Africa: Mpox Outbreak in South Africa

Addis Ababa — On 13 May 2024, the Government of South Africa announced an outbreak of Mpox following the confirmation of a case from Gauteng province with no travel history to countries with an active Mpox outbreak. As of today, a total of 7 laboratory-confirmed cases and two deaths (Case Fatality Ratio – CFR: 28.6%) were reported from Gauteng (3/7), KwaZulu-Natal (3/7), and Western Cape (1/7) provinces. The cases were confirmed at the National Institute for Communicable Diseases (NICD) of South Africa.

All the cases were classified as severe cases of Mpox and required hospitalization. All cases are male, between the ages of 30 and 39 with co-morbidities (HIV-positive), and five of the seven identified as “men who have sex with men.”

Preliminary investigations indicate that all the confirmed cases had no history of travel to countries with ongoing Mpox outbreaks.

Available sequence data from three cases revealed the circulation of Clade IIb in South Africa. Clade IIb led to the largest multi-country Mpox outbreak in 2022.

The Ministry of Health has deployed rapid response teams to support further investigations. Contacts of the confirmed cases are being monitored for 21 days. Additionally, active case search, case management, and risk communication are ongoing in affected communities.

On June 13, 2024, H.E. Dr. Jean Kaseya, Director General of Africa CDC, met with Hon. Joe Phaahla, Minister of Health, and Dr. Sandile Buthelezi, Director General of the National Department of Health, to assess the situation and coordinate the response to this outbreak.

“At Africa CDC, we commend the leadership and efforts of the South African government in managing this outbreak and appreciate the support from partners like WHO. We are committed to supporting South Africa in securing the necessary doses of Mpox vaccines, and building capacity for event-based surveillance focusing on community and health facility. An Mpox outbreak anywhere is a threat everywhere. We call for swift and urgent action to increase access to Mpox diagnostics, vaccines and therapeutics for all affected African countries.”said Dr. Jean Kaseya, the Director General of the Africa CDC.

Since January 2024, seven African countries have reported Mpox, with a total of 8,401 cases and 412 deaths as of June 14, 2024. Notably, 97% of these cases are from the Democratic Republic of Congo.

In response to this dire situation, Africa CDC held a high-level emergency meeting on Mpox in the DRC in April 2024. The meeting underscored the critical need for timely, accurate, and high-quality data on the Mpox to inform decision-making and program interventions. Ministers of Health from Angola, Benin, Burundi, Cameroon, Central African Republic, Congo, Democratic Republic of Congo, Gabon, Ghana, Liberia, Nigeria, and Uganda, along with partners, emphasized the urgent need to strengthen preparedness and response to Mpox in Africa. They highlighted the necessity for cross-border integrated disease surveillance and a coordinated supply of medical countermeasures like diagnostics, vaccines and therapeutics as part of the Pathogen Access and Benefit Sharing (PABS).