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This is a worksheet and not a case list. The intent of this worksheet is to provide some idea of where the most dangerous clade of mpox is occurring/spreading and what the size of the problem is.
As a departure from our usual lists we are incorporating suspected and probable cases if reported by a governmental authority. Lab verification is challenging in this situation. Mpox is easier to clinically diagnose than other viruses.
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Africa CDC - Mpox media event update November 14, 2024 - 3 slides included: 53,903 cases, 1,109 Mpox deaths to date in 2024 - all clades
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Clade 1b is in DRC, Burundi, Kenya, Uganda, Rwanda, Zambia, Zimbabwe
Clade 1a and 1b in Kinshasa, DRC. link
Belgium - 1 case. link Dec. 23. 2024
Burundi - from Eurosurveillance: "...Clade Ib has undergone rapid regional expansion that has included introduction to North Kivu, DRC [2], as well as dissemination to neighbouring countries in East Africa. Case totals were highest in Burundi with 987 confirmed cases as of 13 October 2024." link
Cameroon - Africa CDC rpt: 35 cases, 2 deaths so far in 2024. Likely clades I and II. link
Canada - Travel related case in Manitoba - Nov. 22, 2024
Central African Republic - WHO: "From 1 January to 31 August 2024, the country has recorded 278 suspected mpox cases, of which 47 have been confirmed (see Figure 6), including one death (CFR of 2.1%). Sequenced samples have shown the presence of clade Ia MPXV infection." link Africa CDC rpt says 213 cases, 1 deaths confirmed by WHO link, clade 1a. link link
Congo - Africa CDC rpt says 146 cases, 1 death, no clade mentioned. Health Minister on Aug. 25: "We have recorded 158 suspected cases since the beginning of the year. And, we have had 21 confirmed cases. Until two days ago, we had only 19 confirmed, treated and cured cases. 48 hours ago, we identified two new cases ,” link
DRC - WHO: "Based on currently available information, the spread of mpox in the Democratic Republic of the Congo is attributed to two distinct main outbreaks - spread of MPXV clade Ia in Equateur and other provinces of the country where mpox is endemic, including spread to and outbreaks in Kinshasa, and the spread of clade Ib MPXV in the provinces of North and South Kivu, which also includes a few cases in Kinshasa. Current sequencing capacity in the country is limited and clade distribution might be broader than what is currently known." link WHO director on August 26: "more than 18,000 suspected cases of mpox, with 615 deaths" link - unknown split between clades 1a and 1b (children cases are 1b link ) - media rpt dated August 22: 15,664 cases and 548 deaths link
France - 1 case, announced by health on January 6, 2025
Gabon - 2 cases, traveled from Uganda, WHO confirms clade 1a link link
Germany - 5 total. Government reports a clade 1b mpox infection, detected on October 18, 2024. A family cluster of 4 in December 2024 link
Ghana - Africa CDC rpt: 4 cases, no deaths. Possible clade IIb. link
Guinea - 1 case, 7 year old girl, no clade mentioned, no deaths
India - 2 cases, one is confirmed clade 1b - both are travelers from the UAE.
Ivory Coast - 32 cases, 1 death , WHO confirms clade as clade I & II. link link
Kenya - 13 cases confirmed total. link 5th case is spouse of 4th case who had traveled to Rwanda. several cases clade not confirmed yet. link , WHO confirms 2 cases of clade 1b , 3rd case clade is not determined yet), 1 death - no clade mention in death case, 3rd case has recent travel history to Uganda.
Liberia - Africa CDC rpt: 5 cases, no deaths. Cases referred to in WHO press release as clade II plus here: link
Morocco - 1 case, clade II
Nigeria - NCDC reports total 48 confirmed cases of mpox in 2024, 868 suspected cases and no deaths across 33 states and the Federal Capital Territory. Clade II confirmed by WHO link. Most affected age group are children. link link
Rwanda - MoH reports 4 total cases. All connected through the DRC, no deaths, WHO confirms clade 1b. link link
South Africa - 29 cases including 3 deaths listed. Clade I & IIb link link
Sweden - 1 case. Clade 1b. No deaths
Thailand - 1 case. Clade 1b. No deaths
UAE ? - One confirmed clade 1b case in a traveler from UAE who was diagnosed in India - need more clarification on this case travel history. 2 cases now reported in travelers from the UAE.
Uganda - 1,037 cases. All Clade 1b. 1 death Exponential growth in cases.link
UK - 4 total cases. 1 case with recent travel to African countries where clade 1b has been detected. In treatment. Announced October 30. 3 household contacts of the 1st case confirmed. link
US? - Awaiting subclade on a 1 clade mpox infection in California.
Zambia - Clade 1b link
Zimbabwe - Clade 1b link
Sources:
WHO - Multi-country External Situation Report n. 36, published 14 September 2024 link
Virological.org - Clade Ib Mpox in the Democratic Republic of the Congo (DRC): clinical and virological report of the first case in Kinshasa, the capital city
WHO - Disease Outbreak News: Mpox - African Region - August 22, 2024
WHO - Multi-country outbreak of mpox External Situation Report 35, published 12 August 2024
Data as received by WHO from national authorities as of 30 June 2024 link
Africa CDC - Mpox Situation in Africa – Africa CDC - dated July 30, 2024
@KrutikaKuppalli - former WHO medical officer with mpox experience (see post 2)
Various Ministry of Health department statements as provided. Linked above.
Various news reports believed to be credible. Linked above.
Sources considered but not being used:
WHO Mpox Outbreak Global Trends report dated August 22, 2024 because it spans 2 years (2022-2024) and this list is narrowly focused on the more deadly clade of 1b which has emerged in 2024. link Also, the lab confirmed cases figures used in the WHO report greatly understate the reality on the ground as reported by the African CDC. Mpox, unlike flu, is more easily diagnosed clinically.
As a departure from our usual lists we are incorporating suspected and probable cases if reported by a governmental authority. Lab verification is challenging in this situation. Mpox is easier to clinically diagnose than other viruses.
------------------------------------------------------------
Africa CDC - Mpox media event update November 14, 2024 - 3 slides included: 53,903 cases, 1,109 Mpox deaths to date in 2024 - all clades
-----------------------------------------------
Clade 1b is in DRC, Burundi, Kenya, Uganda, Rwanda, Zambia, Zimbabwe
Clade 1a and 1b in Kinshasa, DRC. link
Belgium - 1 case. link Dec. 23. 2024
Burundi - from Eurosurveillance: "...Clade Ib has undergone rapid regional expansion that has included introduction to North Kivu, DRC [2], as well as dissemination to neighbouring countries in East Africa. Case totals were highest in Burundi with 987 confirmed cases as of 13 October 2024." link
Cameroon - Africa CDC rpt: 35 cases, 2 deaths so far in 2024. Likely clades I and II. link
Canada - Travel related case in Manitoba - Nov. 22, 2024
Central African Republic - WHO: "From 1 January to 31 August 2024, the country has recorded 278 suspected mpox cases, of which 47 have been confirmed (see Figure 6), including one death (CFR of 2.1%). Sequenced samples have shown the presence of clade Ia MPXV infection." link Africa CDC rpt says 213 cases, 1 deaths confirmed by WHO link, clade 1a. link link
Congo - Africa CDC rpt says 146 cases, 1 death, no clade mentioned. Health Minister on Aug. 25: "We have recorded 158 suspected cases since the beginning of the year. And, we have had 21 confirmed cases. Until two days ago, we had only 19 confirmed, treated and cured cases. 48 hours ago, we identified two new cases ,” link
DRC - WHO: "Based on currently available information, the spread of mpox in the Democratic Republic of the Congo is attributed to two distinct main outbreaks - spread of MPXV clade Ia in Equateur and other provinces of the country where mpox is endemic, including spread to and outbreaks in Kinshasa, and the spread of clade Ib MPXV in the provinces of North and South Kivu, which also includes a few cases in Kinshasa. Current sequencing capacity in the country is limited and clade distribution might be broader than what is currently known." link WHO director on August 26: "more than 18,000 suspected cases of mpox, with 615 deaths" link - unknown split between clades 1a and 1b (children cases are 1b link ) - media rpt dated August 22: 15,664 cases and 548 deaths link
France - 1 case, announced by health on January 6, 2025
Gabon - 2 cases, traveled from Uganda, WHO confirms clade 1a link link
Germany - 5 total. Government reports a clade 1b mpox infection, detected on October 18, 2024. A family cluster of 4 in December 2024 link
Ghana - Africa CDC rpt: 4 cases, no deaths. Possible clade IIb. link
Guinea - 1 case, 7 year old girl, no clade mentioned, no deaths
India - 2 cases, one is confirmed clade 1b - both are travelers from the UAE.
Ivory Coast - 32 cases, 1 death , WHO confirms clade as clade I & II. link link
Kenya - 13 cases confirmed total. link 5th case is spouse of 4th case who had traveled to Rwanda. several cases clade not confirmed yet. link , WHO confirms 2 cases of clade 1b , 3rd case clade is not determined yet), 1 death - no clade mention in death case, 3rd case has recent travel history to Uganda.
Liberia - Africa CDC rpt: 5 cases, no deaths. Cases referred to in WHO press release as clade II plus here: link
Morocco - 1 case, clade II
Nigeria - NCDC reports total 48 confirmed cases of mpox in 2024, 868 suspected cases and no deaths across 33 states and the Federal Capital Territory. Clade II confirmed by WHO link. Most affected age group are children. link link
Rwanda - MoH reports 4 total cases. All connected through the DRC, no deaths, WHO confirms clade 1b. link link
South Africa - 29 cases including 3 deaths listed. Clade I & IIb link link
Sweden - 1 case. Clade 1b. No deaths
Thailand - 1 case. Clade 1b. No deaths
UAE ? - One confirmed clade 1b case in a traveler from UAE who was diagnosed in India - need more clarification on this case travel history. 2 cases now reported in travelers from the UAE.
Uganda - 1,037 cases. All Clade 1b. 1 death Exponential growth in cases.link
UK - 4 total cases. 1 case with recent travel to African countries where clade 1b has been detected. In treatment. Announced October 30. 3 household contacts of the 1st case confirmed. link
US? - Awaiting subclade on a 1 clade mpox infection in California.
Zambia - Clade 1b link
Zimbabwe - Clade 1b link
Sources:
WHO - Multi-country External Situation Report n. 36, published 14 September 2024 link
Virological.org - Clade Ib Mpox in the Democratic Republic of the Congo (DRC): clinical and virological report of the first case in Kinshasa, the capital city
WHO - Disease Outbreak News: Mpox - African Region - August 22, 2024
WHO - Multi-country outbreak of mpox External Situation Report 35, published 12 August 2024
Data as received by WHO from national authorities as of 30 June 2024 link
Africa CDC - Mpox Situation in Africa – Africa CDC - dated July 30, 2024
@KrutikaKuppalli - former WHO medical officer with mpox experience (see post 2)
Various Ministry of Health department statements as provided. Linked above.
Various news reports believed to be credible. Linked above.
Sources considered but not being used:
WHO Mpox Outbreak Global Trends report dated August 22, 2024 because it spans 2 years (2022-2024) and this list is narrowly focused on the more deadly clade of 1b which has emerged in 2024. link Also, the lab confirmed cases figures used in the WHO report greatly understate the reality on the ground as reported by the African CDC. Mpox, unlike flu, is more easily diagnosed clinically.
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