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Mpox outbreak threatens normal business for DR Congo, neighbours 

Volunteer pharmacists fill syringes with the JYNNEOS smallpox and monkeypox vaccine during a clinic offered by the Pima County Department of Public Health at Abrams Public Health Center in Tucson, Arizona, U.S., August 20, 2022.

Photo credit: Reuters

Southern African countries have activated emergency measures to tame the spread of Mpox from its epicentre in the Democratic Republic of Congo in what could disrupt the recent rise from the chaos of Covid-19.

The Africa Centre for Disease Control and Prevention (Africa CDC) last week said there have been some 8479 cases, and 401 deaths, from Mpox since January 2024 on the continent, even though there have been cases in 110 countries since last year in May.

In Africa, however, 97 per cent of those cases have been found in the DRC, making it the hotspot for the outbreak.

Africa CDC held a high-level emergency meeting on Mpox in the DRC in April 2024 to advise countries on emergency measures as well as driving a vaccination campaign.  

“Mpox is preventable and manageable, and treatment for both mild and severe cases is available,” Africa CDC said at the time.

The new outbreak that has put neighbours on watch, however, could be from a new variant of the virus that spreads faster, according to an assessment by the World Health Organization (WHO).

The DRC itself reported an increase in the number of cases, with the viral disease now reported in every corner of the country, according to Dr Shungu Lushima, Director of the National Mpox Programme (PNLM) in the DRC.

So far, cases have emerged in South Africa, Mozambique, Cameroon, Nigeria, Sudan, Ghana, Central Africa Republic, Egypt, Benin, Liberia and Morocco, across Africa. 

In South Africa, the Department of Health issued a warning about the symptoms of Mpox on Wednesday and asked people to exercise maximum hygiene.

The Department of Health in South Africa recently confirmed six more cases of Mpox, bringing the total number of infections to 16 since the outbreak began, with three recorded deaths. 

They emphasised the need for cross-border integrated disease surveillance and coordinated supply of medical countermeasures, including diagnostics, vaccines, and therapeutics, as part of the Pathogen Access and Benefit Sharing (PABS). 

Angola, which shares the longest land border with the DRC issued similar rallying calls on safety measures but said it will increase surveillance of its borders to ensure they remain “inviolable order to prevent the disease from reaching the country,” a Ministry of Health statement said on Tuesday.”

Angola, it said, was monitoring the evolution of the disease in neighbouring countries and, as a result, was immediately recommending preventative measures such as frequently washing hands with soap and water or disinfecting with alcohol gel, not hunting or eating the meat of monkeys and rodents such rats, mice and squirrels.

According to the Angolan government, there has been no reported case within its borders yet contrary to reports that Cabinda province enclave had recorded two cases of the new strain.

Angola and DRC share a 2,500-kilometer land border, the longest in Africa, with provinces such as Angola’s Lunda Norte, with its massive diamond deposits, shares the 770 km of land boundary with DRC’s provinces of Kassai, Kassai Central, Lualaba and Kwango. All are porous and often see migrants crossing illegally both ways in search of minerals and other types of trade.

The International Organization for Migration in Angola (IOM) says that due to a lack of sufficient human and technological resources for the vast area’s surveillance needs, the border between Angola and the DRC is constantly vulnerable to instances of irregular migration, smuggling and trafficking in persons.

In the DRC, last year, almost 600 deaths were recorded due to the Mpox in the DRC. The Congo, now identified as the endemic zone for the disease, has so far recorded 410 deaths since the start of the year, data from the Ministry of Health showed this week. 

According to this African Union body, more than 19,000 cases were recorded in the DRC between February 2023 and February 2024, including 1,000 deaths, with children under 5 accounting for one in ten deaths. 

Researchers are particularly concerned about the emergence of more predominantly sexual transmission, notably through prostitution, and the high mortality rate among children up to the age of 15.

In the Democratic Republic of Congo, officials say they are pinning their hopes on vaccination, after the Ministry of Health, Dr Roger Kamba, approved two vaccines due to arrive in the next few days. 

“Cases of the disease are spreading everywhere. We can vaccinate everyone, of course, but we’re going to start where there are several cases. 

“Steps are being taken to obtain the new vaccine that the Minister has authorised. We're waiting for the vaccine to arrive,” Dr Kamba stressed.

He urged the public to remain calm and avoid eating animals found dead, including domestic animals. In the Democratic Republic of Congo, bush meat and monkey meat, suspected reservoirs of the virus, are particularly popular.  

Mpox (formerly known as monkeypox) is a disease caused by infection with a virus, known as Monkeypox virus. This virus is part of the same family as the virus that causes smallpox.

People with mpox often get a rash, along with other symptoms such as fever, rash and swollen lymph nodes, according to a bulletin by the WHO. Incubation (the period between infection and manifestation of symptoms) takes about 21 days.

Though Africa CDC says the disease is rare, its zoonotic nature (which means it affects both animals and humans) makes it easier to spread within a short time.

It occurs primarily in tropical rainforest areas of central and west Africa and can spread can spread in humans through close contact with an infected person or animal, or with material contaminated with the virus such as clothing, bedding and towels, the Africa CDC says. It was first discovered in the DRC in the 1970s. It may go away after a few days of symptoms but it may at times turn deadly. At most 3.6 percent of those infected die.

In the DRC, in North Kivu for example, the government, in collaboration with the WHO, and other UN agencies is putting in place a series of preventive measures, starting with awareness and hygiene.  

While awaiting the launch of large-scale vaccination, DRC officials and the WHO are concerned about new patterns of sexual transmission of the virus, and the WHO is currently conducting a joint mission with the DRC Ministry of Health "to assess the situation". 

"These new patterns of sexual transmission now raise additional concerns about the continued rapid expansion of the epidemic in the country", it adds, adding that "the risk of Mpox spreading to neighbouring countries and worldwide appears significant.”

 
What you need to do:


•    Do not leave your home if you suspect or are confirmed with Mpox, except to seek health care.
•    Avoid contact with wild or domestic animals 
•    Wash hands often with soap and water 
•    Suspected/confirmed cases of monkeypox should be isolated in a room from other family members where possible
•    Persons with monkeypox infection should wear a surgical mask (especially those who have respiratory symptoms e.g., cough, shortness of breath, sore throat) where feasible
•    Disposable gloves should be worn to avoid direct contact with lesions, and these should be disposed of after each use
•    Skin lesions should be covered to the best extent possible (e.g., long sleeves, trousers/long pants) to minimise the risk of contact with others
•    Laundry (e.g., linen and clothing), dishes and all contaminated surfaces may be washed with hot water, detergent, and disinfectant (0.5 percent sodium hypochlorite solution)
•    The importance of hand hygiene using soap and water, or alcohol-based sanitiser should be emphasised.


Reporting by Patrick Ilunga, Peter Dube and Arnaldo Vieira