Informing humanitarians worldwide 24/7 — a service provided by UN OCHA

DR Congo + 18 more

WHO African Region Mpox Bulletin #17 - 15 December 2024

Attachments

Key strategic developments in epidemiology

• Cases: In 2024 alone, 19 countries have reported 16 291 laboratory confirmed cases, including 60 deaths.

• Most affected countries: The Democratic Republic of the Congo (DRC) accounts for most cases in 2024 with 11,984 cases, followed by Burundi with 2,704 cases, and Uganda with 1,027 cases.

• Outbreaks under control: The Republic of Congo, Gabon, Mauritius, Zambia, Zimbabwe and South Africa have reported no new cases in the past 42 days.

• South Africa has not reported any new case in the past 90 days.

• New cases of mpox clade Ib with travel links to Africa were reported in Germany and Belgium

• Angola has reported a new case of mpox outside Luanda the capital city, in Uíge province bordering the DRC.

Epidemiological summary

Since January 1, 2022, Mpox cases have been reported to WHO from 21 Member States within the WHO African Region. As of December 1, 2024, a total of 18, 627 laboratory-confirmed cases, including 82 deaths, have been reported with CFR at 0.5%.

The epidemiological comparison between the WHO AFRO Regional figures (table 1a) and the DRC figures (table 1b) highlights significant disparities in surveillance and testing performance for Mpox cases across Weeks 39 to 50. For the other 13 active countries, WHO AFRO reported a total of 9 226 suspected cases, with 9 226 tests conducted, achieving total testing coverage of 100% and a test positivity rate (TPR) of 35.8%. This high testing coverage ensured timely identification of cases, leaving only 0 suspected cases unresolved after testing. In contrast, the DRC reported a far higher burden of 24,451 suspected cases but conducted only 8,398 tests, resulting in a much lower testing coverage of 34.3% and a TPR of 28.2%. Over 16,000 suspected cases in the DRC remain untested, reflecting critical testing gaps and resource limitations. Weekly trends in WHO AFRO except for DRC, showed consistent testing coverage at 100%, with a gradual rise in positive cases and TPR peaking at 53.7% in Week 50, indicating either rising transmission or improved targeting of high-risk cases. Conversely, the DRC figures showed declining testing coverage over time, dropping from 49.9% in Week 41 to 17.6% in Week 48, despite sustained high numbers of suspected cases. The sharp decrease in testing and the corresponding drop in positive cases to 3.9% in Week 49 suggest under detection and significant surveillance challenges. Overall, the WHO AFRO Regional figures reflect a robust and consistent response, while the DRC figures reveal critical gaps in testing capacity and surveillance, which hinder effective control of the Mpox epidemic. Addressing these gaps through enhanced testing coverage, resource mobilization, and improved surveillance strategies is crucial to reducing the burden of Mpox in the DRC.

In the last 6 weeks from December 15, 2024, 14 countries have collectively reported 2,822 laboratory-confirmed cases with six deaths (CFR=0.2), compared to the 2,840 cases and 12 deaths (CFR=0.4) in the previous 6 weeks.

Note: A significant number of suspected cases, that are clinically compatible with mpox are not tested due to limited diagnostic capacity and never get confirmed. For this reason, suspected cases (where no tests were done or with pending laboratory results) are also shown in this section. Care should be taken when interpreting these cases, as they are collected according to different case definitions. In some countries, suspected cases that are negative after laboratory tests are not removed from case counts. Not all countries have robust surveillance systems for mpox, so case counts are likely to be underestimated.