Mpox Cases to Rise in Africa: What You Need to Know

In August, Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organisation (WHO), declared Mpox a public health emergency following a surge in cases in the Democratic Republic of the Congo (DRC), where the virus was first identified. It has since spread to other African countries and beyond, including the United States of America.

The African Center for Disease Control and Prevention recently predicted that the virus will increase across the continent due to factors like seasonal variations, hunting activities during the dry season and other factors which play a role in the habitat and behaviour of animals acting as the reservoirs of the virus. Also, inadequate access to healthcare was identified.

This surge is expected within December, with a possible stall in the coming year. 

Understanding Mpox

Mpox, formerly known as Monkeypox, is a zoonotic virus transmitted between animal hosts and humans through human-human contact. The virus, first identified in Denmark in 1958, resurfaced in the DRC in 1970. After its eradication in the 1980s, Mpox emerged again in Central, East, and West Africa. Thousands of cases have been recorded annually in the DRC since 2005. 

In Nigeria, an outbreak was formally recorded around 2017 to 2019, with young urban adults being the most affected. Other cases were also recorded among prison inmates, persons exposed to wildlife, households, and sexual partners.

More recently, in 2022, another Mpox outbreak was declared in the DRC. This time, it came with a new strain, ‘Clade Ib’, leading to several outbreaks in other countries that were not previously affected.

Dr Elizabeth Adejire, an epidemiologist with the African Field Epidemiology Network, an independent organisation dedicated to improving health outcomes across Africa, told HumAngle that Mpox symptoms include fever, chills, headache, and muscle pain, progressing to a rash. These rashes begin as flat sores, later forming blisters that spread across the body. 

Enlarged lymph nodes—a condition called lymphadenopathy—distinguish Mpox from other illnesses. “Lymphadenopathy in medical terms is the enlargement of the lymph around the neck, around the armpits, and also in the liver where you find some needle-like swellings around those areas,” she explained.

“Typically, for Mpox, the rash starts mildly, usually bloodstains form, and then progresses,” Dr Adejire stated. She also added that general body weakness, body pain, and some features that mimic malaria are noticed in Mpox patients.

Dr Irene Esu, an Assistant Director at the Federal Ministry of Health and Social Welfare who is a consultant public health physician and a field epidemiologist, stated that those who are more likely to contract the Mpox virus are healthcare workers, hunters, bushmeat consumers, children, and individuals with compromised immunity, such as people living with HIV or diabetes.

According to Dr Esu, people travelling to areas where Monkeypox is endemic around central or west Africa are also susceptible.

‘Prevention is better than cure’

Experts who spoke to HumAngle emphasised avoiding contact with infected individuals or animals, particularly sick or dead wildlife. Proper cooking of bushmeat, regular handwashing, and using personal protective equipment (PPE) in healthcare settings are critical.

Additionally, Dr Adejire urged that people, especially those who have contracted the virus, should avoid sharing their items like bedding, towels, and clothing. She also stressed the need for healthcare workers to prioritise the use of personal protective wear. 

For patients going through the early stages of the infection, the public health expert advised that they take prescribed antibiotics, pain relievers, and non-steroidal anti-inflammatory medication to manage the malaria-like symptoms. 

“It is very crucial to seek medical help, but before you get professional help, whoever is suspected of getting the Mpox virus should stay hydrated, rest and ensure that in case there’s fever or headache or body aches, the person should ensure that they take paracetamol to reduce the aches,” Dr Adejire added. 

Infected individuals are also encouraged to keep the rash clean and covered to prevent secondary infection and transmission of the disease to other people while avoiding contact with other people. “The rash usually comes with a lot of pain and discomfort, so they must take analgesics. They can also apply calamine lotion because the rashes are itchy. The calamine lotion will help relieve the itching and dry those scars,” she said.

In case of an outbreak, Dr Adejire advised that the local health authorities should be informed so that the virus can be well-tracked to prevent further spread. 

“If anyone starts noticing some of the symptoms like difficulty in breathing or maybe they are taking some antipyretics and the fever is not going down, that signals that they need to be referred immediately to a healthcare facility where further investigations will be done and appropriate treatment will be given,” she said, 

While hinting at using protective clothing in handling sick animals, Dr Esu also stressed the need for vaccinations, noting Nigeria’s ongoing campaigns despite a limited supply. In November, only three African countries—Nigeria, Rwanda, and the DRC—received 280,000 vaccine doses, with over 50,000 administered.

“It is expected that Nigeria is going to get more vaccines as time goes by, so for people that are at higher risk, it’s very important for them to get vaccinated,” she added. 

Mpox in Africa

The 40th multi-country situation on Mpox in Africa released in October by WHO revealed sixteen affected countries, with the DRC being the most impacted with over 6,000 cases and 25 deaths. In Burundi, about a thousand cases were recorded with no deaths, while Nigeria had about 94 cases with no fatalities. New cases were recorded in Zambia, Ghana, and the Central African Republic.

Through its Contingency Fund for Emergencies, WHO recently donated $1 million to support African countries plagued by the virus while stressing the need for more funds in line with the regional response plan that requires $15 million to aid surveillance, preparedness and response activities.

The Nigerian Center for Disease and Control Prevention (NCDC) is responsible for preventing, detecting, and controlling infectious diseases like Mpox. With forecasts indicating a rise in Mpox cases across Africa, HumAngle reached out to the NCDC to discuss their strategies for addressing this looming threat and their plans for preventive measures and vaccination updates. Unfortunately, all efforts to contact the agency have been unsuccessful at the time of filing this report.