2024-12-22-世界卫生组织-Multi-country_outbreak_of_mpox,_External_situation_report_44_-_23_December_2024_25页_1mb

Mpox Multi-country External Situation Report Summary

Key Statistics

• Reporting Period: 01 January 2022 to 30 November 2024 (global); 01 January to 15 December 2024 and last 6 weeks as subsets.
• Cases:
  • Cumulative global cases: 117,663 confirmed cases, with 263 deaths (case fatality ratio ~0.2%).
  • In November 2024, 2,726 new confirmed cases reported, showing a 13.2% decline from October.
  • Africa contributed 71.2% of November cases, with DRC as the most affected country (9,513 cases, 43 deaths).
• By Region: African Region led cases in November, with increases in European and Western Pacific Regions; declines in Eastern Mediterranean and Southeast Asia.

Highlights and Epidemiological Trends

• Global Situation: Cases plateaued in some regions, with African Region showing steady increase. Clade Ib and IIb viruses are spreading internationally, driven by sexual contact in non-African areas.
• Africa Focus: High concern due to outbreaks in DRC, Burundi, and Uganda; clade Ib detected in DRC, Burundi, Kenya, Rwanda, Uganda, Zambia, and Zimbabwe. Community transmission ongoing.
• Risk Assessment (WHO, 2024):
  • Clade Ib MPXV: High risk for international spread via sexual contact; most affects non-endemic areas.
  • Clade Ia MPXV: High risk in endemic African areas, linked to zoonotic spillover and human-to-human transmission.
  • Clade II MPXV: Variable risk across regions; clade IIb primarily affects men who have sex with men through sexual contact.
• Recent Cases: Pakistan and Oman report first clade Ib and clade I cases, respectively. Australia saw high cases but potential plateau.

Operational Updates

• Global Response: Focus on emergency coordination, surveillance, community protection, care, and countermeasures for vaccines and diagnostics.
• Vaccines and Diagnostics: WHO supports tecovirimat access; diagnostic tests (e.g., Xpert Mpox) approved for emergency use.
• Surveillance: Enhanced indicator-based systems; genomic sequencing tracks spread and mutations.
• Clade-Specific Details: Clade Ib spreads fastest; DRC shows co-circulation and epidemiological shifts in transmission patterns.

Clade-Specific Outbreaks

• Clade Ib: Expanding beyond DRC to countries like Burundi and Uganda; community transmission via human contact.
• Clade Ia: Endemic in DRC and neighboring areas; sustained human-to-human transmission in sexual networks in Kinshasa.
• Clade IIb: High in Africa, predominantly spread through sexual contact in regions like Australia.
• New Pheno: Clade IIa MPXV emerging in West Africa, showing sustained human-to-human transmission for the first time.

Africa Regional Update

• Countries: 20 nations reported cases in 2024; DRC remains hotspot, with DRC, Burundi, and Uganda driving high caseloads.
• Case Trends: Plateauing in recent weeks; age distribution shifting toward children in some areas. CFR varies by region due to testing limitations.
• Transmission: Human-to-human and sexual contact key drivers; community-based measures advised to control spread.

Early Dec 2024 Cases Outside Africa

• Burundi and Uganda: High confirmed cases; community transmission and sexual networks identified.
• Pakistan and Oman: First cases of clade Ib and clade I reported, likely linked to travel from risk areas.

Operational Components (WHO Strategy)

• 5Cs: Emergency coordination, collaborative surveillance, community protection, safe care, and countermeasure access.
• Tools and Resources: WHO provides technical briefs, public health advice, and guidelines for vaccination, testing, and ethics.

Risk Assessment Changes

• WHO updated risk assessments based on new data, emphasizing higher risk in eastern African countries and global spread potential for clade Ib.

Note: Data subject to reporting delays and verification; interpretations of CFR and spread trends based on available information. For full details, refer to the original report and WHO resources.