Ndembi Nicaise, Folayan Morenike O, Komakech Allan, Mercy Kyeng, Tessema Sofonias, Mbala-Kingebeni Placide, Ngandu Christian, Ngongo Ngashi, Kaseya Jean, Abdool Karim Salim S
Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
N Engl J Med. 2025 Feb 13;392(7):666-676. doi: 10.1056/NEJMoa2411368. Epub 2025 Jan 29.
For decades after the identification of mpox in humans in the Democratic Republic of Congo (DRC) in 1970, the disease was largely confined to the rural areas of Central and West Africa and thus did not garner broad attention. On August 13, 2024, mpox was declared a Public Health Emergency of Continental Security (PHECS) by the Africa Centers for Disease Control and Prevention (Africa CDC), a notice that was followed the next day by a declaration of a Public Health Emergency of International Concern (PHEIC) by the World Health Organization.
In this study we analyzed all mpox cases and deaths, based on clinical or laboratory diagnosis, that were reported to the Africa CDC from January 1, 2022, to October 30, 2024, to identify temporal variations, geographic distributions, and epidemiologic trends.
From January 1, 2022, to August 18, 2024, a total of 45,652 mpox cases were clinically diagnosed and laboratory-confirmed in 12 African countries. These cases resulted in 1492 deaths (case fatality rate, 3.3%). From 2022 to 2024, weekly laboratory-confirmed mpox cases increased by a factor of 2.8 (from 176 to 489 cases), whereas all weekly reported cases (including those with a clinical diagnosis) increased by a factor of 4.3 (from 669 to 2900 cases). The DRC, which had reported approximately 88% of mpox cases in Africa in 2024, had 19,513 cases before the emergency declaration, with a case fatality rate of 3.1% - a weekly average of 591 cases as compared with 281 in 2023. In 2024, six African countries reported their first imported mpox infections, with Burundi also reporting local transmission.
The high mpox disease burden in Africa, especially in the DRC - with a rising number of cases, high case fatality rate, and high degree of spread to other previously mpox-free African countries - is cause for increased international concern. Case detection, contact tracing, public health measures, and affordable vaccines are needed to implement interventions in the DRC to reduce the risk of global spread of the virus.
自1970年在刚果民主共和国发现人类猴痘病例后的几十年里，该疾病主要局限于中非和西非的农村地区，因此未引起广泛关注。2024年8月13日，非洲疾病控制与预防中心（Africa CDC）宣布猴痘为“非洲大陆安全公共卫生紧急事件”（PHECS），次日世界卫生组织宣布其为“国际关注的突发公共卫生事件”（PHEIC）。
在本研究中，我们分析了2022年1月1日至2024年10月30日期间向非洲疾病控制与预防中心报告的所有基于临床或实验室诊断的猴痘病例及死亡情况，以确定时间变化、地理分布和流行病学趋势。
2022年1月1日至2024年8月18日，12个非洲国家共临床诊断并实验室确诊45,652例猴痘病例，这些病例导致1492人死亡（病死率3.3%）。2022年至2024年，每周实验室确诊的猴痘病例增加了2.8倍（从176例增至489例），而每周报告的所有病例（包括临床诊断病例）增加了4.3倍（从669例增至2900例）。2024年，刚果民主共和国报告了非洲约88%的猴痘病例，在紧急声明发布前有19,513例病例，病死率为3.1%，每周平均591例，而2023年为281例。2024年，6个非洲国家报告了首例输入性猴痘感染病例，布隆迪还报告了本地传播情况。
非洲猴痘疾病负担沉重，尤其是在刚果民主共和国，病例数不断增加、病死率高且传播到其他此前无猴痘的非洲国家的程度高，这引发了国际社会更多关注。需要进行病例检测、接触者追踪、采取公共卫生措施以及提供价格可承受的疫苗，以便在刚果民主共和国实施干预措施，降低病毒全球传播的风险。
