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Since 1 January 2022, cases of mpox have been reported to WHO from 17 Member States in the WHO African region. Since 1 January 2024, as of 20 September 2024, 14 countries have reported 6 602 confirmed cases, including 32 deaths. The three countries with the majority of the cases in 2024 are Democratic Republic of the Congo (n = 5 621), 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 32 808 suspected and laboratory tested cases, including 844 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 22 September 2024 (epi week [EW] 38), a total of 696 laboratory confirmed cases with no deaths have been reported in 35 out of the 49 districts (71%). Additionally, 132 laboratory confirmed cases were reported in EW 38 compared 179 cases in the previous week, marking a decrease of 26%. Northern Bujumbura remains the most affected area, accounting for 43.6% of the total cases. A high positivity rate of 40% further underscores significant community transmission, with no deaths reported.

Gabon reported its first confirmed case of mpox on 22 August in Libreville. The case involves 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 22 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 21 days.

The Central African Republic: as of EW 38, the country has identified 17 new suspected mpox cases, three newly confirmed cases in the Gamboula and Kembé-Satéma health districts, and zero new deaths. Mpox is actively spreading in 7 health districts, with 14 districts having reported confirmed cases in 2024. A total of 324 suspected cases and 55 confirmed cases of Mpox have been reported in CAR since the start of 2024. One death has been confirmed, bringing the case fatality rate to 1.81%. A large portion of the confirmed cases are in children (25% under 4 years old) and young adults, with 75% under the age of 20. The strain circulating in the country is Clade Ia. Contact tracing and active surveillance efforts are ongoing, but there is a need for intensified contact monitoring in the affected health districts to break transmission chains.

Cameroon: as of 22 September 2024, the country has reported a total of 81 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. The positivity rate stands at 7.4%, with Clade II identified in multiple regions. Laboratory capacity for Mpox testing remains limited, and there are challenges in community engagement and risk communication.