Sierra Leone is once again facing a public health crisis with an mpox outbreak, but this time, its healthcare system is better prepared. The country, which endured the devastating Ebola epidemic a decade ago and the global COVID-19 pandemic more recently, is leveraging past experiences to manage the situation effectively.
Since the declaration of an mpox emergency on January 13, Sierra Leone has recorded 20 confirmed cases. Fortunately, 10 patients have already recovered, and no fatalities have been reported. The government has moved swiftly to establish specialized treatment centers in major hospitals, ensuring that cases are promptly isolated and managed. Psychosocial support is also being provided to patients and their families.
Testing facilities have been activated across key regions, with three laboratories in Freetown and one additional facility in the eastern part of the country now conducting tests. The outbreak has affected seven districts, with the highest number of infections reported in urban areas such as Freetown. Health authorities, in collaboration with the Africa CDC, are actively monitoring over 200 close contacts to curb the spread of the virus.
Residents have expressed concern over the outbreak, particularly as it stirs memories of past epidemics. Joseph Sesay, a Freetown resident, shared his fears after his cousin was admitted with mpox. Initially mistaking the symptoms for chickenpox, the family realized the seriousness of the situation only after a hospital visit confirmed the diagnosis.
“We are not allowed to visit him in the hospital, and health workers are monitoring our household to prevent further infections. Seeing people in PPEs again brings back painful memories of Ebola, which took the lives of three of my family members,” Sesay said.
While the public remains anxious, health officials are working diligently to prevent misinformation and panic. The Executive Director of Sierra Leone’s National Public Health Agency (NPHA), Professor Foday Sahr, has reassured the nation that containment measures are in place, emphasizing that contact tracing, education, and proper management of cases are the primary strategies being employed.
Mpox, previously known as monkeypox, is a viral disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus. According to the World Health Organization (WHO), there are two main variants: Clade I (with subclades Ia and Ib) and Clade II (with subclades IIa and IIb). The current outbreak in Sierra Leone has been linked to Clade IIb, the same variant that caused a global outbreak in 2022.
The virus spreads through close physical contact, and symptoms include fever, skin rashes, and swollen lymph nodes. While generally less severe than Ebola, mpox still requires medical intervention to manage complications, particularly in individuals with weakened immune systems.
To enhance the national response, the government has reactivated the District Emergency Operation Centres (DEOCs). These centers are responsible for ensuring strict adherence to health protocols and coordinating emergency response efforts across all affected districts.
Training sessions and simulations are being conducted to keep healthcare workers prepared for any escalation. Efforts are also underway to secure mpox vaccines from WHO to protect frontline workers and high-risk populations.
The health sector has also improved its disease surveillance system, with hospitals and local clinics closely monitoring potential cases. At Connaught Hospital, the country’s largest referral hospital, doctors have observed that many male patients present with genital lesions, often accompanied by other infections such as syphilis.
A healthcare worker from the hospital, who requested anonymity, emphasized the importance of strict infection control measures:
“My experience treating mpox patients has reinforced the need for proper PPE usage, infection control, and patient-centered communication. Managing cases effectively requires both medical expertise and empathy.”
Sierra Leone’s past battles with Ebola and COVID-19 have shaped its current approach to disease control. During the Ebola outbreak between 2014 and 2016, the country struggled with an overwhelmed health system, losing nearly 4,000 people, including 7% of its healthcare workforce. However, significant investments in disease prevention and management have since been made.
Dr. Mark Kapuwa, Care Manager at Connaught Hospital, acknowledged the progress:
“During the Ebola outbreak, we were caught off guard. But with COVID-19, we were much better prepared. Now, we have surveillance officers working with doctors to detect suspected mpox cases early, ensuring immediate isolation and treatment.”
Sierra Leone has also pioneered a preventive Ebola vaccination initiative, becoming the first country to immunize 20,000 frontline workers against the virus. This experience has reinforced the importance of proactive measures in combating infectious diseases.
While the current mpox outbreak remains under control, Sierra Leone’s health authorities are not taking any chances. The government’s swift action, combined with public cooperation, will be crucial in preventing further spread. Continuous education campaigns, effective case management, and enhanced surveillance will determine whether the country can successfully contain the outbreak.
As Sierra Leone faces this latest health challenge, it stands as a testament to how past crises can strengthen a nation’s ability to respond, proving that preparedness and resilience are key to managing public health emergencies.
