Gabon’s health ministry announced the country’s first mpox case on August 23, 2024. The patient is a 30-year-old man who had just come back from 2 weeks in Uganda.
His symptoms began a few days before the flight home: fever and fatigue, then a rash. Doctors hospitalized him and placed him in isolation on August 21. Contact tracing is under way.
The ministry said in a statement that its surveillance system has flagged six suspected cases so far. One sample has tested positive. With Gabon on the list, at least 14 African countries have now reported mpox since the start of the year.
Burundi carries the heaviest load
A day earlier, the World Health Organization (WHO) posted an update on the newest affected countries and called the spread across the region unprecedented. “The modes of transmission in these countries are not fully described yet and are likely to include exclusive human-to-human transmission,” the agency said. It added that the virus appears to move first through sexual networks and then into households and other settings.
Of the five countries in that report, Burundi is the hardest hit. Officials there counted 474 suspected cases as of August 17. Of 358 patients tested, 142 were positive, and the virus was identified as the novel clade 1b strain circulating in eastern Democratic Republic of the Congo (DRC).
Confirmed cases have turned up in 26 of Burundi’s 49 districts. Bujumbura Nord, an urban area, accounts for roughly one third of them. Men make up 55.6% of patients. Children younger than 5 years old make up 60.3% of cases. No deaths have been reported.
Travel links elsewhere
Only a few cases have been confirmed in the other newly affected countries, and most trace back to travel.
Kenya has confirmed one clade 1b case, a 42-year-old man who had visited Uganda and was passing through Rwanda on the way to Tanzania when his illness was identified. Results are pending on another suspected case, and tests on 12 others came back negative.
Rwanda reported two lab-confirmed cases in July. One was a 33-year-old woman who travels often to the DRC, caught at an entry point. The other was a 34-year-old man who had recently visited the country, found at a hospital. Two more followed in August, a man who had been in Burundi and a man who had visited the DRC. Sequencing confirmed clade 1b.
Uganda’s first two confirmed cases were identified in July, both clade 1b. The patients, women aged 37 and 22, were picked up at a screening point on the DRC border.
Ivory Coast has confirmed seven cases this year across three health districts, all from clade 2, the strain circulating globally. Four of the patients are male, and all are older than 15 years. The country had reported mpox before, but not since clade 2 began circulating.
Vaccines and mistrust
Reuters reported in an exclusive that the WHO has told Gavi, the Vaccine Alliance, and UNICEF they can begin buying mpox vaccine before WHO clearance, to speed up immunization. WHO authorization is expected in the next few weeks.
In the DRC, where the outbreak is centered, the group Insecurity Insight examined 650 Facebook comments from this month. Many voiced mistrust of local authorities after the WHO emergency declaration, and some accused officials of exploiting the situation for financial gain and embezzling aid funds.
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