countries. As of 15 September, no secondary cases have been reported.

Recommendations

In addition to the recommendations published in the Rapid Risk Assessment for the EU/EEA of the mpox epidemic caused by monkeypox virus clade I in affected African countries on 16 August 2024, ECDC has collected rapid scientific advice for public health authorities in EU/EEA countries on this website (Mpox rapid scientific advice on public health measures), particularly related to the following topics:
•    Information for travellers to areas with ongoing MPXV transmission;
•    Diagnosis and isolation of cases, and infection prevention and control measures;
•    Contact tracing;
•    Substances of human origin;
•    Vaccination;
•    Surveillance.

References

1. European Centre for Disease Prevention and Control (ECDC). Risk assessment for the EU/EEA of the mpox epidemic caused by monkeypox virus clade I in affected African countries. Stockholm: ECDC; 2024. Available at: https://www.ecdc.europa.eu/en/publications-data/risk-assessment-mpox-epidemic-monkeypox-virus-clade-i-africa