Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to provide additional information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo (DRC); the first Health Advisory about this outbreak was released in December 2023.
Since January 2023, the DRC has reported the largest number of yearly suspected clade I mpox cases on record. While clade I MPXV is endemic, or naturally occurring, in DRC, the current outbreak is more widespread than any previous DRC outbreak and has resulted in clade I mpox transmission to some neighboring countries. The Republic of the Congo (ROC), which borders DRC to the west, declared a clade I mpox outbreak in April 2024, and there have been confirmed cases in the Central African Republic (CAR). While clade I mpox is endemic in ROC and CAR, the epidemiologic pattern of recent cases suggests a possible link to DRC.
In late July 2024, Burundi, Rwanda, and Uganda, which sit on the eastern border of DRC, reported confirmed cases of mpox, with some cases having linkages to DRC. Rwanda and Uganda have confirmed these cases are due to clade I MPXV; in Burundi, clade-specific testing is underway, but cases are presumed to be clade I due to DRC’s proximity. Mpox is not known to be endemic in these countries.
No cases of clade I mpox have been reported outside central and eastern Africa at this time. Because there is a risk of additional spread, CDC recommends clinicians and jurisdictions in the United States maintain a heightened index of suspicion for mpox in patients who have recently been in DRC or to any country sharing a border with DRC (ROC, Angola, Zambia, Rwanda, Burundi, Uganda, South Sudan, CAR) and present with signs and symptoms consistent with mpox. These can include: rash that may be located on the hands, feet, chest, face, mouth, or near the genitals; fever; chills; swollen lymph nodes; fatigue; myalgia (muscle aches and backache); headache; and respiratory symptoms like sore throat, nasal congestion, and cough.
Recommendations for the Public
The risk of clade I mpox spreading to the United States is very low at this time.
Seek medical care immediately and avoid contact with others if you have been in the DRC or its neighboring countries in the last 21 days and develop a new, unexplained skin rash (lesions on any part of the body), with or without fever and chills.
Consider getting vaccinated against mpox if you have risk factors and are eligible for vaccination. CDC continues to recommend that people who are eligible for vaccination receive two doses of the JYNNEOS vaccine for the best protection. People at risk for mpox who have only received one dose more than 28 days prior should receive a second dose as soon as possible. JYNNEOS vaccine is believed to protect against mpox clades.
Review CDC Travel Health Notices for the DRC and neighboring countries before traveling. People with risk factors for MPXV infection who are not able to be vaccinated or (e.g., pregnant people, infants less than 1 year, people with eczema or active skin conditions, and people who are immunocompromised) should avoid situations that might increase their risk for mpox.
All travelers to areas with mpox cases should protect themselves by avoiding close contact with people who have skin or genital lesions; avoiding contact with dead or live wild animals; avoiding contact with materials used by sick people like clothing, bedding, or in health care; avoiding materials that came into contact with wild animals; and avoiding eating or preparing meat from wild animals (bushmeat), or using products made from wild animals in countries where mpox occurs in animals.
For more Information:
• General inquiries: CDC-INFO (1-800-232-4636)
• About Mpox: Discover, History, and Virus Types: About Mpox | Mpox | Poxvirus | CDC
• Mpox Information for the Public: Your Health | Mpox | Poxvirus | CDC
