Uganda on high alert over monkeypox outbreak in DR Congo

The increase in cases of monkeypox infections in the neighbouring Democratic Republic of Congo (DRC) is raising concerns about the possible cross-border spread of the viral disease to Uganda.

Monkeypox (officially known as mpox), the World Health Organisation (WHO) said, is spreading through sexual contact and other forms of close physical contact.

Data from the WHO also indicates that in 2024 alone, as of May 26, up to 7,851 monkeypox cases were reported in the DRC, including 384 deaths of the infected people as the new variant of clade I MPXV spreads. 

Lt Col Dr Henry Kyobe, the chief epidemiologist at the Ministry of Health, told this publication on Sunday that they have a robust response strategy to prevent and combat the viral disease.

“We are keenly looking at this outbreak in Congo with a view of preparations on our side,” Dr Kyobe said, adding:  “We have a response plan which we are revising and of course heightening our case finding and then public awareness, specifically for the at-risk population.” 

He further said the people tested in Uganda, their results have all turned out negative.  

“But of course [for] monkeypox, you see the pustules of swelling and the consistency with what we call a febrile rush similar to other conditions. So, we are keeping a very keen eye on those to make sure that we don’t miss them,” he said.

He added: “We have a sentinel surveillance beaming into DRC, concentrated around the Kasese, specifically the Bwera hospital, looking at both designated border points and non-designated border points. And in the circumstances, we know that people will drift where there is good health care.”

According to information from the WHO, the new variant of clade I MPXV, thought to have emerged around mid-September 2023, has been described in South Kivu, DRC. It carries mutations, which indicate “adaptation of the virus due to circulation among humans”  and its human-human transmission has been going on. 

“It is not known if this variant is more transmissible or leads to more severe disease than other clade I MPXV strains. Additionally, it carries gene deletions that affect diagnostics in the Democratic Republic of the Congo,” information from the WHO reads. 

The WHO also indicates that the disease can be spread from infected animals to humans. According to information from the WHO, common symptoms of mpox include a rash that may last from two to four weeks.

“This may start with or be followed by fever, headache, muscle aches, back pain, low energy, and swollen glands (lymph nodes). The rash looks like blisters or sores and can affect the face, palms of the hands, soles of the feet, groin, genital and or anal regions. These lesions may also be found in the mouth, throat, anus, rectum or vagina, or on the eyes,” information from the WHO reads further.

Asked about the seriousness of the disease threat to Uganda, Dr Kyobe said: “I can’t say the threat is big [to Uganda]. But I can say it is something that we are keenly looking at for years, almost three years and counting.”

“We also know that the epidemiology is shifting in Congo, largely because of clade 1, which is concentrated in Central Africa and is shifting from predominantly contacts and the men who have sex with men, transitioning into heterosexual transmission and also affecting people who are immunocompromised, children and also having school clusters,” he added.

He also said they are concerned about the effect of the disease on pregnant mothers and poor pregnancy outcomes, including premature labour, abortions, and all the like.

“And of course, noting that we have a lot of cross-border movements, including refugees in Uganda, then having people with HIV, a proportion of them are not appropriately suppressed, meaning they are vulnerable, and of course the children [who are also at risk of severe disease and death],” he added.