Also feared to cause drastic public health effects in Africa is another outbreak in 2024—the resurgence of the zoonotic virus Mpox, which periodically threatens the continent. The current one is an unprecedented outbreak in terms of scale and multiple regional velocities. The 2024 Mpox-outbreak is by no means a mere health disaster; instead, it is multidimensional and underlines, in large terms, the weaknesses that exist within public health systems, the present social-economic challenges African communities contend with, and the large-scale consequences of an outbreak of disease, especially in an increasingly interconnected world today.
The 2024 resurgence of thepox attracts immediate response from local and international players. Since the outbreak is dynamic at the moment, understanding its origin, impact, and how response measures can be applied will assist in controlling the epidemic and even preventing it in the future. This paper contextualizes the Mpox outbreak in Africa witnessed in 2024 through a historical perspective, as well as the causes and transmission of the virus and its many significant implications for Africa.
Historical Background
Origin of Mpox
MPox is a viral disease first recognized in laboratory monkeys in 1958, hence monkeypox. However, the first-ever human case was registered in 1970 in the Democratic Republic of Congo during a time when the fight against smallpox had intensified. It is from the same family: the Orthopoxvirus genus, with varieties like variola virus—the causative agent for smallpox—vaccinia virus used in making the smallpox vaccine, and cowpox virus.
Mpox is primarily a zoonotic infection or at least one in which transmission is from an animal to a human. Rodents and primates are thought to be the primary reservoirs for the virus. Human-to-human transmission does occur but is generally less efficient than animal-to-human transmission. As a result, Mpox is a less severe condition than that of human-to-human transmission. That said, it can still result in considerable morbidity and mortality, especially in at-risk populations.
Previous Outbreaks in Africa and Worldwide
Mpox is a disease that has been endemic in various African countries, generally within Central and West Africa, since the first reports on the pathogen. Outbreaks have been sporadic, and the extent of the impact of these outbreaks varies. The recurrent outbreaks of the disease have become a severe problem in the DRC, where the pathogen is endemic. Outbreaks in countries other than the DRC have also been reported over time, including Nigeria, Cameroon, and the Central African Republic.
MPOX became internationally recognized after a 2003 outbreak in the United States that was linked to imported African rodents. Although the outbreak was relatively small, it raised awareness that MPOX could spread beyond the African continent and become a global health issue.
Since 2000, cases of Mpox have been reported increasingly outside of Africa in the 21st century, notably in Europe and North America. Most of the accusations have been thrown at international travel and trade, which eased the movement of infected animals or people and hence spread the disease. However, most cases of disease reporting have come from Africa, which remains at the epicentre.
The 2024 Outbreak
Timeline and Spread
The Mpox outbreak in 2024 was first observed in Nigeria at the beginning of January, a country with several previous outbreaks. Case detection was first done in rural areas but took no time to spread to urban centres, which caused alarm among public health officials. By March, the outbreak had spread to the neighbouring countries: Ghana, Cameroon, and DRC. By mid-2024, there had been reports of pox cases in more than 20 African countries.
It included increased human mobility, urban demographic density, as well as weak healthcare infrastructure in most regions affected by the outbreak. In contrast to a couple of countries in the earlier outbreaks, the 2024 one could provide a clear view of the rapid cross-border threat posed by Mpox, which made it practically impossible to contain the virus.
Countries and Regions Most Affected
As of August 2024, Nigeria, the DRC, Cameroon, and Ghana were the most affected countries. Notably, Nigeria was the top nation, with over 5,000 infections reported and hundreds of death cases. A large number of cases have also been reported in the DRC, where Mpox has been endemic for a very long time, and new regions are being reported that were never affected.
Now, reports and increased numbers have been surfacing from other West African countries like Sierra Leone, Liberia, and Ivory Coast, also causing alarm in the region. The same is true for many Central African countries. The disease has impacted most Cameroon and the Central African Republic, whose healthcare systems could not facilitate all the patients.
According to the World Health Organization, there had been over 15,000 laboratory-confirmed cases and over 1,200 deaths on the continent by mid-2024. Because conditions are prevalent in remote and conflict-ridden areas where people have no access to health services, they are under-reported.
Environmental, Social, and Economic Factors
Environmental changes present one of the main factors contributing to the severity of the 2024 Mpox outbreak in Africa. Deforestation, urbanization, and an increase in agricultural activities trigger more and more interactions between human populations and animals, which consequently create more and more opportunities for the spillover of zoonotic diseases such as Mpox into human populations. It increases with the disturbance of natural habitats, so the exact epidemiology specified is the continuous close contact between rodents or the possible intermediary host, primates, and humans.
Social and economic factors have also affected the outbreak’s spread. Most of the African countries affected by Mpox are low-income countries with poor health infrastructure, relatively low access to clean water and sanitation systems, and widespread poverty. Such conditions create a milieu where infectious diseases can be propagated rapidly and are hard to control. In rural areas, much less provision is made for health services, and therefore, MPOX can be spread unnoticed for weeks or even months before authorities realize it.
The Role of Human Involvement and Climate Change
The conversion of ecosystems and, more specifically, deforestation and land use change, are unmistakable causes of Mpox in 2024. When they chop or burn trees to have farmland or for timber plantations, humans intrude into the ecosystem of animals that are reservoirs of the Mpox virus. Such situations have brought humans closer to wildlife, establishing new routes through which the virus can transmit from animals to humans.
Another favorable condition is climate change. Climate change, such as changes in temperature and rainfall, affects the distribution and behavior of animals and those that harbor the Mpox virus. In other areas, they remain large in places where temperature increases have favored their movement and proximity to inhabited areas. Further, global warming has resulted in a lack of food and water in many regions of Africa and, thus, the increased movement of people carrying diseases.
Transmission and Symptoms
How Mpox is Transmitted
Zains are mainly acquired from animal hosts through direct contact with their blood, saliva, feces or histories, and the skin or mucosal lesions of aos. In Africa, for instance, cases have been reported with those who had contact with monkeys, Gambian giant rats, and squirrels. Consuming infected animals’ meat prepared by “bush meat” that is inadequately cooked can also lead to an infection.
Human-to-human transmission occurs through direct contact with infectious people’s respiratory droplets, skin lesions of the infected people, or objects contaminated with pathogens. Transmission can also be through the placenta from mother to fetus or through contact with body fluids when the baby is still in or shortly after birth. Although human-to-human transmission is less efficient than animal-to-human transmission, it has played a role in the spread of 2024, especially in population-concentrated cities.
Symptoms of Mpox
The incubation period of Mpox is between 6 to 13 days, although this can be from 5 to 21 days. The infection can be divided into two periods: The infection can be divided into two periods:
- Fever
- Headache
- Backpain
- Swelling of the lymph nodes
- Muscle Aches
- Intense Asthenia
Changes and Development of the Signs
However, there have been changes in the severity and manifestation of symptoms of the disease in the 2024 outbreak. For that particular illness, some patients have had serious forms of the disease—pneumonia, sepsis, encephalitis, corneal infection, and even blindness. These severe types are prevalent in children, pregnant women, and people with a weakened immune system.
Mpox has in the past been the deadliest and caused complications, resulting in one to 10 deaths depending on the type of the virus and the health of the infected people. The outbreak in 2024 has featured CFR on the higher end of this range, most notably in the developing world, where access to health care is a luxury.
Effect on State Health Organizations
The strain on Healthcare Infrastructure
The 2024 Mpox has caused an immense burden on public health facilities throughout Africa. Most of the affected countries have found it hard to contain the high number of patients in their hospitals, especially in rural areas where there are few health facilities. Hospitals and clinics have been deluged, and there has been a shortage of beds, healthcare practitioners, and medical equipment.
In Nigeria, for instance, big hospitals in cities such as Lagos and Abuja have lamented that they are over capacity, and many patients are treated in tents and make-shift structures. The situation is worse in the rural areas where the health facilities and equipment are limited and, in most cases, inadequate. In the DRC, Mpox is reported to be endemic, and the outbreak has compounded some of the existing issues, such as limited resources for health systems as well as few professionals in the field of health.
Medication and Other Health Related Needs and Services
One of the most significant factors observed during the 2024 outbreak is the problem of healthcare access. In most of the impacted areas, there are understandably not enough hospitals to provide the required services. What child welfare facilities are available are also grossly underfunded and most staffed by inexperienced workers. Such patients are likely to incur long distances to access care, which puts a time and effort lag on diagnosis and, therefore, treatment.
It has also brought out the scarcity of other essential healthcare items, including personal protective gear, antiviral stockpiling, and vaccines. Mpoz, albeit an airborne disease, presents self-limited complications; severe cases demand interventions such as antibiotics for bacterial infections and additional treatment for additional complications such as dehydration and pneumonia. The absence of such resources has prejudiced some areas, resulting in high mortality rates.
At Affected Areas:
It has spread in Cameroon, affecting the Northwestern and Southwestern Regions, where there are poor health facilities due to the ongoing conflict. Due to the insecurity situation, many healthcare workers have either been transferred from their duty stations or are unable to get to their workplace, resulting in inadequate staff and health facilities being overwhelmed by the disease.
The government of Ghana has stationed emergency response centers in places where the disease is prevalent, and they have since been flooded with people in this condition. The affected communities have relied on herbalists and CHWs, most of who are ill-equipped and have little understanding of the disease.
Government and International Response
African Governments’ Response
The African governments’ response to the 2024 Mpox outbreak has been mixed depending on the level of preparedness and stockpiling the country in question had for the disease. In Nigeria, various natural resources have been deployed to fight the disease after the government declared it a health risk. It has involved establishing isolation facilities, carrying out mass communications, and putting up programs to educate people on the disease and its prevention.
In the DRC, where Mpox is endemic, the government has had to draw on its experience in past Mpox outbreaks. Nonetheless, the outbreak witnessed in 2024 overwhelmed the capacity of health facilities, especially rural ones, due to poor access to health facilities. To enhance disease control, the government has enrolled the support of international organizations in disease monitoring and the supply of resources to enhance disease control in affected zones.
IHOs and INGOs
UN health organizations such as the WHO and other global health organizations like the CDC have been closely involved in addressing the Mpox outbreak in Africa. Such organizations have assisted countries prone to these diseases by training health professionals, developing laboratories and other diagnostic facilities, and helping with disease reporting.
Non-governmental organizations have also been instrumental in responding to the situation. Some recently reacted organizations include Médecins Sans Frontières (MSF), which has deployed its teams to some of the affected areas to offer its medical assistance. These NGOs have also contributed to producing information that informs the public on immunizations and other disease prevention measures.
Key Initiatives and Strategies
Population vaccination has been a critical strategy for responding to the Mpox 2024 outbreak. Some African countries have started the exercise with an emphasis on those most at risk, including healthcare workers, persons who attend to patients, and individuals living and working in camps. These campaigns use the smallpox vaccine, which also provides immunity to Mpox.
Another difference with similar campaigns is that this has also been done through public awareness activities, which have also been a part of the response. The cultures used by the Governments and NGOs over Mpox and how it spreads include radio, television, and social media. Neither of these campaigns has aimed to promote effective medication and treatment for the disease. Still, all of them have targeted showing that people should be aware of the symptoms of the disease and the need to solve the problem in its early stages, as well as avoiding close contact with infected animals.
Social and Economic Impact
Effects on Livelihood and Everyday Life
The outbreak of Mpox has taken a heavy toll on the livelihoods of millions in the Land. In most regions where it is raging, the outbreak has thrown a spanner in daily life, crippling economies and societies. Markets have been shut, travel restrictions imposed, and public gatherings restricted to avoid spreading the virus. Whereas these measures have been indispensable, they have had equally enormous economic implications, particularly for those whose daily bread depends on meager wages or informal employment.
In rural areas where farming is the primary livelihood activity, the outbreak has stopped farming activities. Farmers have been unable to work in the highly hit areas due to sickness or fear of contracting the virus. It simply means reduced outputs in agricultural production, food shortage, and spiraling food prices, making the situation worse economically for these people.
It has affected businesses, especially in the service sector, where the residents of urban areas live. Restaurants, hotels, and any other kind of business that involves people’s contact began losing customers because of the fear of being infected. This has resulted in very many workers losing their jobs and others having their earnings lowered, especially people with low-income jobs.
Vulnerable Populations
This outbreak of Mpox mainly affects women, children, and poor people. In most of the affected areas, women are sacrosanct carers and are thus more susceptible to acquiring the infectious disease while attending to their sick family members. More than that, children are at risk of severe morbidity or even death from Mpox, especially those who are undernourished or whose immunity is lowered.
Those living below the poverty line, on the other hand, are much more exposed to the economic impact of the outbreak. Most are employed in informal labor and do not have occupational or health safety nets. On the contrary, poverty in such societies has escalated to unlikely levels in the short term, making it even harder for them to obtain the materials they may need to continue and heal.
Cultural and Regional Challenges
Public Mistrust and Misinformation
Public mistrust and misinformation are one big challenge in managing the 2024 Mpox outbreak. Given the history of colonization, public corruption, and earlier public health failures in most African countries, deep-seated mistrust in governmental and international health organizations prevails. This trust has been further lowered by false information and conspiracy theories propagated across social media.
Misinformation about Mpox has included false claims about the origins of the virus, the safety and efficacy of vaccines, and the intentions of healthcare workers. In some communities, there have been reports of people refusing to seek medical care or participate in vaccination campaigns due to fears that they will be harmed or experimented on. It has made controlling the outbreak and protecting public health more difficult.
Traditional beliefs and practices have contributed equally to the response to the outbreak of Mpox. According to some communities, Mpox is believed to be a result of witchcraft, while in others, it is manifested as the ancestral spirits’ anger. Hence, people would visit traditional healers rather than seek modern medical care. Yet, even if conventional healers could contribute to better public health, especially in rural areas, their practices do not agree with modern medicine, making them potentially unknowing contributors to the virus’s potential spread.
Efforts to engage traditional leaders and healers in responding to the outbreaks have been varied. In some instances, traditional leaders are known to support vaccination and preventive measures actively. In other cases, this is perceived as contrary to cultural practices and norms.
Solving Regional and Cultural Challenges
To find solutions to the two challenging issues of cultural and regional origin, governments and international bodies have tried to connect with the local communities, seeking to establish trust through dialogue and cooperation and from working with traditional leaders, religious groups, and community-based organizations to propagating culturally sensitive and highly relevant public health messages tied to local belief systems and practices, kicked in.
In some places, community-based health workers have been trained to bridge modern medicine to traditional practice. Many times, these workers come from within the community they serve and have significantly called people’s attention to Mpox, dispelling myths and motivating them to visit health facilities and join vaccination campaigns.
Comparative Analysis with Previous Outbreaks
Differences in Scale and Response
This outbreak is much larger than those in the past. While Mpox has been established, the virus has been circulating endemically in some African countries for several decades; the current outbreak has affected more countries and people. It is partly due to increasing human mobility, environmental changes, and weaknesses within public health systems.
The response to the 2024 outbreak has been much different than previous outbreaks. Before this, the order of the day was always containment by isolation and quarantine. On the contrary, the scale of the 2024 outbreak means a more comprehensive approach is required with mass vaccination campaigns, public awareness efforts, and international collaboration.
The public perception of Mpox has changed over the years. The previous outbreaks have painted Mpox as a sporadic, exotic disease, and this has been associated with Africa’s primarily rural setting. The global spread of Mpox in recent years and the magnitude of the outbreak in 2024 has increased awareness of the disease and its repercussions on public health.
Outbreak results from 2024 are evolving, but lessons can already be learned from history: among them are the value of early warning and response, the demand for vigorous public health systems, and the value of international cooperation in the management of infectious diseases.
Future Projections and Recommendations
Future Likely Course of the Outbreak
The future course of the 2024 outbreak of Mpox in Africa remains very challenging to establish, though various prospective factors will influence the trajectory. These are the effectiveness of the ongoing public health intervention measures, the availability of vaccines and treatments, and health systems’ capacity to deal with the outbreak.
Given the current efforts to contain the outbreak, it can be expected that, if successful, the number of new cases might start taking a downward turn in a few months. Nonetheless, a high risk is posed for further spread, especially in areas with weak health infrastructure and poverty. Continued surveillance measures, public awareness, and vaccination campaigns would be instrumental in ensuring the virus does not recur.
Strengthening Public Health Systems
One critical lesson from the 2024 Mpox outbreak is the need to build more resilient African public health systems. It involves enhanced surveillance of diseases, access to health care, and adequate resourcing and staffing of health facilities. Strengthening public health systems will help control the current outbreak and improve response capacity to future public health emergencies.
Investing in research and development is crucial, including epidemiological studies of Mpox, new vaccines, treatments, and environmental and social parameters driving the virus’s spread. Local capacity building for research and development would be necessary to make sure that Africa is better prepared against such outbreaks in the future.
Improving Preparedness and Prevention
Other critical recommendations are those that enhance preparedness and prevention. These would include developing and putting in place national and regional preparedness plans, strengthening systems of early warning, enhancing coordination by governments, international organizations, and NGOs, and executing public education campaigns to put across such issues as hygiene, proper handling of animals, and vaccination.
It would also be essential to target the underlying drivers of the outbreaks at the heart of environmental degradation, climate change, and socio-economic inequalities. It will call for a multisector approach to involve the health sector, agriculture, education, and social services.
Conclusion
The outbreak of pox experienced in Africa in 2024 magnifies to the rest of the world the continued zoonotic diseases in a fast-changing world. It exposed the weaknesses in health systems, the socio-economic challenges many African communities face, and, most importantly, that of global coordination in responding to health threats.
With the 2024 Mpox outbreak still ongoing, much more can be done at all levels to prevent future outbreaks and keep populations safe. Overall efforts should include strengthening public health systems, the enhancement of preparedness, and prevention, with the ultimate goal of addressing the drivers of disease outbreaks. This outbreak, and the prevention of another such, will need a cooperative global effort and sustained vigilance.
References
- World Health Organization (WHO). (2024). Mpox Outbreaks in Africa: An Overview. Retrieved from WHO website.
- Centers for Disease Control and Prevention (CDC). (2024). Mpox Information for Healthcare Providers. Retrieved from CDC website.
- Médecins Sans Frontières (MSF). (2024). Responding to the Mpox Outbreak in Africa. Retrieved from MSF website.
- African Union (AU). (2024). Public Health Preparedness in Africa: Lessons from the Mpox Outbreak. Retrieved from AU website.
