Mpox downgrade likely as more countries reach ‘end phase – Africa CDC

The Africa Centres for Disease Control and Prevention (Africa CDC) says the continent is moving closer to meeting the criteria for downgrading Mpox as a Public Health Emergency of Continental Security.

The move, it said, becomes imperative as more countries record zero cases for extended periods.

Prof. Yap Boum, Incident Manager for Health Emergencies at Africa CDC, made the remarks on Thursday during the continent’s virtual weekly press briefing.

Boum said that seven countries have now reached the “end phase”, while Sierra Leone is expected to enter the “control phase” on Dec. 16, after maintaining more than 42 days without a confirmed case.

According to him, this is in line with the standard outbreak-control threshold of two incubation periods.

He said the agency uses clear benchmarks before declaring an outbreak over at the national and continental levels.

“At the continental level, we expect more than 45 days with no cases before a country is classified as being in the control phase.

“Sierra Leone will join that group on Dec. 16. Once enough countries maintain this status, we can consider downgrading mpox at the continental level,” he said.

He explained that Africa CDC applies five major criteria to determine whether mpox can be downgraded, including the absence of sustained human-to-human transmission, declining regional risk, and the ability of countries to detect and respond to new cases.

Although recent population movements from the Uvira region of the Democratic Republic of Congo (DRC) into Burundi raised concerns about the potential spread of infectious diseases, he said the influx is not expected to significantly alter the mpox outlook.

“Movement of people always introduces some risk, but Burundi has demonstrated strong surveillance and response capacity.

“They have already proved they can detect cases, isolate them, and manage outbreaks effectively,” he said.

He added that cross-border coordination remains critical, especially for tracking contacts and harmonising surveillance between DRC, Burundi, South Sudan and neighbouring countries.

“Africa CDC, in partnership with the World Bank, is supporting countries to strengthen bilateral agreements and operational procedures that enable joint outbreak investigation, information-sharing and case management.

“If there is no memorandum of understanding between countries, contact tracing across borders becomes impossible.

“We are accelerating these MOUs and regional meetings to improve harmonisation of surveillance and response,” he said.

He noted that while the WHO lifted the global mpox emergency in September, the Africa CDC must base its own decision on African epidemiological data, country readiness, and regional risks.

He said they remain confident that if current trends continue, mpox could soon transition out of emergency status on the continent.

Our corresponent reports that Mpox (formerly called Monkeypox) is caused by the mpox virus, also a member of the orthopoxvirus family (closely related to smallpox).

Symptoms include fever, headache, swollen lymph nodes, and a rash that looks similar to smallpox but is usually milder.

Mpox spreads through close contact with an infected person, animal, or contaminated materials.

In recent years, Mpox outbreaks have increased worldwide, partly because population-level immunity from smallpox vaccination has waned.