By NewsDesk @bactiman63
While the Democratic Republic of the Congo (DRC) has reported a decline in cases of diseases like measles this year, other infectious diseases are higher in 2020.
One such disease is monkeypox. The World Health Organization (WHO) reports a total of 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio 3.7%), have been reported in 127 health zones from 17 out of 26 provinces through September 13 this year.
During the same period in 2019, 3,794 suspected cases and 73 deaths (CFR 1.9%) were reported in 120 health zones from 16 provinces while a total of 2,850 suspected cases (CFR 2.1%) were reported in 2018.
Monkeypox cases were reported in health zones which are also experiencing multiple disease outbreaks, including measles, polio due to cVDPV, malaria, cholera, and COVID-19, in addition to an ongoing Ebola virus disease outbreak in Equateur Province which continues to experience armed conflict and violence. The security situation in the Democratic Republic of the Congo remains unstable, further disrupting surveillance efforts and response activities. Affected regions for this outbreak continue to experience armed conflict and population displacements.
Potential exposure might be linked to proximity to the forest with many possible animal reservoirs, including for hunting activities.
WHO says monkeypox is a sylvatic zoonosis with incidental human infections that occur sporadically in the rain forests of Central and West Africa. It is caused by the monkeypox virus (MPXV) which belongs to the Orthopoxvirus family, the same group of viruses as smallpox.
There are two distinct clades of monkeypox virus, the Congo Basin clade and the West African clade. Monkeypox due to the Congo Basin clade virus has seen reported mortality of up to 10% of cases, whereas the West African clade usually displays fatal outcomes in less than 1% of cases. HIV infection appears to increase the risk of death in people infected with monkeypox virus.
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The animal reservoir remains unknown. However, evidence suggests that native African rodents may be potential sources. Contact with live and dead animals through hunting and bush meat are presumed drivers of human infection. The disease is self-limiting with symptoms usually resolving within 14-21 days. Severe cases occur more commonly among children and immunocompromised population, particularly persons with HIV, and are related to the extent of virus exposure, patient health status and severity of complications. The case fatality ratio has varied between epidemics but has been between 1% and 10% in documented events. There is no specific treatment licensed for monkeypox and a recently approved vaccine is not yet widely available for the public sector.
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Please review information for Équateur province regarding armed conflict, violence and population displacements:
“…ongoing Ebola virus disease outbreak in Equateur Province which continues to experience armed conflict and violence. The security situation in the Democratic Republic of the Congo remains unstable, further disrupting surveillance efforts and response activities. Affected regions for this outbreak continue to experience armed conflict and population displacements.”
Perhaps this information is borrowed from the previous outbreak in the east of DRC. I am working in Équateur in the response and it is not an area of armed conflict, violence, or displacement.
Best wishes,
JF, NGO registered nurse