UPDATe - 3 September 2024
NCDA is monitoring the mpox outbreak in Democratic Republic of Congo and neighbouring countries closely to better understand the situation and plan our Global NCDA Forum accordingly. We have met with our collaborating partners, including the Rwanda Ministry of Health, the Rwanda Biomedical Centre, Rwanda NCD Alliance, as well as Africa CDC. We want to reassure you that the risk of transmission is extremely low for delegates. We are putting in place additional measures to secure a safe event for everyone in October, in line with WHO Africa and the Rwanda Ministry of Health recommendations.
A summary of the situation in Africa and Rwanda, as well as details of the mitigation measures at the Kigali Convention Centre is included below.
Mpox - situation at a glance
Following an escalation of mpox cases in DRC and the region, on 14 August 2024, the WHO Director-General determined that the upsurge constitutes a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (IHR), the highest level of alarm. The same week, Africa CDC declared mpox a Health Emergency of Continental Alert.
As of 18 August 2024, the WHO African Region has reported 17,947 suspected mpox cases, including 563 suspected deaths and 2,186 laboratory-confirmed cases, with 13 confirmed deaths across 12 countries since January 2024. The Democratic Republic of the Congo (DRC) remains the hardest hit, accounting for 86.4% of all confirmed cases in the region in 2024, with 1,888 confirmed cases and eight deaths reported this year.
Mpox in Rwanda
As of 7 August 2024, four confirmed mpox cases and zero deaths have cumulatively been reported in Rwanda. Sequencing analysis has confirmed MPXV Clade Ib. Whereas only four mpox isolated cases have been reported, please be advised that appropriate public health and social measures are recommended and should be followed during gatherings
On 23 August, Rwanda’s Minister of Health, Dr. Sabin Nsanzimana, announced through a video message that the Ministry is working closely with national institutions and international health organisations to completely eradicate Mpox outbreak. Significant measures are being implemented to prevent the spread of the disease, noting that individuals who have been treated for Mpox have already recovered. The Minister highlighted that in Rwanda, Mpox has predominantly affected individuals involved in sex work or those with frequent sexual activity, as the disease spreads primarily through close physical contact. This transmission method differs significantly from that of COVID-19, which primarily spreads through respiratory droplets.
mitigation Measures for the Forum
WHO advises that countries establish or strengthen cross-border collaboration arrangements for surveillance and management of suspect cases of Mpox, the provision of information to travellers and conveyance operators, without resorting to general travel and trade restrictions unnecessarily impacting local, regional, or national economies. Rwanda has therefore not implemented any travel restrictions related to Mpox.
Risk assessment for the Forum and mitigation measures: Based on currently available surveillance data, no case of mpox has been detected at the meeting location in Kigali. It is unlikely for meeting participants to get infected via local communities and animals, therefore the risk is low. In addition, delegates are primarily comprised of advocates and health professionals who are cognizant of the importance of precautionary measures and better informed to apply individual-level responsibility to their decisions and actions.
However, during the Forum, like any other large gathering, the frequent interactions between attendees, including talking or breathing very closely to others and the mobility of attendees, present a minimal risk.
Measures have been taken to mitigate this risk in the Kigali Convention Centre, and delegates are encouraged to practice the mitigation measures as explained below
- Hand Hygiene: Delegates will be encouraged to wash their hands with soap and water or use alcohol based hand sanitisers, which will be freely provided at the Global Forum next to all rooms. All delegates at the event are encouraged to carry hand sanitizers and any prescription medications for regular use.
- Mask Availability: Disposable masks will be available to anyone experiencing respiratory symptoms or feeling particularly vulnerable.
- To reduce the risk of transmission, it’s recommended to avoid close or intimate contact, including shaking hands, hugging, and kissing. Mpox can spread through direct skin-to-skin contact with infected lesions.
- Convention Center Cleaning: The conference rooms will undergo regular cleaning with standard disinfection procedures. Particular attention will be given to high-touch surfaces.
- Sanitisation of Common Areas: Toilets, bathrooms, and other common surfaces will be thoroughly cleaned multiple times a day, using WHO-recommended disinfectants to prevent contamination.
- Medical services: the Kigali Convention Centre will have a staffed medical centre, in case any delegate is feeling unwell.
- Isolation: In the unlikely event that a delegate develops symptoms and is confirmed positive for Mpox, arrangements will be made for isolation. If necessary, arrangements for further care will be made as advised by the physicians.
Public health advice on mpox
The below is for informational purposes only. Public health advice on mpox can be found on the WHO website.
What is MPOX?
- Mpox, previously known as Monkeypox, is an infectious viral zoonotic disease caused by the monkeypox virus, which is an Orthopoxvirus genus in the family Poxiviridae. Two different clades exist: Clade I and Clade II.
- The symptoms begin with flu-like symptoms such as fever, headache, muscle aches, backache and exhaustion. Lymphadenopathy (swelling of the lymph nodes) is also common and can help distinguish it from other pox-like diseases. Include skin rash or mucosal lesions accompanied by fever, swollen lymph nodes, sore throat, and body aches, among others.
- The rash begins within 1 to 3 days (sometimes longer) after the onset of fever. The rash often starts on the face and then spreads to other parts of the body, including the palms of the hands and soles of the feet. It goes through diUerent stages—macules, papules, vesicles, pustules—before finally forming scabs, which eventually fall out.
- Mpox spreads from person to person via direct contact or through exposure to infected animals or contaminated materials.
- The incubation period of mpox is usually 6–13 days but can range from 2–21 days.
- Most people will recover within 2-4 weeks with appropriate care.
- In Africa, the mpox outbreak in 2024 is characterized by a mixed pattern of zoonotic and person-to-person transmission (few have been through sexual contact).
How is MPOX transmitted?
Mpox is transmitted through close contact with someone who has symptoms, including:
- Skin-to-skin (providing care without PPE, hugging, touching, including sexual contact)
- Face-to-face (droplets during talking)
- Mouth-to-skin (oral sex)
- Mouth-to-mouth (e.g., kissing)
- From contaminated bedding, towels, clothing, surfaces or objects.
- Bites or scratches from infected animals.
- Direct contact with the blood, bodily fluids, or skin/mucosal lesions of infected animals.
The risk of mpox is not limited to people who are sexually active or gay, bisexual, and other men who have sex with men. Anyone who has close contact with someone who has symptoms or someone who comes in close contact with sick/dead animals is at risk.
How can I protect myself?
To protect yourself and others against mpox, know the signs and symptoms, how the virus spreads, and what to do if you get ill.
- Avoid close contact with anyone who has mpox, including sexual contact.
- Do not share bedding or clothing with individuals who are sick with mpox.
- Wash your hands frequently with soap and water or an alcohol-based hand rub.
- Avoid close physical contact with people who are showing symptoms of mpox.
- Wear protective clothing if you are caring for someone who is infected. If you think you might have mpox, you can act to protect others by seeking medical advice and isolating yourself from others until you have been evaluated and tested.
- If you have mpox, you should isolate yourself from others until all your lesions have crusted over, the scabs have fallen off, and a new layer of skin has formed underneath. This will stop you from passing on the virus to others.
What do I do if I suspect I have mpox?
- Isolate and avoid contact with others as much as possible.
- If you must interact with others, wear a mask and cover any lesions to reduce the risk of spreading the virus.
- Contact a health worker to get advice and follow the recommendations.
- Get tested and wait for the results.
- Do not scratch or touch the rash or lesions, as this can worsen the condition and increase the risk of spreading the virus.
- Frequently wash hands with soap and water, especially after touching your face, the rash or anything that may have come into contact with the virus.
- Use alcohol-based hand sanitizer if soap and water are not available.
- Clean and disinfect frequently touched objects and surfaces.
- Protect others by avoiding contact with them.
