Mpox outbreak

An MSF community health education team raise awareness about mpox at a camp for displaced people in the east of the DRC

Mpox (previously known as monkeypox) is a viral disease usually found in West and Central Africa.

Since the beginning of 2024, there has been a surge in infections driven by a new variant of the virus. This is centred on the Democratic Republic of Congo (DRC) with cases also reported in neighbouring countries. On 14 August, the World Health Organization classified the mpox outbreak as a “public health emergency of international concern”.

Médecins Sans Frontières / Doctors Without Borders (MSF) teams are already present in the DRC, where we are treating patients and working to protect at-risk communities.

Explained: What is the mpox outbreak?

The DRC is experiencing a severe outbreak of mpox, with more than 14,000 suspected cases and 511 deaths recorded.

Mpox is caused by different strains of the virus, each known as 'clades'.

Clade 1 (found in Central Africa) has been circulating in the DRC for years, while Clade 2 (West Africa) was responsible for the global spike in cases in 2022.

However, this new outbreak is due to an offshoot of Clade 1 – identified as Clade 1B – which causes more severe disease and appears to spread more easily.

How is MSF responding to the mpox outbreak?

MSF has launched emergency teams to respond to the epidemic across the DRC.

Since mid-June alone we have responded by:

Treated more than 1,400 patients in MSF-supported healthcare facilities
Delivered more than 6,300 awareness sessions to support communities to protect themselves
Followed up more than 1,500 cases as part of our contact-tracing work

MSF has been operating in the DRC for decades, delivering healthcare and treating people affected by insecurity, displacement and disease.

Between 2018 and 2020, MSF teams in the DRC responded to a catastrophic Ebola epidemic – the second-worst outbreak in world history.

View of the patient triage area at the Budjala general referral hospital. MSF also deployed a team in the Budjala health zone in South Ubangi to support health authorities in the response against Mpox. More than 329 patients have already been treated in 5 health centers and at the treatment unit of the Budjala general referral hospital.

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Questions about mpox

What are the symptoms of mpox?

Symptoms of mpox include:

Painful rashes and swellings
Fever
Headache
Muscle aches
Back pain
Exhaustion

The infection can clear up on its own after between 14 and 21 days and most patients recover within a month. However, some people may become very sick, and the disease can be fatal.

The current outbreak is driven by the Clade 1B variant which causes a more severe infection than previous strains.

How is mpox spread?

Mpox can be spread via close contact with an infected person.

The 2022 outbreak (caused by Clade 2) was thought to be spread mostly by sexual contact.

The current outbreak of Clade 1B appears to spread more easily, including via ‘close household contact’. This may involve talking and breathing near an infected person or touching contaminated objects such as bedding, clothing and towels.

Previous spikes in mpox cases have often been related to zoonotic transmission (animal to human), but the latest variant has been spreading via human-to-human transmission in a sustained way for months.

Is there an mpox vaccine?

There are already two vaccines for mpox that are approved for use by healthcare authorities.

However, the process for ‘emergency use’ has not been completed. This prevents key organisations such as Gavi – the global vaccine alliance – from distributing the vaccines.

Crucially, there are currently no vaccines available in the DRC. However, negotiations are underway, and priority areas are being identified.

Spotlight: Mpox in displacement camps

Mpox was already endemic to specific parts of the DRC and has caused sporadic outbreaks.

Worryingly, the new epidemic is spreading at an alarming rate and has reached most of the country’s 26 provinces. This includes spikes in the eastern region where communities are already facing a humanitarian crisis.

A view of Rusayo displacement camp, outside Goma, where an estimated 85,000 people are sheltering

North Kivu is a province that has long been affected by conflict and insecurity, with over 1.6 million people forced from their homes. As a result, thousands live in extremely crowded displacement camps with poor access to clean water and sanitation, while there are regular mass movements of people.

This creates a very real risk of an explosion in mpox cases.

MSF is concerned that the virus has already been recorded in camps around the city of Goma where more than 600,000 are sheltering in such conditions.

We are calling for the mobilisation of all healthcare organisations involved to protect those most at risk, work with communities and deliver vaccinations where they are needed most.