Though mpox activity is declining in Africa’s highest burden countries, trends are on the upswing in others, including Kenya, Liberia, Ghana, and Nigeria, a top official from Africa Centres for Disease Control and Prevention (Africa CDC) said yesterday at the group’s weekly health emergencies briefing.
The World Health Organization (WHO) last week wound down the global mpox emergency, but Africa CDC has continued the public health emergency of continental security due to the fragility of progress over the past several months and the need to keep momentum going until the outbreaks are under control. Also, the African region is battling several other outbreaks, including cholera, measles, dengue, Lassa fever, and most recently Ebola.
Ngashi Ngongo, MD, PhD, MPH, who leads the group’s incident management team, said though suspected and confirmed cases were up in the most recent reporting week, the overall trend continues to reflect a decline. Over the past year, cases have already outpaced the total for 2024 and officials have especially been worried about deaths, which rose sharply this year, especially in groups affected by underlying health conditions such as HIV.
Liberia is seeing significant and sustained activity, with Montserrado County, home to the capital city Monrovia, accounting for 66% of confirmed cases. Ngongo said 88% of the country’s active cases are being managed through home isolation. He said Kenya’s outbreak is still expanding with no sign of a plateau and cases concentrated in three counties: Mombasa, Busia, and Nairobi.
Eleven countries have rolled out their mpox vaccination programs, most recently Kenya. Malawi and Zambia are expected to receive doses of the MVA-BN vaccine over the next week.
CEPI to support LC16 study in the DRC
The Coalition for Epidemic Preparedness Innovations (CEPI) yesterday announced up to $10.4 million to support a study on the performance of the LC16 vaccine in use against mpox in the Democratic Republic of Congo (DRC). Japan donated nearly 1.6 million doses of the live-attenuated vaccine against smallpox for use against mpox, and the DRC has approved it for emergency use and recently added it to its immunization campaign. Made by KM Biologics, Japan drew the doses from its bioterrorism countermeasure stockpile. Japan used it in 1974 to successfully vaccinate young children, an ag- group hit hard in the DRC’s outbreaks and is not currently eligible for the MVA-BN vaccine. LC16 is administered with a bifurcated needle.
The study is set to launch this fall, with the International Vaccine Institute as the study sponsor, with support from the DRC’s health ministry and the country’s National Public Health Laboratory (INRB). The INRB is the principal investigator, with the Japan Institute for Health Security as the co-investigator.
Sharp cholera rises in Chad and Republic of Congo
Regarding cholera, Ngongo said Chad and the Republic of Congo are reporting new outbreaks. Ngongo said the drivers in Chad include the movement of refuges from Sudan, overcrowded refugee camps, and hygiene challenges in affected areas. In the Congo, cases are focused on vulnerable areas along the Congo River and places where sanitation is poor.
Elsewhere, cases are on the rise in Burundi, and to a lesser degree Ethiopia.
Though Sudan remains the country with the highest case numbers, he said health officials are seeing some stabilization. Sudan, South Sudan, and the DRC remain the highest burden countries, accounting for 75% of the region’s cases and deaths, he said.
Twenty-three of Africa’s countries have battled cholera outbreaks this year. As a whole, cholera cases declined by 33% over the past 6 weeks, with deaths down slightly.
In a related development, the World Health Organization (WHO) today released its global cholera report for 2024, which reflects that cases rose 5% compared to 2023, with deaths up 50%.
“More than 6,000 people dying from a disease that is both preventable and treatable. While these numbers are themselves alarming, they are underestimates of the true burden of cholera,” the WHO said, noting that the rising case-fatality rate in Africa shows gaps in life-saving care and the fragility of health systems.
Oral cholera vaccine supply constraints eased some in 2024 with increased production and shifts to single-dose campaigns. However, supply constraints have continued into 2025, with 31 countries reporting outbreaks since the beginning of the year.