CDC Response to Mpox Outbreak in the Democratic Republic of the Congo

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Situation in DRC

The Democratic Republic of Congo (DRC) is experiencing its largest mpox outbreak ever recorded. Since January 1, 2023, DRC has reported 12,569 suspect mpox cases and 581 deaths. Among African countries where mpox is commonly reported, DRC typically has the most cases annually. However, cases normally occur in remote, forested areas, rather than the capital or other large cities.

The current outbreak is widespread in DRC, with cases reported in 22 of the DRC’s 26 provinces and in the capital city of Kinshasa and a few other large cities. Only a small percentage of the reported cases have been tested. However, among those testing positive, many are Clade I.  Within monkeypox virus, a clade is a grouping of viruses that share certain characteristics, such as sharing similar genetic sequences or causing illness in a similar way. Of particular concern, the type of monkeypox virus causing the cases (Clade I) makes people sicker and more often leads to death than the type that caused the 2022-23 global outbreak (Clade II).

Because mpox is commonly found in DRC, it’s likely that at least some of the illnesses associated with this outbreak are the normal background cases, but it’s been more recognized since it’s being reported in a wider area than normal. Some of the infections have been tied to sexual contact, which marks the first reported instances of such transmission of Clade I.

What CDC is doing in the United States

CDC has issued an advisory for U.S. clinicians to be aware of the possibility for mpox in travelers who recently have been to DRC. Additionally, CDC has alerted travelers to and from the DRC to be aware of mpox symptoms and to seek immediate medical attention if a new, unexplained skin rash develops.

What CDC is Doing in DRC

CDC has been supporting DRC mpox research and response for more than 20 years.  Currently, CDC staff in DRC has been providing extra technical assistance to the DRC Ministry of Health and working with the World Health Organization (WHO) team on the ground in DRC. CDC has provided laboratory support and additional funds to help provide support for contact tracing and community outreach.

Refresher on mpox

Mpox is a rare viral disease that is related to smallpox. It is caused by the monkeypox virus and usually spread to people from animals, but it can also be spread between people.

People with mpox often get a rash that may be located on hands, feet, chest, face, or mouth or – as seen during global outbreak – near the genitals, including penis, testicles, labia, vagina, and anus. The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine.

  • The rash will go through several stages, including scabs, before healing.
  • The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms of mpox can include:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Exhaustion
  • Muscle aches and backache
  • Headache
  • Respiratory symptoms (e.g., sore throat, nasal congestion, or cough)

Bottom line

There have been no cases of Clade I mpox reported in the United States at this time. The anticipated risk of mpox being imported into the United States from the DRC outbreak is low and would primarily be among those who have recent travel to DRC. People in the United States who have already had mpox or are fully vaccinated should be protected against Clade I should it arrive here. Casual contact, such as might occur during travel, is unlikely to pose significant risks for transmission of either clade. The best protection against mpox is two doses of the JYNNEOS vaccine.