The World Health Organization (WHO) released its 35th report on the multi-country mpox outbreak on August 12, highlighting a continued global transmission of the disease.
In June, a total of 934 new laboratory-confirmed mpox cases and four deaths were reported from 26 countries. The figures reflect ongoing mpox transmission worldwide, with the African Region being the most affected, accounting for 61% of the new cases reported in June.
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Regional breakdown
In June, the African region reported 567 new cases, the highest among all regions, followed by the Americas with 175 cases, the European region with 100 cases, the Western Pacific region with 81 cases, and the South-East Asia region with 11 cases. The Eastern Mediterranean region reported no cases.
The report, however, shows that due to a decline in reporting, the current data is likely an underestimation of the actual number of cases.
Key updates in Africa
In the African region, DR Congo reported the majority of cases, with 96% of the confirmed cases originating from the country. In 2024, only 24% of suspected cases in DR Congo have been tested, with a 65% positivity rate, suggesting that the true burden of disease is likely higher than reported.
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Recent updates from July to August 2024 reveal that four new countries in Eastern Africa--Burundi, Kenya, Rwanda, and Uganda--have reported their first mpox cases. All cases are linked to the ongoing outbreak in East and Central Africa and have been identified as clade I. Côte d'Ivoire is also experiencing an outbreak linked to clade II MPXV, and South Africa has reported two additional cases.
Risk assessment
The WHO's assessment of mpox risk highlights significant concerns for different regions. The highest risk is observed in eastern DR Congo and neighboring areas. In these regions, mpox primarily affects adults and spreads predominantly through sexual contact, linked to clade Ib.
Additionally, certain areas within DR Congo, where mpox is endemic, pose a high risk due to the disease's impact on children and its diverse transmission methods, associated with clade Ia.
Moderate risk is noted in Nigeria and other endemic countries across west, central, and east Africa. Here, mpox affects children and adults and spreads through multiple transmission routes, tied to clades I and II. This moderate risk extends to regions where outbreaks mostly affect men who have sex with men, associated with clade IIb.
Epidemiological trends
From January 1, 2022, to June 30, 2024, the global mpox outbreak resulted in 99,176 laboratory-confirmed cases and 208 deaths reported from 116 countries. In June, new cases were comparable to those reported in May.
The African region reported a rise in cases, while other regions experienced fluctuations or stable numbers. The 10 countries with the highest cumulative number of cases are the USA, Brazil, Spain, France, Colombia, Mexico, the UK, Peru, Germany, and DR Congo, which has now entered the top ten for the first time.
Recent developments
In June and July 2024, Burundi, Kenya, Rwanda, and Uganda reported their first mpox cases. The cases in these countries are all linked to the expanding outbreak in East and Central Africa, with clade Ib identified. In Côte d'Ivoire, mpox has re-emerged with clade II MPXV, while South Africa reported two additional cases.
WHO response
Due to the rapid escalation of mpox cases, particularly in Africa, the WHO has upgraded the global mpox multi-country event to "an acute grade three emergency".
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The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, extended recommendations for another year, initiated the emergency use listing process for mpox vaccines, and allocated funds to enhance the response in Africa.
An emergency committee under the International Health Regulations (IHR) will advise on whether the situation constitutes a Public Health Emergency of International Concern (PHEIC).
The UN health agency urges member states to strengthen surveillance, improve outbreak detection and response, and collaborate on global preparedness. This includes increasing access to diagnostics, clinical care, vaccines, and ensuring stigma-free communication.
The WHO Strategic Framework calls for adapting public health interventions to local contexts and integrating mpox response with ongoing health programmes.
