Mpox Outbreak: A Rising Concern in Africa – Zimbabwe and Zambia Report First Cases

Mpox Outbreak: A Rising Concern in Africa – Zimbabwe and Zambia Report First Cases

In a growing public health crisis, Zimbabwe recently confirmed its first two cases of mpox, marking a significant event in the country's health history. These cases follow the first mpox diagnosis in neighboring Zambia just days earlier, indicating an alarming spread of the virus across southern Africa. This is part of a broader trend of mpox outbreaks in African nations, including the Democratic Republic of Congo (DRC), which remains the epicenter of the disease.

Mpox, a viral infection known for its flu-like symptoms and characteristic blistering skin rash, has been recognized as a significant public health emergency in recent years, with outbreaks spreading rapidly across borders. The most recent wave of infections has caught the attention of global health organizations such as the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (CDC), both of which have issued warnings and declared public health emergencies due to the virus's impact.

Zimbabwe's First Cases of Mpox
Zimbabwe's first mpox cases were confirmed in October 2024, affecting two individuals from different regions of the country. The first case involved an 11-year-old boy residing in Harare, the capital city. The child had recently traveled to South Africa, a country where mpox has been actively spreading, with at least 25 confirmed cases by October 9, 2024. The provinces of Gauteng, KwaZulu-Natal, and the Western Cape have seen the highest incidence of infections. South Africa’s National Institute for Communicable Diseases (NICD) has been closely monitoring these outbreaks, although the exact variant affecting the Zimbabwean boy remains unidentified.

The second Zimbabwean case was a 24-year-old man from Mberengwa, a town in southern Zimbabwe. He had recently returned from Tanzania, where no mpox cases had been officially recorded up to that point. However, Tanzania's proximity to the DRC, where mpox has been rampant, places it in a high-risk category for cross-border spread. The DRC continues to struggle with the highest number of mpox infections, with 6,169 confirmed cases and 25 deaths reported in 2024 alone, according to WHO figures.

Both Zimbabwean patients are currently receiving medical care at home, and contact tracing is underway to prevent further spread of the virus. Zimbabwean Health Minister Douglas Mombeshora reassured the public that the situation is under control, urging people not to panic. However, these developments have heightened concern among neighboring countries and global health organizations.

Zambia's First Mpox Case
Just before Zimbabwe confirmed its cases, Zambia reported its first instance of mpox infection. The case involved a 32-year-old Tanzanian national who had traveled extensively within Zambia before developing symptoms. The individual entered Zambia in early September 2024 and began showing signs of mpox in early October. Given the patient’s extensive travel and interactions at various locations in Zambia, health authorities raised concerns about the potential for local transmission and cross-border spread.

The strain of mpox in Zambia, like in Zimbabwe, has yet to be identified, adding to the uncertainty surrounding the outbreak. Zambia’s health ministry has been working to trace the patient’s contacts and implement measures to contain the virus, but the risk of further transmission remains a pressing issue.

Mpox in Africa: A Growing Crisis
The recent cases in Zimbabwe and Zambia are part of a broader pattern of mpox outbreaks across Africa. In August 2024, the WHO declared mpox a global public health emergency after observing a surge in cases in the DRC, the epicenter of the outbreak. The DRC's outbreak has affected neighboring countries, and the disease continues to spread across Africa, with nearly 30,000 suspected mpox cases reported this year. Most of these cases have occurred in central Africa, but outbreaks have also been detected in West Africa, and sporadic cases have emerged in Europe and Asia.

Mpox, caused by a virus similar to smallpox, typically leads to mild illness, with symptoms such as fever, headache, muscle aches, and a distinctive rash of pus-filled blisters. However, severe complications can occur, particularly in young children, pregnant individuals, and those with compromised immune systems. In Africa, over 800 people have died from mpox in 2024, further emphasizing the seriousness of the outbreak.

A key concern in the current mpox outbreak is the emergence of a new, more severe variant known as clade Ib. This variant, first detected in the eastern DRC, is believed to cause more severe disease and carry a higher mortality risk than clade II, the strain responsible for the global mpox outbreak in 2022. Clade Ib is thought to be more easily transmissible, which has raised alarm among health experts.

Vaccine Rollout and Public Health Response
In response to the escalating mpox crisis, African nations have initiated vaccine rollouts to curb the spread of the virus. However, as with the COVID-19 pandemic, issues of vaccine access and distribution are complicating efforts to contain the outbreak. The Global Preparedness Monitoring Board, in its most recent annual report, highlighted concerns about inequitable vaccine distribution, warning that the mpox outbreak runs the risk of repeating the same mistakes made during the COVID-19 pandemic. Access to vaccines remains a significant issue, particularly in lower-income countries in Africa, where healthcare infrastructure is often under-resourced.

The mpox vaccine is particularly important because a person with the virus can transmit it until their rash is fully healed, making containment more challenging. Public health campaigns are being ramped up across affected countries to educate the population on recognizing symptoms, seeking early medical care, and taking preventive measures to avoid further transmission.

Clade Ib vs. Clade II: The Battle of Variants
The appearance of the clade Ib variant has introduced new challenges in managing the mpox outbreak. While clade II was largely responsible for the global outbreak in 2022, which was primarily spread through sexual contact, clade Ib seems to be more easily transmitted through non-sexual means. This raises concerns about the variant's potential to spread more widely in community settings, such as schools, workplaces, and public transport.

The symptoms of clade Ib mpox are similar to those of clade II, with the hallmark rash being the most prominent sign. The rash can appear anywhere on the body and is often accompanied by fever, muscle pain, and swollen lymph nodes. The illness typically lasts about four weeks, during which time the person remains infectious. While most cases are mild, severe illness and death are more likely among vulnerable populations, such as young children, pregnant people, and individuals with weakened immune systems.

Mpox: Public Health Measures and the Role of Medical Professionals
The emergence of mpox in Zimbabwe and Zambia highlights the critical need for robust public health measures across the African continent. For medical students and doctors, the outbreak offers important lessons in disease surveillance, contact tracing, and community education. Medical professionals play a crucial role in containing the spread of mpox, particularly by educating the public on how to recognize symptoms, the importance of early treatment, and the need for preventive measures.

Healthcare workers should be familiar with the guidelines set forth by the WHO and national health agencies for handling mpox cases, including proper isolation procedures for infected patients, use of personal protective equipment (PPE), and protocols for contact tracing. Vaccination campaigns will also be key in controlling the outbreak, and healthcare providers will be instrumental in administering vaccines and ensuring that high-risk populations receive timely immunization.

In addition to clinical care, medical professionals must also contribute to the ongoing research efforts to better understand the virus. Understanding how clade Ib differs from clade II in terms of transmission dynamics and clinical outcomes will be critical for developing more effective treatments and preventive measures.

The Future of Mpox: What to Expect
As the mpox outbreak continues to evolve, global health agencies are closely monitoring the situation. The rapid spread of the virus across Africa underscores the need for coordinated international efforts to contain the outbreak and prevent it from escalating into a larger global crisis.

Medical students and doctors will need to stay informed about the latest developments in mpox research and treatment guidelines. Public health systems in Africa and beyond must prioritize equitable vaccine distribution, community education, and early detection of new cases. The lessons learned from the COVID-19 pandemic should be applied to the current mpox crisis to ensure that the response is swift, coordinated, and fair.

While the outbreak in Zimbabwe and Zambia is concerning, it also presents an opportunity for the global health community to strengthen its response to emerging infectious diseases. By working together, medical professionals, governments, and international organizations can mitigate the impact of mpox and prevent further loss of life.