Mpox in African countries (Update 4)

The World Health Organization reports continuing transmission of mpox in Africa. Countries reporting laboratory-confirmed cases from 1 January 2024 to the latest update of 5 December 2024 are:

Democratic Republic of the Congo: 9 513 cases (43 deaths)

Burundi: 2 334 cases (1 death)

Uganda: 785 cases (4 deaths)

Nigeria: 145 cases

Côte d’Ivoire: 101 cases (1 death)

Central African Republic: 85 cases (2 deaths)

Liberia: 62 cases

Rwanda: 52 cases

South Africa: 25 cases (3 deaths)

Kenya: 23 cases (1 death)

Congo: 22 cases

Cameroon: 9 cases (2 deaths)

Ghana: 3 cases

Morocco: 3 cases

Angola: 2 cases

Gabon: 2 cases

Zimbabwe: 2 cases

Guinea: 1 case

Mauritius: 1 case

Zambia: 1 case

Mpox is a zoonotic infection caused by the monkeypox virus (MPXV) that occurs mostly in West and Central Africa.

Transmission occurs when a person comes into close contact with lesions, bodily fluids or respiratory droplets from an infected animal or human, or from contact with objects or materials which are contaminated with the virus.

Two different genetic groups (clades) of MPXV exist: Clade I and Clade II.

Advice for travellers

Those travelling to areas affected by ongoing mpox outbreaks should take sensible precautions to protect themselves from the risk of infection, by:

• practising meticulous hand hygiene if visiting or caring for ill friends and relatives
• avoiding contact with primates and rodents, including their blood and other parts, and avoid consuming undercooked meat from any source
• wear protective clothing, including gloves, if involved in the slaughter of, or care of animals in these regions

Travellers to any destination who may be sexually active during travel (including GBMSM) should:

• be aware of the risk of mpox
• talk to sexual partners about their sexual health, ask if symptomatic and always practise safe sex
• avoid close physical contact, including sexual contact with someone who is diagnosed with or has suspected mpox
• maintain good personal hygiene and wash hands often, avoid touching eyes, nose and mouth with unwashed hands
• know the symptoms of mpox and check themselves regularly. Travellers should be aware it can take up to 3 weeks for symptoms to appear after contact with an infected person
• share contact details with new sexual partners to help limit further transmission where cases occur
• seek health advice and self-isolate whilst waiting to get tested if symptomatic

Vaccination

Routine pre-exposure vaccination against mpox infection is not recommended for the majority of people, except for those at high risk of exposure (e.g. some healthcare workers, people whose sexual networks mean they are more likely to come into contact with mpox).

For further information on the mpox vaccine, including eligibility, see:

• UKHSA: Smallpox and mpox: the green book, chapter 29
• NHS inform: Vaccination to help protect against mpox (monkeypox)
• NHS UK: Mpox

The vaccination against mpox is only available through the NHS to eligible groups and is not currently available to purchase privately or at a pharmacy.

After Travel

Travellers should be advised to seek medical help during, or for 21 days after, travel if they develop symptoms of mpox and have:

• had close contact with someone who may have mpox, or
• returned from African countries where mpox is present. These travellers should also be screened for malaria.

Travellers returning from countries with Clade I mpox (currently Central and East African countries)

The United Kingdom Health Security Agency (UKHSA) classifies Clade I mpox as a high consequence infectious disease (HCID).

Travellers returning from countries where there is an outbreak of Clade I mpox to a UK airport or port of entry and have any symptoms of mpox, should speak to a member of port or border staff for advice.

Travellers who develop symptoms of mpox within 21 days of return from an affected country should isolate at home and call NHS 24 (Scotland) or NHS 111 (rest of UK) for advice, reporting details of their travel history

Further information is available on Mpox, Sexual Health Risks and LGBT travellers

Advice to travellers will be updated as appropriate.