This week, the Africa Centres for Disease Control and Prevention (Africa CDC) announced the mpox clade I outbreak as a Public Health Emergency of Continental Security, which was followed by a declaration from the World Health Organization (WHO) labeling it a Public Health Emergency of International Concern. The U.S. government has expressed its support for these declarations and will collaborate closely with African governments, Africa CDC, and WHO to ensure an effective response to the outbreak, prioritizing the health and safety of the region’s population.
In 2022, the global clade II mpox outbreak resulted in over 95,000 cases reported in 115 countries where the disease is not endemic. Clade I mpox is associated with more severe infections and a higher mortality rate compared to clade II. Clinical data mainly from endemic countries like the Democratic Republic of the Congo (DRC) informs these conclusions. It is anticipated that clade I mpox would lead to lower morbidity and mortality rates in the U.S. than in the DRC.
The DRC is currently facing its highest number of suspected cases on record, with the disease now appearing in several neighboring countries where mpox has not previously been reported.
U.S. Government Involvement in the Mpox Response
Since 2023, the U.S. government has been closely monitoring the clade I mpox outbreak in DRC and surrounding regions, collaborating with the DRC government and various health partners to mitigate the outbreak’s impact and protect public health. The U.S. support for the mpox response builds on over 20 years of strong health partnerships with DRC and Africa, targeting infectious diseases such as HIV, tuberculosis, and malaria. In the fiscal year 2023, over $2.65 billion was allocated in bilateral health funding for Central and Eastern Africa. This support also reinforces the longstanding global health security partnership between the U.S. and DRC.
In addition to ongoing health initiatives, the U.S. has allocated an extra $17 million to bolster clade I mpox preparedness and response in Central and Eastern Africa. This funding has strengthened surveillance, risk communication, community engagement, and provided essential laboratory supplies, diagnostics, clinical services, and vaccine planning.
Vaccination is a key component of the outbreak response. To assist in these efforts, the U.S. is donating 50,000 doses of the FDA-approved JYNNEOS vaccine to the DRC. The U.S. is also working alongside other nations, WHO, and international partners to promote additional donations to aid vaccine distribution and tackle delivery challenges.
Mpox Preparedness in the United States
Currently, the risk of clade I mpox from the DRC to the general public in the United States is extremely low, with no known cases reported domestically. Thanks to proactive measures taken over the past nine months, the U.S. is well-equipped to quickly identify, contain, and manage any clade I cases that may arise. The U.S. has an effective surveillance system, which includes clinical testing and wastewater analysis. High-risk individuals are encouraged to receive the JYNNEOS mpox vaccine, known to be safe and effective against severe disease from mpox. Individuals who have recovered from clade II mpox or are fully vaccinated against mpox are likely to be protected from serious illness caused by clade I mpox.
The CDC has released an updated Health Alert Network advisory urging healthcare providers to consider clade I mpox in patients who have traveled to the DRC or adjacent countries within the past 21 days. Clinicians are asked to submit specimens for clade-specific testing for any patients showing symptoms consistent with mpox. Given the geographic spread of clade I mpox, the CDC issued an updated Travel Health Notice on August 7, 2024, advising travelers to DRC and neighboring countries to take heightened precautions.