TUESDAY, Nov. 5, 2024 (HealthDay News) — In an early sign that the mpox outbreak in Africa might be ebbing, some health officials report that case counts seem to be stabilizing in the Congo, the epicenter of the outbreak.

The World Health Organization first declared the mpox outbreak a global health emergency in August, but recent WHO data has shown the Congo has reported about 200 to 300 lab-confirmed mpox cases every week, down from nearly 400 cases a week in July, the Associated Press reported.

Still, the WHO acknowledged that only 40% to 50% of suspected infections in Congo were being tested and the virus continues to spread elsewhere on the continent, the AP reported.

While doctors are encouraged by the drop in infections in some parts of Congo, they are worried by the small number of vaccine doses the central African nation has received so far to fight the outbreak, the AP reported. WHO estimates that only 50,000 people have been immunized in the Congo, which has a population of 110 million.

“If we miss this opportunity, the likelihood of another significant outbreak increases substantially,” Dr. Zakary Rhissa, who heads operations in Congo for the charity Alima, told the AP.

The Africa Centres for Disease Control and Prevention has estimated Congo needs at least 3 million mpox vaccines to stop the virus, and another 7 million are needed for the rest of Africa. So far, WHO and its partners have allocated 900,000 vaccines to nine African countries affected most by mpox, the AP reported.

“We’ve seen how past outbreaks, such as the one in Nigeria in 2017, can lead to larger global events if not effectively contained,” Rhissa noted. That 2017 Nigerian outbreak triggered the 2022 global outbreak of mpox that affected more than 100 countries.

In this latest outbreak, less than half of the people who are most at risk in the Congo have been vaccinated, Heather Kerr, Congo director for the International Rescue Committee, told the AP.

“We only have a tiny amount of vaccines, and nothing for the kids,” she said.

Dr. Salim Abdool Karim, an infectious diseases expert at South Africa’s University of KwaZulu-Natal, said mpox outbreaks typically peak quickly because of how the virus spreads. But there are now two complicating factors: the virus’ transmission via sex and the continued spillover from infected animals.

“We’re in new territory with mpox this time,” he told the AP. “But we’re never going to solve this until we vaccinate most of our people.”

To that end, the first batches of donated vaccines arrived in the capital city of the Congo in September.

UNICEF will spearhead the vaccination campaign, Congo’s Health Minister Samuel-Roger Kamba told reporters after the delivery of those first doses, the AP reported.

About 380,000 doses of mpox vaccines have been promised by Western partners such as the European Union and the United States, Dr. Jean Kaseya, head of the Africa Centres for Disease Control and Prevention, told reporters recently.

Meanwhile, the U.S. Centers for Disease Control and Prevention issued an alert in early August that advised health care providers to be on the lookout for the new mpox strain in patients who have recently been in the Congo or any neighboring country (Angola, Burundi, Central Africa).

Still, “due to the limited number of travelers and lack of direct commercial flights from [Congo] or its neighboring countries to the United States, the risk of clade I mpox importation to the United States is considered to be very low,” the CDC added at the time.

However, what’s most worrying about the new outbreak is that the death rate linked to the new strain of the disease appears higher: About 3 percent of those infected have died, instead of the 0.2 percent observed in the 2022 outbreak.

In 2023, scientists discovered that the mpox virus has gained mutations allowing it to spread more easily between people. Sexual transmission, often through heterosexual prostitution, is a main conduit for infection in Africa.

Dr. Nicole Lurie is executive director for preparedness and response at the Coalition for Epidemic Preparedness Innovations, a nonprofit that finances vaccine development.

Speaking to the New York Times recently, she said, “this outbreak has been smoldering for quite a long time, and we continually have missed opportunities to shut it down. I’m really glad that everybody is now paying attention and focusing their efforts on this.”

More information

Find out more about mpox at the U.S. Centers for Disease Control and Prevention.

SOURCE: Associated Press; WHO, news release, Aug. 26, 2024; New York Times

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