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In 2024, as of 29 September 2024, 14 countries have reported 6,752 confirmed cases, including 32 deaths. The three countries with the majority of the cases in 2024 are the Democratic Republic of Congo. As of 29 September 2024, 14 countries had reported 6,752 confirmed cases, including 32 deaths. The three countries with the majority of the cases in 2024 are the Democratic Republic of Congo (n = 5,610), Burundi (n = 853), and Nigeria (n = 78). 

A significant number of suspected mpox cases, that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and thus never get confirmed. For this reason, we include suspected cases in this section of the report. In 2024, 14 countries have reported both 37 325 suspected and laboratory tested cases, including 996 suspected and confirmed deaths. 

This indicator should be interpreted with caution, as suspected mpox cases are recorded according to varying national case definitions. In some countries, suspected cases that undergo testing are not removed from the count, regardless of whether the test result is positive (confirmed case) or negative (discarded case). Moreover, not all countries have robust surveillance systems for mpox, meaning reported case counts are likely underestimate the extent of community transmission.

Burundi declared the mpox epidemic driven by clade Ib of the virus on 25 July 2024. The situation escalated rapidly in the following weeks and, as of 29 September 2024 (epi week [EW] 39), a total of 853 laboratory confirmed cases with no deaths have been reported in 38 out of the 49 districts (77.5%). Two new districts were affected during EW 39, and 219 new laboratory confirmed cases were reported in the same week compared to 132 cases in the previous week, marking an increase of 66%. Children under the age of five represent 27.3% of all confirmed cases. A total of 31 066 alerts have been recorded through surveillance efforts, with 442 new alerts identified in the past 7 days (week 39). Currently, 432 individuals are hospitalised, with 157 new admissions reported during this period. Meanwhile, 421 patients have been discharged overall, including 74 new discharges in week 39. Contact tracing has been vigorous, with 6 250 contacts listed cumulatively, and 936 new contacts traced in the current reporting week. In terms of testing, 2 095 tests have been performed to date, with 352 of those conducted during this reporting period. Northern Bujumbura remains the most affected area, accounting for over 40% of the total cases. A high positivity rate of 40.7% further underscores significant community transmission, with no deaths reported.

Gabon reported its first confirmed case of mpox on 22 August in Libreville. The case involved a 30-year-old male who had recently travelled to Uganda, where he likely contracted the virus. Upon returning to Gabon, he developed symptoms, including fever, fatigue, and a generalized skin rash, and sought medical attention on 21 August. As of 29 September 2024, out of 15 suspected cases identified and tested, two tested positive for Mpox (the first case and a known contact of the first case). Gabon has not reported any new cases in the past 28 days.

The Central African Republic: In EW 39, There have been 14 new suspected cases in Week 39, with no new deaths reported. Two new confirmed cases were identified, with the last cases recorded in Mbaïki and Bangassou districts on September 26, 2024. Seven patients remain hospitalized across five districts. Since the start of 2024 (Weeks 1-39), CAR has reported a total of 350 suspected Mpox cases, of which 57 have been confirmed, along with 1 confirmed death. Notably, 19% of confirmed cases are children under the age of 4, and 81% of cases are individuals below 25 years old. The outbreak remains active in seven health districts, while 14 districts have reported at least one confirmed case during the year. The circulating Mpox strain in CAR has been identified as Clade Ia. Efforts include finalising the national response plan and distributing 13 tons of personal protective equipment (PPE) provided by USAID and WHO. Preparations for educating school teachers on mpox awareness are also underway.

Cameroon: as of 29 September 2024, the country has reported a total of 89 suspected mpox cases, of which 6 (5 males and one female) have been confirmed including two related deaths, spread across 7 regions. The last positive case was reported on 7 September 2024. Laboratory testing has been conducted on 93% of the suspected cases, with a positivity rate of 10.7%. Clade II has been identified as the circulating strain in regions such as the North-West and South-West. Laboratory capacity for mpox testing remains limited, and there are challenges in community engagement and risk communication.