Sierra Leone battles mpox surge
May 8, 2025
Mpox cases in Sierra Leone are surging dramatically, with the country now averaging 100 new infections daily and accounting for half of Africa’s confirmed cases last week. The outbreak, driven by clade 2b, predominantly affects males aged 30 to 35 and includes a significant number of patients with HIV. While nearly 24,000 people—mainly health workers—have been vaccinated, limited isolation beds and low contact-tracing capacity hinder containment. Despite this, Africa CDC reports promising progress in other high-burden countries like Uganda, Burundi, and the DRC. Continued vigilance, funding, and expanded vaccination remain vital to halt the virus’s spread across the region.
Sierra Leone has rapidly emerged as Africa’s latest mpox epicenter, with a dramatic 71% week-over-week surge in new cases and an average of 100 new infections reported daily. Declared in January 2025, the outbreak has prompted the Africa Centres for Disease Control and Prevention (Africa CDC) to classify the country as one of the continent’s most affected. According to Dr. Ngashi Ngongo, who leads the mpox incident management team, the exponential growth is being driven by clade 2b—the global strain that fueled outbreaks in other regions in 2022. Most cases are occurring in Western Area province, home to Sierra Leone’s capital, Freetown.
The outbreak disproportionately impacts males aged 30 to 35 and includes a vulnerable population of individuals with HIV, who comprise 7% of reported cases. Despite effective testing coverage, Sierra Leone faces critical infrastructure gaps: only 60 isolation beds are available, leaving most patients to recover at home—a setup that hampers effective quarantine and increases the risk of community spread. While nearly 24,000 people have been vaccinated so far, the country’s low contact-tracing ratio remains a concern.
In contrast, other high-burden countries are showing encouraging signs. In the Democratic Republic of the Congo, response activities have resumed in conflict-affected North and South Kivu, and testing coverage is improving in Kinshasa. Uganda has seen a 60% decline in cases from its peak, although deaths continue among people with HIV. Burundi has recorded an 84% drop in cases since October 2024, and intensified surveillance efforts are underway to interrupt remaining transmission chains.
While Africa CDC officials are cautiously optimistic about trends in Uganda, Burundi, and the DRC, Dr. Ngongo warns, “we’re not yet out of the woods.” Sustained efforts in vaccination, surveillance, and community engagement remain essential to turning the tide against mpox in Sierra Leone and beyond.