The World Health Organization (WHO) Director-General, Dr. Tedros Adhanom Ghebreyesus, has declared the upsurge of mpox in the Democratic Republic of the Congo (DRC) and other African countries a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005). This declaration follows the recommendation of an Emergency Committee of independent experts who reviewed data from WHO and affected countries.
The alarming rise of a new mpox clade in eastern DRC and its spread to neighboring countries has raised significant concern. Ghebreyesus said in the news release, "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”
Dr. Matshidiso Moeti, WHO Regional Director for Africa said, “Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to help reinforce measures to curb mpox. With the growing spread of the virus, we’re scaling up further through coordinated international action to support countries to bring the outbreaks to an end.”
More about mpox in DRC
I recommend all infection prevention and control professionals keep an eye on the evolving mpox outbreak in Central and Eastern Africa and refresh their preparedness skills; not out of fear but as a good and proactive practice.
If history has taught us anything, it is that downplaying an uncontained outbreak is a risky move for an IP, even if the outbreak is far away. People travel, outbreaks expand, and diseases spread.
Pathogens are getting stronger than before, and when IPs are not proactive, it can prove to be a costly mistake. Mitigating an outbreak takes some upfront work, but it's much better than dealing with the consequences of inaction.
Although we cannot prevent everything from happening, our focus on patient safety as IPs should at least emphasize emergency preparedness. In my experience, this approach offers a better return on investment: Patients stay safe, health care workers maintain their peace of mind while staying effective, and healthcare facilities save on costs. To me, that's a win-win.
--Carole W. Kamangu, MPH, RN, CIC, founder and CEO of Dumontel Healthcare consulting, and originally from the DRC. Her newsletter can be found here.
The growing number of cases, particularly the sexually transmissible strain of clade 1b, which has recently emerged in the DRC and spread to Burundi, Kenya, Rwanda, and Uganda, underscores the urgency of this response.
This PHEIC declaration marks the second time in 2 years that mpox has been classified as a global health emergency. Mpox, caused by an Orthopoxvirus, was first identified in humans in 1970 in the DRC and is endemic in several central and West African countries.
In July 2022, a multicountry outbreak of mpox led to the virus being declared a PHEIC due to its rapid spread through sexual contact across countries that had not previously seen the virus. That emergency status was lifted in May 2023 following a sustained decline in global cases.
Mpox has been reported in the DRC for over a decade, with the number of cases steadily rising yearly. Last year saw a significant surge in cases, and this year has already surpassed those numbers, with over 15,600 cases and 537 deaths reported. The recent emergence and rapid spread of a new strain, clade 1b, primarily through sexual networks, and its detection in neighboring countries is particularly alarming and has been a key factor in the decision to declare the current PHEIC.
WHO has released $1.45 million from its Contingency Fund for Emergencies to support the response. It is appealing for additional donor funding to meet the full scope of needs in combating the mpox outbreak.
APIC Answers the Call for Infection Preventionists
In time for WHO Monkeypox public health emergency announcement, the Association for Professionals in Infection Control and Epidemiology (APIC) has an updated tool for infection preventionists (IPs) and epidemiologists.
APIC’s Emerging Infectious Diseases Task Force has created a Mpox Playbook that IPs can download and customize for use in their facilities.
About the pathogen-specific Playbook, APIC CEO Devin Jopp EdD, MS says in a statement:
"The Mpox Playbook was designed for facilities to be able to respond as soon as they suspect an outbreak and prevent its spread. To respond, IPs and epidemiologists must identify the pathogen, prevent its transmission, and ensure that workers are operating safely. They must also make sure that patients are safe, both in the facility and at discharge, and keep an open line of communications to health care stakeholders."
Jopp said, "IPs are often incident command leaders when disease outbreaks hit their facilities, and the updated playbook is designed to help them prepare and mobilize quickly. It’s critical that we use what we learned during COVID-19 and the prior mpox outbreak in 2022 to improve infectious disease outbreak response to protect the patients and staff in our nation’s health care facilities.”
