Unprecedented Monkeypox Outbreak in the DRC

December 5, 2023

The Democratic Republic of the Congo (DRC) is grappling with a severe monkeypox outbreak, with the World Health Organization (WHO) reporting a staggering 12,569 suspected cases and 581 deaths from January 1 to November 12, 2023. This marks the highest annual case count ever recorded and poses significant challenges for the affected regions.

Geographic Spread and New Milestones

Infections have surfaced in areas previously unaffected by monkeypox, including Kinshasa, Lualaba, and South Kivu, indicating a concerning geographic spread. Two unprecedented milestones for the DRC were noted during this outbreak – the first confirmed sexually-transmitted monkeypox infections and the first cases reported in the country’s capital, Kinshasa.

Provincial Impact and Endemic Status

The outbreak has impacted 22 out of 26 provinces, with 11 provinces previously identified as endemic for monkeypox. Over the years, the number of provinces reporting cases has increased, reaching 22 provinces as of November 2023. This contrasts with the previous largest outbreak in 2020 when 17 provinces recorded 4,594 suspected cases.

Monkeypox Virus and Sexual Transmission

Monkeypox is caused by the monkeypox virus (MPXV) endemic in densely forested regions of West, Central, and East Africa. In the DRC, it was first identified in humans in 1970. The WHO highlighted a growing outbreak of monkeypox cases linked to sexual transmission. Two types of MPXV exist – Clade I and Clade II. Clade I MPXV, known as the Congo Basin Clade, is the only type detected in the DRC, and sexual transmission cases were reported in April 2023.

First Outbreak in Kinshasa

A notable development is the occurrence of monkeypox cases in Kinshasa, the capital of the DRC, for the first time. From August 18 to November 12, 2023, 102 suspected cases were reported in eight health zones, including 18 confirmed cases and one confirmed monkeypox death. This shift to a large urban area signifies a changing epidemiology of monkeypox in the DRC.

Ongoing Assessment

Amidst these challenges, a joint mission by the Ministry of Health and the WHO is underway in the country to comprehensively assess the situation. The evolving nature of the outbreak demands swift and coordinated efforts to contain the spread, provide medical care, and implement preventive measures to curb the unprecedented impact of monkeypox in the DRC.

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