Investigation of a mpox outbreak in Central African Republic, 2021-2022
C. Besombes,
F. Mbrenga,
C. Malaka,
E. Gonofio,
L. Schaeffer,
X. Konamna,
B. Selekon,
J. Namsenei-Dankpea,
C. Gildas Lemon,
J. Landier,
C. von Platen,
A. Gessain,
J.C. Manuguerra,
A. Fontanet,
E. Nakouné
Affiliations
C. Besombes
Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France; Sorbonne Université, Paris, France
F. Mbrenga
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
C. Malaka
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
E. Gonofio
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
L. Schaeffer
Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France
X. Konamna
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
B. Selekon
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
J. Namsenei-Dankpea
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
C. Gildas Lemon
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
J. Landier
IRD, Aix Marseille Université, INSERM - SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
C. von Platen
Institut Pasteur Paris- Centre de Recherche Translationnelle- CC, France
A. Gessain
Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France; Université Paris Cité, CNRS UMR 3569 - Unité Épidémiologie et Physiopathologie des Virus Oncogènes, France
J.C. Manuguerra
Environment and Infectious Risk Research Unit, Laboratory for Urgent Response to Biological Threats (ERI-CIBU), France
A. Fontanet
Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France; Conservatoire National des Arts et Métiers, PACRI Unit, Paris, France; Corresponding author at: Institut Pasteur, Paris, France.
E. Nakouné
Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
Human monkeypox virus is spreading globally, and more information is required about its epidemiological and clinical disease characteristics in endemic countries. We report the investigation of an outbreak in November 2021 in Central African Republic (CAR). The primary case, a hunter, fell ill after contact with a non-human primate at the frontier between forest and savannah. The ensuing investigation in a small nearby town concerned two families and four waves of inter-human transmission, with 14 confirmed cases, 11 suspected cases and 17 non-infected contacts, and a secondary attack rate of 59.5% (25/42). Complications were observed in 12 of the 19 (63.2%) confirmed and suspected cases with available clinical follow-up data: eight cases of bronchopneumonia, two of severe dehydration, one corneal ulcer, one abscess, two cutaneous superinfections, and six cutaneous sequelae (cheloid scars, or depigmentation). There was one death, giving a case fatality ratio of 1/25 (4.0%) for confirmed and suspected cases. This outbreak, with the largest number of confirmed cases ever described in CAR, confirms the potential severity of the disease associated with clade I monkeypox viruses, and highlights the need for rapid control over virus circulation to prevent the further national and international spread of infection.
