Already over 1000 dead

Mpox still not under control in Africa

The colored electron micrograph shows Mpox virus particles (brownish) located in infected cells (green).

(Bild: NIAID via AP)

New cases of the disease every week and now more than a thousand deaths: the health authorities in Africa have been battling Mpox for months. Even though vaccination campaigns have begun, there seems to be no end in sight to the outbreak for the time being.

Every week, Jean Kaseya, Director of the African health authority CDC Africa, repeats in his situation reports: "Mpox in Africa is not under control". For him and other health experts, the situation is a bit like déjà vu.

As was the case during the Covid pandemic, the weaknesses of the continent's healthcare infrastructure are evident: too little laboratory and testing capacity, but above all too little in-house vaccine production. Health authorities on the continent are reliant on rich countries to provide vaccines from their own stocks to protect against the virus.

Outbreaks now in 20 countries
According to the CDC and the World Health Organization (WHO), there are currently Mpox cases in 20 African countries - the first case occurred in Angola last week. Since the beginning of the year, the number of cases has risen to almost 60,000, with 1164 deaths linked to Mpox so far this year.

Mpox, formerly known as monkeypox, occurs again and again in Central Africa - mainly transmitted from rodents to humans. The fact that there have never been any major outbreaks over the decades is partly due to the smallpox vaccination that used to be common. It also protects against the closely related Mpox virus. Smallpox has been considered eradicated since 1980, so vaccinations were discontinued.

Global Mpox alert declared
In mid-August, the CDC Africa and WHO declared the highest alert level due to the Mpox outbreaks in Africa and the new, potentially more dangerous variant Ib. This is intended to encourage authorities around the world to be more vigilant. It was also necessary to develop a common strategy on the continent, while the cases spread from the particularly affected Democratic Republic of Congo (DRC) to more and more countries outside of Central Africa.

However, more than 90 percent of cases continue to be recorded in Central Africa. Congo, Uganda and Burundi also accounted for 95.5 percent of the 2680 new cases recorded last week.

Delays in the vaccination campaigns
By the first half of November, the DRC, Rwanda and Nigeria had received a total of 280,000 doses of vaccine. However, vaccination started with delays in Congo and Nigeria. Poor infrastructure in huge areas, a lack of refrigeration facilities and power shortages are making the distribution of vaccines even more difficult, especially in rural regions.

In addition, the vaccine doses delivered so far are ultimately just a drop in the ocean: when the alert was declared, Kaseya had already spoken of at least ten million vaccine doses that would be needed on the continent to put a stop to the outbreak.

The existing vaccines against Mpox (pictured is a vial of the vaccine) are not yet approved for children.

(Bild: AFP/Aubin Mukoni)

No vaccine solution for children yet
In addition, children and adolescents under the age of 15 are among the groups particularly affected. They account for between 40 and more than 50 percent of cases of the disease in individual countries. However, as not all countries record cases of illness in children separately, there are no figures for all affected countries.

However, the existing vaccines against Mpox have not yet been approved for children. There is now hope, according to Ngashi Ngongo, the CDC Africa's Mpox manager, in the latest report on Thursday. Japan has promised the Democratic Republic of Congo three million doses of a vaccine that is also suitable for children from the age of one. However, the approval process in the African country is still pending.

Hygiene measures only have limited effect
Distance and hygiene measures, which were already used to try and minimize infections during the corona pandemic, can only have a limited effect - especially in the heavily affected eastern Congo. Around seven million people are living in extremely cramped conditions in refugee camps here after fleeing armed fighting in the conflict-ridden region.

"You can't even think about isolating all suspected cases because there is a huge population and there is no space or facilities for them," Agnese Commelli, a doctor with the aid organization Doctors Without Borders in Goma in eastern Congo, told the German Press Agency.

Many sick people wait and see
Many people only visit the health services at an advanced stage of the disease, as Commelli explains. "They don't walk four kilometers or more to the nearest health post just because they have a fever. They come when they are feeling worse and the rash is already advanced." The doctor has also found that the fear of contracting Mpox is not particularly pronounced: "It's not Ebola."

Until a visit to the doctor, relatives and neighbors are therefore often infected, especially where people live close together. In addition to the characteristic skin rash, typical symptoms include chills, fever, headaches, muscle aches and back pain.

Fatal cases occur mainly in regions with limited access to medical care. They often affect children, especially those who are malnourished, and people with weakened immune systems. After contracting Mpox, people develop immunity to re-infection that lasts for years. People who are already ill therefore do not initially need a vaccination.