Chronology of Mpox Outbreaks Across the Globe in 2024

The countries affected in 2024

  1. Initial Mpox Outbreaks in Africa
  • Democratic Republic of Congo (DRC):
  • December 2022: The Democratic Republic of the Congo declared a national outbreak of Mpox. An incident management system was established in February 2023 in response to the increasing number of reported cases.
  • September 2023: An outbreak of Mpox began in South Kivu province, which later spread to neighboring North Kivu, primarily driven by sexual contact transmission. A new variant of clade I MPXV emerged, carrying predominantly APOBEC3-type mutations, indicating adaptation due to human circulation.
  • Mid-September 2023: The new clade I variant began sustained human-to-human transmission. This marked the first documented sustained community transmission of the virus in the country.
  • 2024: As of May 26, a total of 7,851 Mpox cases and 384 deaths (CFR 4.9%) were reported in the Democratic Republic of the Congo. The cases were spread across 177 of the 519 health zones (34%) in 22 out of 26 provinces (85%).
  • Ongoing Concerns: The outbreak continues to raise concerns due to high incidence rates, geographic expansion, the emergence of a novel strain, sustained community transmission, resource constraints, limited public awareness, insufficient treatment and vaccine availability, and competing public health priorities. The WHO assesses the risk associated with Mpox in the country as high.
  1. Mpox Outbreaks to Thailand
  • First Clade 1b case outside Africa:
    15 August 2024: A 66-year-old European male tested positive for the clade Ib variant of mpox after arriving in Bangkok from Africa. He was hospitalized on August 15, 2024, with confirmation of the virus on August 22. Authorities identified 43 contacts, placing them under 21-day surveillance for potential symptoms.
  1. Mpox Outbreaks in India

Here is record of mpox outbreaks in India

  • 14 July 2022: Kerala’s State Health Minister, Veena George, announced India’s first suspected case of Mpox, which was later confirmed by the National Institute of Virology (NIV). India became the tenth country in Asia and the first in South Asia to report a case.
  • 24 July 2022: The first locally transmitted case was reported in Delhi involving a middle-aged male with no recent travel history. He was isolated in Lok Nayak Hospital, New Delhi.
  • 2023
  • Throughout 2023: India reported more than 30 cases of Mpox, indicating an ongoing outbreak. The cases were a part of the broader outbreak caused by the West African clade of the monkeypox virus.
  • This timeline summarizes the key developments of the Mpox outbreak in India during 2022 and 2023, highlighting its emergence and local transmission.
  • July 2024:
    India reported its first case of the Clade 1b variant in a 38-year-old man returning to Kerala from Dubai. This strain is linked to the African outbreak, and India’s government has mobilized 35 testing labs and issued advisories for increased vigilance across states.
  • September 2024

A 38-year-old from Malappuram, Kerala, who arrived from the UAE on September 18, and a 29-year-old man in Kochi have tested positive for Mpox. Both cases mark recent infections in Kerala within two weeks, with one linked to the highly transmissible clade 1b strain.

  1. Mpox outbreaks in Pakistan
  • 16 August 2024:
    Pakistan reported its first cases of Mpox, with four confirmed cases in Khyber Pakhtunkhwa (KP) as of August 16, 2024. These cases were linked to travelers returning from the UAE, and health authorities have implemented strict quarantine and monitoring measures. The nationwide tally now stands at four, with additional testing underway.
  • Aug 19, 2024: Pakistan detected one case of the Mpox virus of the Clade 2 variety. No cases of the Clade 1b strain, which has raised global concern, have been diagnosed.
  • Aug 31, 2024: The number of Mpox cases in Pakistan rose to five after confirmation of the virus in a 51-year-old male air passenger from Orakzai at Peshawar. He was in stable condition and transferred to the Police and Services Hospital Peshawar for treatment.
  1. Mpox Outbreaks in Morocco
  • 12 September 2024:
    Morocco confirmed its first Mpox case in a man from Marrakech. The health ministry stated his condition is stable, though details about the specific variant have not been released.
  1. Mpox Outbreaks in Burundi
  • July 25, 2024: Burundi confirmed its first Mpox case.
  • Sept 17, 2024: School-age children (5 to 19 years old) accounted for 33% of Mpox cases in Burundi, raising concerns as families prepared for the school year. The country reported a total of 564 Mpox cases, with 62.9% of those under 19 years old, and over 1,576 suspected cases.
  1. Mpox Outbreaks in the Philippines
  • August 2024:
    The Philippines reported three new cases, bringing the total number of active Mpox cases to eight in 2024. All cases involve the milder MPXV Clade II variant. The country has reported a total of 17 cases since July 2022
  • Sept 18, 2024: The Philippines reported a new case of the Mpox outbreaks, the first since December. The patient, a 33-year-old Filipino male from Manila, has no history of foreign travel. Health Secretary Teddy Herbosa emphasized that heightened government surveillance following the outbreak in Africa led to the detection of this case, stating, “The mpox virus is among us.”

Global Health Response to Mpox Outbreaks

  • WHO Declaration:
    In response to the escalating situation, the World Health Organization (WHO) declared Mpox a Public Health Emergency of International Concern, particularly due to the rapid spread of the Clade 1b variant across Africa and into other regions.
  • European Alert:
    The European Centre for Disease Prevention and Control (ECDC) elevated its risk level for Mpox to “moderate” after a Clade 1b case was confirmed in Sweden.

Vaccine Efforts

  • Vaccination Push:
    Efforts to extend the Mpox vaccine to adolescents aged 12-17 are underway, particularly in Europe, where Bavarian Nordic is seeking approval for this age group.
  • WHO Guidelines:
    WHO has not recommended mass vaccination, instead emphasizing surveillance, behavior changes, and targeted vaccination for high-risk populations.
Conclusion

Mpox is now a multinational epidemic, with clusters of cases in Africa, South Asia, and other regions. Health authorities across affected countries are ramping up surveillance, testing, and preventive measures to curb the virus’s spread. The global situation remains dynamic, with efforts focused on containment, vaccination, and public awareness.

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