The number of smallpox cases in Congo may be stabilizing. Experts say more vaccines are needed to eradicate virus

GOMA, Congo (AP) — Some health officials say smallpox cases appear to be “stabilizing” in Congo, a possible sign that the main epidemic that the World Health Organization declared a global emergency in August may be waning. .

According to WHO, in recent weeks, between 200 and 300 laboratory-confirmed cases of MPOX have been reported in the Congo every week. That’s down from nearly 400 cases per week in July. The decline is also noticeable in Kamituga, a mining town in eastern Congo where a new, more contagious mpox variant first emerged.

But on Friday the UN health agency acknowledged that only 40% to 50% of suspected cases in Congo are being tested – and that the virus continues to spread in parts of the country and elsewhere, including Uganda.

While doctors are encouraged by the decline in infections in some parts of Congo, it is still unclear exactly what physical contact is driving the outbreak. Health experts are also disappointed by the low number of vaccine doses the Central African country has received (265,000) and say getting the vaccine to where it is needed is proving challenging in the sprawling country. The WHO estimates that 50,000 people have been vaccinated in Congo, which has a population of 110 million.

Scientists also say broader vaccination efforts across the continent are urgently needed to stop the spread of smallpox and avoid further worrisome genetic mutations like the one discovered earlier this year in Congo after months of low circulation.

“If we miss this opportunity, the likelihood of another serious outbreak increases significantly,” said Dr. Zachary Rissa, who heads Congo operations for the charity Alima.

There have been about 43,000 suspected cases and more than 1,000 deaths in Africa this year, mostly in Congo.

“We have seen how past outbreaks, such as in Nigeria in 2017, can lead to larger global events if not contained effectively,” he said. The 2017 epidemic led to a global outbreak of MPox virus in 2022, affecting more than 100 countries.

Rissa said the decline in cases in Kamituga, where mpox initially spread among sex workers and miners, opens the door to more vaccination, surveillance and education programs.

Georgette Hamouli, an 18-year-old sex worker, was unaware of the smallpox virus until immunization teams arrived last week in the poor area where she works in Goma, the largest city in eastern Congo.

“They told us we were at high risk of infection,” she said. “We insist on condoms with our clients, but some refuse… if they don’t want to use a condom, they pay twice as much.”

Hamouli said she and her other sex-working friends received 2,000 Congolese francs ($0.70) from the charity to receive the MPV vaccine, but it wasn’t the money that convinced her.

“The vaccine is also necessary,” she said. “I think we’re protected now.”

The Africa Centers for Disease Control and Prevention estimates that Congo needs at least 3 million MPOX vaccines to stop the virus, and another 7 million for the rest of Africa. So far, WHO and partners have allocated 900,000 vaccines to nine African countries affected by MPOX, and expect 6 million vaccines to be available by the end of this year.

Smallpox epidemics in Burundi, Kenya, Rwanda and Uganda originated in the Congo, and a number of cases in travelers have also been identified in Sweden, Thailand, Germany, India and the UK.

Less than half of the people most at risk in Congo have been vaccinated, according to Heather Kerr, director of the International Congo Rescue Committee.

“We only have a small number of vaccines and nothing for children,” she said.

Vaccines for Congo mostly come from donor countries such as the United States and through UNICEF, which largely uses taxpayer money to buy the shots.

“We’re seeing a philanthropic approach where we’re seeing very little vaccine donation to Africa,” said Dr. Chris Beirer, director of the Institute for Global Health at Duke University. “What we need is a public health approach where we immunize the population on a large scale.”

Drugmaker Bavarian Nordic, which makes the most widely used MPOx vaccine, said it would sell the shots destined for Africa at the lowest price possible.

The advocacy group Public Citizen estimates that UNICEF paid $65 per dose of the Jynneos mpox vaccine made by Bavarian Nordic, far more than almost all other vaccines used in public health programs.

Dr Salim Abdul Karim, an infectious disease expert at the University of KwaZulu-Natal in South Africa, said mpox outbreaks usually peak and disappear quickly due to how the virus spreads. This time, however, he said there were two complicating factors: sexual transmission of the virus and the continued spread of the virus from infected animals.

“This time we are in new territory with mpox,” he added. “But we will never solve this problem until we vaccinate the majority of our population.”

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Cheng reported from London.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. AP is solely responsible for all content.