Monkeypox in African Union Member States – Africa CDC

Global update (non-endemic countries)[1]: As of September 14, 2022, 59,179 confirmed cases of monkeypox and 136 deaths have been reported from 103 countries/territories worldwide. The countries reporting the majority of cases are mainly in Europe and North America.[2]

Africa Update (endemic[3] and non-endemic countries): Since early 2022, the continent has reported 4,667 cases (559 confirmed; 4,108 suspected) and 127 deaths (CFR: 2.8%) of monkeypox from eight endemic MS: Benin (3 suspected; 3 confirmed; 0 deaths), Cameroon (29; 7; 2), CAR (17; 8; 2), Congo (14; 5; 3), DRC (2,775; 163; 110), Ghana (535; 84; 4), Liberia (31; 2 ; 0), Nigeria (704; 277; 6) and four non-endemic MS: Egypt (0; 1; 0), Morocco (0; 3; 0), South Africa (0; 5; 0) and Sudan (0 ;1;0). This week, a total of 423 new cases (39 new confirmed; 384 new suspects) and three new deaths of monkeypox were reported in Benin, Congo, Ghana and Liberia.

Benign: The West African Health Organization (WAHO) has reported three suspected cases and no deaths due to monkeypox. This is the same number of cases compared to the previous report. A total of six cases (3 confirmed and 3 suspected) and no deaths have been reported.

congo: The Ministry of Health reported 11 new cases (9 suspected and 2 confirmed cases with zero deaths due to monkeypox. This is an increase of more than 100% in the number of cases compared to the last report. Cumulatively 29 cases (5 confirmed, 14 suspected) and three deaths (CFR: 10%) have been reported.

Ghana: WAHO has reported 399 cases (37 confirmed and 362 suspected) and three deaths (CFR: 0.9%) of monkeypox. This is a 64% increase in the number of new cases compared to the last report. A total of 619 cases (84 confirmed, 535 suspected) and four deaths (CFR: 0.7%) have been reported.

Liberia: WAHO has reported 10 new suspected cases with no deaths from monkeypox. This is the same number of cases compared to the last report. A total of 33 cases (2 confirmed, 31 suspected) and no deaths have been reported.

Figure 1. Confirmed monkeypox cases reported by week in AU Member States since January 2022[4]

The majority of cases reported by AU Member States are from the Central and West African regions, with DRC and Nigeria accounting for 79% of all confirmed cases reported (Table 1). Most cases were reported after the week of May 15 and this could be the result of increased surveillance in MS (Figure 1).

Table 1. Cumulative monkeypox cases and deaths reported in African Union Member States in 2022 – as of 14 September 2022.

Country Total cases (new) Total number of deaths (new) CFR[5]
Suspected Confirmed
Benign 3 (3) 30) 0 0%
Cameroon 29 (0) 7 (0) 2 (0) 5.6%
Central African Republic 17 (0) 8 (0) 2 (0) 8%
Republic of Congo 14 (9) 5 (2) 30) ten%
Democratic Republic of Congo 2775 (0) 163 (0) 1100) 3.4%
Ghana 535 (362) 84(37) 4 (3) 0.7%
Egypt 0 (0) ten) 0 0%
Liberia 31 (10) 2 (0) 0 0%
Morocco 0 30) 0 0%
Nigeria 704 (0) 277 (0) 6 (0) 0.6%
Sudan 0 ten) 0 0%
South Africa 0 5 (0) 0 0%
TOTAL 4,108 (384) 559 (39) 127 (3) 2.8%

Geoscope of events and levels of risk assessment

The Africa Centers for Disease Control and Prevention (Africa CDC) has conducted a preliminary assessment of the geographic scope (geoscope) and level of risk of reported monkeypox events in Africa and globally. Given that this outbreak is currently affecting multiple countries both on and off the continent, the Geoscope’s assessment is high. If other AU Member States report illness related to this outbreak, we will reassess and escalate accordingly. For the level of risk assessment, we considered the following criteria: morbidity and mortality of the disease, likelihood of spread within and to other AU Member States, and availability of effective treatments, vaccines or medicines. other control measures. We classified the level of risk as moderate given that monkeypox is not an easily transmitted and self-limiting disease with low mortality, which lacks effective treatment for those infected. We are monitoring the situation closely and will periodically reassess the risk.

Africa CDC response activities

  • The Africa CDC’s Emergency Operations Center (EOC) has shifted into response mode to support the preparedness and response efforts of African Union Member States, in close collaboration with relevant partners.
  • The Africa CDC, in collaboration with the NCDC and the African Society for Laboratory Medicine (ASLM), Trained 20 AU Member States in monkeypox diagnosis. Africa CDC also continued to distribute test kits to AU Member States to meet surveillance and detection needs in endemic and non-endemic countries. Additional cycles of training in laboratory diagnosis are planned.
  • Africa CDC continues to coordinate sequencing support to AU Member States as a surveillance tool for all variants of monkeypox.
  • Africa CDC has also engaged with Ministries of Health in highly affected Member States to provide support to areas most in need.
  • Africa CDC is communicating with global partners to ensure adequate access to test kits and vaccines by AU Member States.
  • Africa CDC is organizing training on surveillance, case management and risk communication and community engagement scheduled for September 19-23, 2022 in DRC

Recommendations to AU Member States

Member States are invited to:

  • Establish laboratory diagnostic and genomic sequencing capacity for orthopoxviruses, including monkeypox
  • Establish and/or strengthen existing monkeypox surveillance efforts
  • Develop and distribute general and tailored risk communication messages to the community as a whole as well as specific populations currently affected and at risk (e.g. sex workers, immunocompromised people, children)
  • Increase knowledge on the clinical management of monkeypox and infection prevention control measures
  • Report new cases of monkeypox in the current outbreak in multiple countries to Africa CDC ([email protected])

The general public is invited to:

  • See a doctor if you have monkeypox-like symptoms (for example, develop a rash with or without previous symptoms of fever, swollen lymph nodes, body aches and weakness), especially if you have been in contact with a case positive
  • Practice effective hand hygiene by washing your hands with soap and water or using an alcohol-based hand sanitizer, especially after contact with an infected animal or human
  • Avoid contact with animals that may harbor the virus, including sick or found dead animals in areas where monkeypox occurs
  • Avoid contact with any potentially contaminated materials, such as clothing and bedding, that animals with monkeypox have come into contact with
  • If considered close contact with a case of monkeypox, individuals should self-monitor for the development of symptoms for up to 21 days after the last exposure to a case.
  • If you are infected with monkeypox, follow your doctor’s recommended isolation protocols to minimize transmission to other people, including pets and other animals that may be infected with monkeypox.

References

  1. European Center for Disease Prevention and Control (ECDC) – Risk Assessment: Multi-Country Monkeypox Outbreak (23 May 22)
  2. Nigerian CDC Monkeypox National Public Health Response Guidelines – https://ncdc.gov.ng/themes/common/docs/protocols/96_1577798337.pdf
  3. US CDC – Information for the clinical management of monkeypox
  4. US CDC – Global map of the 2022 monkeypox outbreak | monkey pox | Pox virus | CDC
  5. US CDC – Monkeypox: Get the Facts
  6. WHO – Monkeypox fact sheet
  7. WHO – Monkeypox outbreak in several countries in non-endemic countries
  8. WHO – Laboratory tests for monkeypox virus: interim advice
  9. WHO – Meeting of the International Health Regulations Emergency Committee (2005) regarding the Multi-Country Monkeypox Outbreak

WHO – Statement by the Director General on the report of the 2005 IHR Emergency Committee meeting concerning the outbreak of monkeypox in several countries


[1] Global case and death counts include numbers reported in Africa.

[2] US CDC – https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html; WHO – https://worldhealthorg.shinyapps.io/mpx_global/

[3] Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, Republic of Congo and Sierra Leone

[4] The high number of confirmed cases reported in the DRC during the week of July 15 is likely the result of cluster reporting.

[5] The case fatality rate is the proportion of the total number of deaths compared to the total number of cases, suspected and confirmed.