Sierra Leone becomes new Mpox hotspot in Africa

ETHIOPIA—Sierra Leone has become the latest country to be added to the Africa CDC’s Incident Management Support Team (IMST) list of nations most affected by mpox, as cases continue to surge and raise alarm across the continent.

The outbreak began when Sierra Leone confirmed its first mpox case on January 10, 2025.

In response, Minister of Health Dr. Austin Demby quickly declared a Public Health Emergency, stressing that swift action was necessary to prevent further spread of the virus.

During a recent online media briefing, Dr. Ngashi Ngongo, who leads the Africa CDC’s mpox response, shared updates on the situation.

He noted that while some of the region’s main hotspots, such as Burundi, Uganda, and the Democratic Republic of the Congo, are beginning to see a decline in cases, Sierra Leone is experiencing a worrying rise.

 In April alone, the country reported over 200 new confirmed cases, pointing to increased transmission.

By early May, Sierra Leone accounted for half of all confirmed mpox cases in Africa, with the outbreak expanding rapidly over the previous six weeks.

Cases rose by 71% in just one week, with the country averaging around 100 new cases each day.

Dr. Ngongo expressed deep concern, stating, “In just one week, the number of notified cases increased by 71 percent, and confirmed cases rose by 61 percent. This shows the epidemic is on an upward trend. We are particularly worried about the exponential growth in Sierra Leone.”

The data reveals that 68% of patients are men, mostly between 30 and 35 years old.

Additionally, 7% of those infected are people living with HIV—a group already at higher risk, as seen in other African countries during this outbreak.

An IMST mission to Sierra Leone in April found the country’s health system severely overstretched.

Mpox treatment centers have only 60 isolation beds, far from enough to accommodate the more than 1,000 patients needing care.

As a result, about 800 active cases are currently managed at home, which poses its own challenges.

Dr. Ngongo explained that compliance with home isolation is very low, as many patients continue to participate in social activities, increasing the risk of further spread.

Moreover, the assessment revealed that Sierra Leone relies mostly on passive surveillance, meaning people seek care only when their symptoms become severe.

 This has led to a positivity rate exceeding 50%, suggesting that many cases are not detected early enough to prevent further transmission.

While the country has good testing coverage, contact tracing remains weak, with fewer than one in six confirmed cases having their contacts identified.

The genomic sequencing rate is also low, currently well below 1% instead of the recommended 5%.

On the vaccination front, nearly 24,000 people in Sierra Leone have received the mpox vaccine, with almost 60% of recipients being healthcare workers.

However, with a population of 8 million and just over 61,000 doses available, officials say only those at highest risk can be prioritized.

Sierra Leone is one of 10 African countries to receive vaccine supplies, thanks to support from partners such as Gavi, UNICEF, and the Africa CDC.

Since early 2024, 24 African countries have reported a total of 129,711 mpox cases, with 29,609 confirmed and about 1,751 deaths related to the disease.

In Sierra Leone, all 16 districts are now affected, and authorities are particularly concerned about the severity of cases among people living with HIV.

Looking ahead, Africa CDC is calling for urgent action to address vaccine shortages not only in Sierra Leone but across the continent.

 The agency is advocating for increased vaccine availability in the short term and is pushing for local vaccine manufacturing and strategic stockpiling in the medium and long term to better prepare for future outbreaks.

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