This week, the Africa Centres for Disease Control and Prevention (Africa CDC) announced a Public Health Emergency of Continental Security due to the outbreak of clade I mpox. Concurrently, the World Health Organization (WHO) declared it a Public Health Emergency of International Concern, a move supported by the United States government. The U.S. will collaborate closely with African nations, Africa CDC, and WHO to ensure an effective response to the outbreak and to protect public health in the region.
In 2022, the world faced a significant outbreak of clade II mpox, resulting in over 95,000 cases in 115 non-endemic countries. Clade I mpox is noted for causing more severe infections and a higher mortality rate compared to clade II. Current clinical data on clade I is predominantly sourced from endemic areas, primarily the Democratic Republic of the Congo (DRC). It is anticipated that its impact in the United States would be less severe than in the DRC.
The DRC is witnessing an unprecedented number of suspected mpox cases, with the disease now being reported in several neighboring countries where it had not previously existed.
Regarding the Mpox response, the U.S. government has been monitoring the clade I mpox situation in the DRC and its borders since 2023. Collaborative efforts with the DRC government, along with regional and global health allies, aim to mitigate the outbreak’s impact and enhance public health safety. U.S. support builds on long-standing health initiatives within DRC and across Africa, addressing infectious diseases such as HIV, tuberculosis, and malaria for over two decades. In fiscal year 2023, the U.S. allocated more than $2.65 billion in health funding to Central and Eastern Africa. This response is part of an ongoing commitment to global health security in partnership with the DRC.
In the past few months, the U.S. has provided an additional $17 million for clade I mpox preparedness and response in Central and Eastern Africa. This funding has bolstered surveillance, risk communication, community engagement, and the provision of necessary laboratory supplies, clinical services, and vaccine strategies.
Vaccination is a vital part of the response strategy. The U.S. plans to donate 50,000 doses of the FDA-approved JYNNEOS vaccine to the DRC and is actively working with other nations, WHO, and international partners to facilitate vaccine donations and address delivery challenges.
As for the United States, the risk of clade I mpox transmission from the DRC remains very low, with no known cases reported domestically. Thanks to efforts implemented over the past nine months, the U.S. is prepared to quickly identify, contain, and manage any domestic cases. A robust surveillance system, including clinical testing and wastewater analysis, has been established. High-risk individuals are encouraged to receive the JYNNEOS mpox vaccine, which has proven to be safe and effective against severe cases of mpox. Those previously infected with clade II mpox or fully vaccinated are believed to have some protection against severe illness from clade I.
The CDC has issued a new Health Alert Network advisory, urging clinicians to assess for clade I mpox in patients who have traveled to the DRC or its neighboring areas within the last 21 days. Clinicians are advised to submit specimens for testing if these patients exhibit symptoms of mpox. In light of the geographical spread of clade I mpox, the CDC also issued an updated Travel Health Notice on August 7, 2024, recommending that travelers to the DRC and surrounding countries exercise enhanced precautions.