The Africa Centres for Disease Control and Prevention (Africa CDC) has warned that the high number of smallpox cases, limited diagnostic capacity and high mortality rate from the disease are some of the pressing challenges hampering the continent’s response to the disease, as the number of cases increases across Africa.

ADDIS ABABA, Aug. 24 (Xinhua) — The Africa Centers for Disease Control and Prevention (Africa CDC) has warned that the rising number of smallpox cases, limited diagnostic capacity and high mortality rate from the disease are pressing challenges hampering the continent’s response to the disease, as cases increase across Africa.

The challenges are also linked to the rapid spread of the disease to new countries and disparate efforts to combat smallpox, while it is more than necessary to improve coordination of efforts, said Jean Kasia, director general of the Africa Centers for Disease Control and Prevention, in an update on the outbreak in several African countries issued on Friday.

Data from the Africa CDC shows that from the beginning of 2024 until August 23, a total of 21,466 probable cases of smallpox, formerly known as “monkeypox,” and 591 deaths have been reported in 13 member countries of the Africa CDC (African Union).

The 13 African Union members that have reported cases of smallpox so far are Burundi, Cameroon, Central African Republic, Republic of Congo, Côte d’Ivoire, Democratic Republic of Congo, Gabon, Liberia, Kenya, Nigeria, Rwanda, South Africa and Uganda.

“The reported cases and deaths are just the tip of the iceberg, given that smallpox is mostly a benign condition and that surveillance, testing, contact tracing and reporting are limited,” Kasia said in an update to African health ministers about the ongoing outbreak in Africa.

He also warned of the high mortality rate from smallpox, which is usually between 3% and 4%, and added that the link between the disease and HIV was of particular concern for Africa.

According to Cassia, several previously untouched African countries have reported their first imported cases of smallpox, and there is a high risk of the virus spreading outside Africa.

“As I write this, Gabon has confirmed its first case, while Sierra Leone and Malawi are testing suspected cases,” he said.

He also reminded that a negative laboratory test result does not mean that there is no epidemic.

On August 13, the Africa CDC confirmed that the ongoing smallpox outbreak in Africa was a public health emergency of continental concern, citing “the clear and present danger posed by the onslaught of smallpox on the continent.”

A day after the Africa CDC declared a Public Health Emergency of Continental Concern (PHECS), the World Health Organization also declared smallpox a Public Health Emergency of International Concern (PHEIC), activating the highest global alert level for the disease for the second time in two years, while increasing numbers of cases of the new, more deadly strain are being reported across Africa and beyond.

Mr. Kasia stressed that the African Union’s specialized health agency, in declaring the continent-wide public health emergency of concern, consulted “the best African epidemiologists and laboratory experts” as well as international experts and appropriate agencies, including the China CDC, the US CDC, the European CDC, and the World Health Organization.

“The conclusion is that it is not advisable to rely solely on laboratory test results to diagnose smallpox. We need a comprehensive approach that integrates laboratory tests with clinical assessment and epidemiological data that are essential to accurately diagnose and manage smallpox,” he noted. “The diagnosis and management of smallpox should be a comprehensive approach,” he said.

Earlier this week, the Africa CDC announced that smallpox vaccination could begin “in the coming days” due to rising cases on the continent.

The Africa CDC chief stressed that by working closely with African countries, WHO and various partners, as well as leveraging the African Union’s capacity for policy, guidance and advocacy to address the pandemic, the agency has supported African countries in their preparedness and response activities.

He also explained that his organization is deploying about 200 epidemiologists and logisticians to all African countries affected by smallpox. This comes on the back of the deployment of 24 experts to support the response in the Democratic Republic of the Congo and other hard-hit countries.

Noting that a continental smallpox strategy has been developed to mobilize resources and coordinate response to the outbreak, Mr. Kassia highlighted that an incident management team has been established under the leadership of the Africa CDC.