By John Ikani
A rise in monkeypox infections in neighbouring Democratic Republic of Congo (DRC) has Ugandan health officials on high alert for potential cross-border spread of the viral disease.
The World Health Organization (WHO) classifies monkeypox, also known as mpox, as transmissible through sexual contact and other close physical interactions.
As of May 26, 2024, WHO data shows a concerning rise in the DRC, with 7,851 reported cases and 384 deaths linked to a new clade I MPXV variant.
Uganda’s Ministry of Health Chief Epidemiologist, Lt. Col. Dr. Henry Kyobe, expressed vigilance in a recent interview. “We’re closely monitoring the Congo outbreak to prepare on our end,” Dr. Kyobe stated.
“We’re revising our response plan, intensifying case finding, and raising public awareness, particularly among at-risk populations.”
He emphasized that all tested individuals in Uganda have received negative results. However, Dr. Kyobe cautioned, “Monkeypox can present with pustules, swelling, and a febrile rash resembling other illnesses. We’re maintaining a close watch to avoid missing any cases.”
“We have established sentinel surveillance focused on the Kasese region, particularly Bwera Hospital, covering both designated and non-designated border points,” Dr. Kyobe added. “Given the potential for people to seek better healthcare across borders, we’re prepared for such scenarios.”
WHO reports suggest a new clade I MPXV variant emerged in the DRC around mid-September 2023, displaying mutations that indicate “adaptation to human circulation,” with confirmed human-to-human transmission.
While the variant’s increased transmissibility or severity compared to other clade I MPXV strains remains unclear, WHO information highlights the presence of gene deletions impacting diagnostics in the DRC.
According to the WHO, the disease can also spread from animals to humans. Common symptoms of mpox include a rash lasting two to four weeks, potentially preceded or accompanied by fever, headache, muscle aches, back pain, fatigue, and swollen lymph nodes.
The rash manifests as blisters or sores, affecting the face, palms, soles, groin, and genital or anal areas. These lesions may also appear in the mouth, throat, anus, rectum, vagina, or on the eyes.
Dr. Kyobe downplayed the immediate threat to Uganda but acknowledged ongoing vigilance. “We’ve been closely monitoring the situation for nearly three years now,” he stated.
“The changing epidemiology in Congo is concerning,” Dr. Kyobe continued. “Clade 1, typically concentrated in Central Africa, is shifting transmission patterns from predominantly men who have sex with men to heterosexual contact. It’s also affecting immunocompromised individuals, children, and causing school clusters.”
Dr. Kyobe expressed particular concern for pregnant women and potential complications like premature birth and miscarriage.
“We have significant cross-border movement, including refugees. Additionally, a portion of our HIV-positive population is not virally suppressed, making them vulnerable,” Dr. Kyobe noted. “Children are also at increased risk of severe disease and death.”
