In a concerning turn of events, African nations reported a staggering 2,532 new mpox cases last week, primarily concentrated in the Democratic Republic of the Congo (DRC) and Burundi. This surge has propelled the total number of recorded cases to a chilling 50,840 since the start of the year, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

In addition to the rising case count, there have been 32 new fatalities linked to the virus. Dr. Jean Kaseya, the director-general of Africa CDC, emphasized the escalating situation, particularly in Uganda, and revealed that the outbreak is spreading into new territories, including the district of Paoua in the Central African Republic (CAR), situated near the Chad border.

Testing Improvements and Vaccination Challenges

Despite some progress in testing capabilities across the continent, significant challenges remain. Notably, Rwanda recently reported 20 additional cases after a four-week period with no new infections. Dr. Ngashi Ngongo, leading the incident management team at Africa CDC, attributed this surge to a backlog in testing and highlighted Rwanda's simultaneous battle against a Marburg virus outbreak.

Countries that have initiated vaccination campaigns are seeing encouraging uptake; however, there’s a major gap in immunization coverage for children, who are among the most affected by the outbreak. The Bavarian Nordic Jynneos vaccine is currently approved for use only among adolescents and adults. Africa CDC is strategizing with Japanese authorities to obtain around 3 million doses of the LC16 vaccine, a tool historically used for children's immunization in the 1970s.

The DRC and Rwanda are leading vaccination efforts with notable success, while Nigeria faces delays in its campaign launch, originally set for October 29 but now postponed to November 18 due to logistical issues.

International Support and Vaccine Distribution

Dr. Kaseya called for international partners outside Africa to fulfill their commitments to aid the outbreak response. He specifically mentioned the United States, which has pledged 1 million vaccine doses and $500 million to assist in combating the outbreak. Ongoing discussions with U.S. officials are anticipated to strengthen global health collaborations.

In a collaborative effort, Africa CDC, alongside partners like the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, UNICEF, and the World Health Organization, has allocated 899,000 doses of mpox vaccine to nine countries. This distribution, designed to ensure fair and efficient use of limited resources, heavily focuses on the DRC, which continues to face the greatest burden of the outbreak.

Upcoming Trials for Vulnerable Populations

In a groundbreaking initiative, CEPI has announced an investment of $8.1 million to conduct a safety and immunogenicity trial of the Jynneos vaccine in pregnant and breastfeeding women, as well as children under the age of two. This trailblazing study aims to enroll 350 pregnant women and 250 infants and toddlers in the DRC, set to commence in early 2025. The trial promises to yield vital data that could prompt an expansion of vaccine access for the most vulnerable groups, who are at heightened risk of severe complications from mpox.

With an expected 5.85 million doses arriving by the end of the year, experts remain cautiously optimistic about addressing this public health emergency. As the continent grapples with both mpox and other viral outbreaks, the collaboration of international partners and a robust vaccination strategy will be crucial in overcoming these daunting health challenges.