Skin lesions that are characteristic of mpox are seen on a young patient at Kavumu hospital in South Kivu province, Democratic Republic of the Congo, on August 30, 2024. Photo Credit: WHO
Geneva: Uganda currently leads the world in confirmed mpox cases, with a staggering 200 to 300 new cases emerging each week, all attributed to clade Ib MPXV. According to the latest World Health Organization’s ‘Multi-country external situation report’, released today, cases of mpox due to clade Ib monkeypox virus (MPXV) continue to be reported primarily in Africa, where eleven countries have reported community transmission of this strain in the past six weeks.
The report noted that the Democratic Republic of the Congo has the highest cumulative mpox cases in Africa for 2025, although recent weeks have seen a decline in reported cases, likely due to reduced testing capabilities. Clades Ia and Ib MPXV remain active in the region.
In Sierra Leone, the situation is worsening, with over 200 new confirmed cases in the last week alone, indicating a surge in transmission, while epidemiological data is still being compiled. Conversely, Burundi is experiencing a downward trend, with fewer than 50 new cases weekly, a significant drop from the peak of over 200. Malawi has also reported its first mpox cases linked to clade Ib MPXV, with no travel connections to other affected nations, hinting at local transmission. China has also confirmed a second mpox case associated with clade Ia MPXV, which is connected to travel from the Democratic Republic of the Congo.
Since its first detection in September 2023, clade Ib MPXV has been detected in 29 countries, the report said. Most of these countries have reported only travel-related cases, infections in individuals who were exposed in countries with community transmission of clade Ib MPXV in Central or Eastern Africa, or who were contacts of travellers returning from these regions.
In the Democratic Republic of the Congo, where clade Ib MPXV originated, cases have been reported in 10 provinces: South Kivu, North Kivu, Kinshasa, Kasai, Tshopo, Tanganyika, Haut-Katanga, Mai-Ndombe, Lomami, and Kongo-Central. Within Africa, community transmission of clade Ib MPXV has also been reported in Burundi, Kenya, Malawi, the Republic of Congo, Rwanda, South Africa, South Sudan, Uganda, the United Republic of Tanzania, and Zambia. Countries which have previously reported cases but not reported any cases within the past six weeks include Angola and Zimbabwe.
Outside Africa, 16 countries have reported cases of mpox due to clade Ib MPXV: the United Kingdom of Great Britain and Northern Ireland (12 cases), Germany (10 cases), China (seven cases), Belgium (five cases), Thailand (five cases), the United States of America (four cases), France (three cases), Qatar (three cases), Brazil, Canada, India, Oman, Pakistan, Sweden, Switzerland and the United Arab Emirates (one case each).
The report said community transmission was only documented in the United Kingdom, where the eleventh reported case had no known link to travel or to a confirmed case with travel history.
Most mpox outbreaks in other parts of Africa and on other continents are due to clade IIb MPXV, a continuation of the multi-country outbreak that began in 2022. Most regions report the circulation of clade IIb lineage B.1, while lineage A.1 continues to circulate in Nigeria and some countries in the WHO Eastern Mediterranean Region. The most affected population outside of Africa, where low levels of transmission are reported, continues to be men who have sex with men, primarily exposed through sexual contact. In instances where others have been affected, such as women and children, it has not led to sustained transmission. In western Africa, cases are reported in different age groups and include males and females, highlighting potentially different transmission dynamics, which are not fully understood.
The multi-country outbreak of mpox driven by clade IIb MPXV that began in 2022 showed that sexual contact can sustain community transmission of MPXV for long periods of time. Likewise, subclades Ia and Ib have also been shown to be spreading through sexual contact, and their transmission is being sustained in different settings. Much remains to be understood about transmissibility and sustainability of transmission through non-sexual direct physical contact for all clades, WHO said. In settings where human-to-human transmission persists, it is likely driven by a combination of sexual, household, and community contact.
– global bihari bureau
