United States Government’s Response to the Clade I Mpox Outbreak in the Democratic Republic of the Congo and Other Countries in the Region

This week, the Africa Centres for Disease Control and Prevention (Africa CDC) declared the mpox clade I outbreak a Public Health Emergency of Continental Security, and the World Health Organization (WHO) declared this outbreak a Public Health Emergency of International Concern. The United States government supports those declarations. The United States will continue to work closely with African governments, Africa CDC and WHO to ensure an effective response to the current outbreak and to protect the health and lives of people of the region.

In 2022, the world experienced a global outbreak of clade II mpox, which led to more than 95,000 cases across 115 non-endemic countries. Clade I mpox tends to cause a higher number of severe infections and have a higher mortality rate than clade II mpox. The evidence for clade I mpox clinical outcomes is based primarily on data from endemic countries, particularly DRC. We expect it would cause lower morbidity and mortality in the United States than in the DRC.

DRC is currently experiencing the largest number of annual suspect cases ever recorded and the disease has now been identified in several neighboring countries where mpox (clade I or clade II) has not been found in the past.

U.S. Government Partnership on the Mpox Response

The United States Government has been closely monitoring the spread of clade I mpox in the DRC and neighboring countries since 2023, and we have been working closely with the Government of DRC, as well as regional and global health partners to reduce the impact of this outbreak and safeguard public health. U.S. government support for the mpox response also builds on our robust, longstanding health partnerships with DRC and throughout Africa, which have helped combat infectious diseases such as HIV, tuberculosis, and malaria for over 20 years. In fiscal year 2023, the United States allocated more than $2.65 billion in bilateral health funding in Central and Eastern Africa. This response also builds on a longstanding partnership on global health security between DRC and the United States.

In addition to ongoing health support, in the last few months the United States has provided an additional $17 million USD to support clade I mpox preparedness and response efforts in Central and Eastern Africa. The funding has enabled stronger surveillance, risk communication, and community engagement, as well as needed laboratory supplies and diagnostics, clinical services, and vaccine planning.

Vaccination will be a critical element of the response to this outbreak. To support this effort, the United States is donating 50,000 doses of the Food and Drug Administration (FDA)-approved JYNNEOS vaccine to DRC. The United States is working with other countries, WHO, and international partners to encourage donations that support vaccine efforts and address challenges to vaccine delivery.

Mpox Preparedness for the United States

The risk to the general public in the United States from clade I mpox circulating in the DRC is very low, and there are no known cases in the United States at this time. Due to efforts over the last nine months, the United States is well prepared to rapidly detect, contain, and manage clade I cases should they be identified domestically. The United States has a robust surveillance system in place, including through clinical testing and wastewater analysis. We continue to encourage those at high risk to get vaccinated with the JYNNEOS mpox vaccine, which has been demonstrated to be safe and highly effective at preventing severe disease from mpox. Those who have already had clade II mpox or are fully vaccinated against mpox are expected to be protected against severe illness from clade I mpox.

CDC has issued an updated Health Alert Network advisory urging clinicians to consider clade I mpox in people who have been in DRC or neighboring countries in the previous 21 days; clinicians are also asked to submit specimens for clade-specific testing for these patients if they have symptoms consistent with mpox. Given the geographic spread of clade I mpox, the U.S. CDC issued an updated Travel Health Notice on Aug. 7, 2024, recommending travelers to DRC and neighboring countries practice enhanced precautions.