2025-01-27-世界卫生组织-Multi-country_outbreak_of_mpox,_External_situation_report_46_-_28_January_2025_26页_1mb

Mpox Summary Report

Core Content

This report provides an update on the global and regional epidemiological situation of mpox (monkeypox virus, MPXV) as of 19 January 2025, with a focus on Africa, particularly the Democratic Republic of the Congo (DRC), Burundi, and Uganda. It outlines the spread of different MPXV clades, the impact of outbreaks, and the challenges faced in controlling the disease.

Main Outbreaks and Clades

Clade Ia MPXV

• Predominant in the DRC, where it affects both endemic and previously unaffected provinces.
• Community transmission is observed in several provinces, including Kinshasa and South Kivu.
• Sporadic cases continue to be reported in the Central African Republic and Republic of Congo.
• Co-circulation with clade Ib MPXV is noted in several provinces.
• Sustained human-to-human transmission is increasingly observed in Kinshasa, with high rates of APOBEC3-driven mutations.
• No sequencing data available for four provinces (Ituri, Kasai Oriental, Lomami, and Haut-Lomami).

Clade Ib MPXV

• Predominant in the DRC, with community transmission reported in Burundi, Kenya, Rwanda, and Uganda.
• Travel-related cases have been identified in countries outside Africa, including China, Germany, Thailand, the United Kingdom, the United States, Canada, France, India, Pakistan, Belgium, and Sweden.
• No deaths have been reported in these non-African countries.
• Secondary transmission has occurred in the UK, Germany, Belgium, China, and France.
• Imported cases are typically among adults who traveled during their incubation period or with early symptoms.
• Age distribution is shifting, with increasing cases among children in some regions.

Clade IIa MPXV

• Reported in Côte d'Ivoire, Guinea, and Liberia in 2024.
• Sustained community transmission is observed in Côte d'Ivoire and Liberia.
• First time co-circulation of clade IIa and IIb MPXV is reported in these countries.
• Cases are reported in both adults and children, with limited epidemiological links, suggesting ongoing, largely undetected community transmission.
• Less understood in terms of transmission modes compared to other clades.

Clade IIb MPXV

• Most prevalent outside Africa, especially in men who have sex with men (MSM) populations.
• Australia experienced an unprecedented outbreak in 2024, which has since subsided.
• Other regions (Americas, Europe, Southeast Asia, Eastern Mediterranean) report ongoing low-level transmission, mainly among MSM.
• No deaths have been reported in these regions.

Key Figures

Global Summary (1 Jan 2022 – 31 Dec 2024)

• Total confirmed cases: 124,753
• Total deaths: 272
• Number of reporting countries: 128
• Global CFR: 0.2%

Recent Period (1 Jan 2024 – 19 Jan 2025)

• Africa: 20,345 confirmed cases, 64 deaths (CFR: 0.3%)
• DRC: 14,530 confirmed cases, 43 deaths (CFR: 0.3%)
• Burundi: 3,116 confirmed cases, 1 death (CFR: 0.03%)
• Uganda: 2,031 confirmed cases, 10 deaths (CFR: 0.5%)

Last Six Weeks (9 Dec 2024 – 19 Jan 2025)

• Africa: 2,935 confirmed cases, 5 deaths
• DRC: 1,316 confirmed cases, 0 deaths
• Burundi: 570 confirmed cases, 0 deaths
• Uganda: 984 confirmed cases, 5 deaths

Global Trends

• Monthly confirmed cases in December 2024: 3,831, a 5.6% decline from November.
• Africa reported the highest number of cases (86.2% of total), with a 6% increase compared to November.
• Americas: 62% decline in cases
• Western Pacific: 40% decline
• South-East Asia: 29% decline
• Europe: 23% decline
• Eastern Mediterranean: No change in cases

Key Challenges and Observations

• DRC remains the most affected country, with ongoing circulation of both clade Ia and Ib MPXV.
• Community transmission is increasingly observed in DRC and other African countries.
• Escalating violence in eastern DRC poses additional challenges to mpox response.
• Imported cases are often linked to travel-related exposure and sexual contact.
• Testing limitations in some areas, particularly in DRC, result in the inclusion of suspected cases in the total count.
• Festive season in late 2024 may have impacted surveillance and reporting.
• New hotspots in South Kivu and Kinshasa, both of which have international airports and strong cross-border connectivity.
• Azerbaijan has reported its first mpox case with no clade information available.

Operational Updates

• Emergency coordination and collaborative surveillance are ongoing.
• Community protection measures and safe and scalable care are being implemented.
• Access to countermeasures is being improved through Mbox resources.
• Annex 1 provides a summary of the latest WHO rapid risk assessment from November 2024.

Conclusion

The mpox outbreak continues to be a significant public health concern, with the DRC remaining the epicenter of the disease. The spread of clade Ib MPXV has expanded beyond the DRC into neighboring countries and further afield, with travel-related cases being detected in multiple countries. While the global CFR remains low, the increasing proportion of cases among children and the sustained transmission in certain regions indicate the need for continued vigilance and targeted public health interventions.