Mpox, a viral disease that was first identified in humans in 1970 in the Democratic Republic of Congo (DRC), remained largely confined to the rural and remote regions of Central and West Africa for decades. For many years, it was considered a relatively obscure health concern, largely affecting isolated communities in these regions. However, the disease began to attract international attention due to its unusual behavior in recent years. A significant turning point occurred on August 13, 2024, when the Africa Centers for Disease Control and Prevention (Africa CDC) declared mpox a Public Health Emergency of Continental Security (PHECS), signaling a dramatic shift in how the disease was viewed on the African continent. Just a day later, the World Health Organization (WHO) followed suit by declaring mpox a Public Health Emergency of International Concern (PHEIC), recognizing the growing threat posed by the virus.
Historically, mpox outbreaks in Africa were typically localized and characterized by relatively low case numbers, with infections primarily occurring in rural areas. The virus is spread to humans through direct contact with infected animals or humans, with symptoms similar to smallpox, including fever, rash, and swollen lymph nodes. Though the disease is generally less severe than smallpox, it can cause serious complications, particularly in immunocompromised individuals or those with underlying health conditions.
The more recent escalation in the epidemiology of mpox in Africa can be attributed to a variety of factors. One key element is the increasing number of urban outbreaks. Traditionally, the virus thrived in rural settings, where human-animal interactions were more frequent and closely associated with the transmission cycle. However, in recent years, there has been a notable shift, with mpox cases emerging in urban centers, far from the virus’s traditional habitat. This urbanization of the disease, alongside sporadic cross-border transmission, has complicated efforts to contain its spread.
Another significant factor in the evolving epidemiology of mpox is the growing recognition of its potential for human-to-human transmission. Previously considered a zoonotic disease (transmitted from animals to humans), recent outbreaks have revealed the capacity of the virus to spread through person-to-person contact. This has raised concerns about the virus’s ability to propagate in larger, more densely populated areas, where transmission is facilitated by close interactions and limited access to healthcare.
In response to these growing concerns, African countries have ramped up their surveillance and response efforts. Public health agencies have been working closely with the World Health Organization and other international partners to improve diagnostic capacity, enhance contact tracing, and ensure that vaccines and antiviral treatments are accessible in the most affected regions. Despite these efforts, the rapid spread of the virus has strained health systems and posed new challenges to public health authorities, particularly in countries with limited resources.
The declaration of mpox as a Public Health Emergency of Continental Security (PHECS) by the Africa CDC marked a significant milestone in the continent’s fight against the disease. This designation signaled a unified commitment among African nations to prioritize the response to the outbreak, ensure regional coordination, and bolster the response capacity of public health systems. By collaborating with global health organizations like the WHO, Africa is seeking to strengthen its response to outbreaks, increase disease surveillance, and improve public health education to prevent further spread.
Globally, the declaration of a Public Health Emergency of International Concern (PHEIC) by the WHO has raised the stakes in the fight against mpox. It has highlighted the need for enhanced international cooperation, research, and support to contain the disease. This declaration also reinforces the understanding that diseases like mpox do not respect national borders and that a global response is essential to prevent further outbreaks from spreading across continents.
As the epidemiology of mpox continues to evolve in Africa and beyond, ongoing vigilance, timely intervention, and improved healthcare infrastructure will be critical in managing the disease and preventing future public health crises. The recent developments mark a new phase in the global understanding of mpox, with a collective effort needed to curb its spread and mitigate its impact on affected communities.
