Data as received by 09:00 (CAT), 21 September 2022
## Readiness Status - [**WHO African Region Monkeypox Readiness Status**](https://app.powerbi.com/view?r=eyJrIjoiMjdjNzQyNjctNmUxMy00MGJkLTg4OWMtN2E4NjQ1MjUyM2E4IiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9) - **39/47** Countries tracking Monkeypox Preparedness ## Risk assessment - Global risk: **Moderate** - WHO Regional risk African Region: **Moderate** ## Epidemiological Update - September 21, 2022- Since **1 January**, a total of **{total_cases}** laboratory confirmed cases of Monkeypox and **{total_deaths}** deaths have been reported to WHO from **{total_countries}** countries in the African region.- Since the last African Region Monkeypox situation report published on **September 14**, a total of **{total_cases}** new cases and **{total_deaths}** deaths have been reported.- In the past seven days, **{total_countries_with_cases}** countries reported an increase in the weekly number of cases and **{total_countries_with_deaths}** reported deaths.- There are **{total_countries_with_no_cases}** countries which have not reported new cases for over **21 days**, the maximum incubation period of the disease.- As of today, the country with the largest number of confirmed cases is **{country}** with a total of **{total_cases}** cases.# {country}## Facts, Updates and Resources## Keyfacts - Vaccines used during the smallpox eradication programme also provided protection against monkeypox. Newer vaccines have been developed of which one has been approved for prevention of monkeypox. - Monkeypox is caused by monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae. - Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%. - Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus. - Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. - Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions. - An antiviral agent developed for the treatment of smallpox has also been licensed for the treatment of monkeypox. - The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Monkeypox is less contagious than smallpox and causes less severe illness. - Monkeypox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications. ## Updates WHO continues to closely monitor the situation, and support international coordination and information sharing with the Member States and partners. Clinical and public health incident response have been activated by Member States to coordinate comprehensive case finding, contact tracing, laboratory investigation, isolation, clinical management, implementation of infection prevention and control measures, and vaccination activities, as well as support ongoing epidemiological and countermeasures research. ## Gatherings Gatherings may represent a conducive environment for the transmission of the monkeypox virus as some settings which entail close, prolonged, and frequent close contact interaction between people may pose a higher risk of monkeypox virus transmission. However, such events can be used as opportunities to conduct outreach for specific population groups with public health messaging. As outlined in the Temporary Recommendations, WHO recommends the following actions: In countries with no history of monkeypox in the human population (or not having detected a case for over 21 days) public health authorities and other stakeholders should continue to focus risk communication and community support efforts on settings and venues where close contact activities or intimate encounters may take place. This includes engaging with and supporting the organizers of large and smaller scale events so that they may promote personal protective measures and risk-reducing behaviour. In countries with recently imported cases of monkeypox and/or otherwise experiencing human-to-human transmission of monkeypox virus, including in key population groups and communities at high risk of exposure, health authorities and other stakeholders should continue to engage with organizers of gatherings (large and small), including those that may facilitate close contact or intimate encounters (e.g. venues for sex-on- premises), to promote personal protective measures and behaviours, apply a risk-based approach to the holding of such events and discuss the possibility of postponing events for which risk measures cannot be put in place. All necessary information should be provided for risk communication on personal choices and for infection prevention and control including regular cleaning of event venues and premises. ## WHO Guidance and Public Health Recommendations * WHO Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi- country outbreak of monkeypox, 23 July 2022. https://www.who.int/news/item/23-07-2022-second-meeting-of-the- international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of- monkeypox * WHO Director-General's statement at the press conference following IHR Emergency Committee regarding the multi- country outbreak of monkeypox, 23 July 2022. https://www.who.int/director-general/speeches/detail/who-director- general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country- outbreak-of-monkeypox--23-july-2022 * WHO Global clinical data platform for monkeypox case report form (CRF), 15 July 2022. https://www.who.int/publications/i/item/WHO-MPX-Clinical_CRF-2022.2 * Public health advice for gatherings during the current monkeypox outbreak, 28 June 2022: https://www.who.int/publications/i/item/WHO-MPX-Gatherings-2022.1 * WHO Surveillance, case investigation and contact tracing for Monkeypox: Interim guidance, 24 June 2022. https://www.who.int/publications/i/item/WHO-MONKEYPOX-surveillance-2022.1 * WHO Vaccines and immunization for monkeypox: Interim guidance, 14 June 2022. https://apps.who.int/iris/bitstream/handle/10665/356120/WHO-MPX-Immunization-2022.1-eng.pdf * Clinical management and infection prevention and control for monkeypox: Interim rapid response guidance, 10 June 2022. https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1 * WHO Technical brief (interim) and priority actions: enhancing readiness for monkeypox in WHO South-East Asia Region, 28 May 2022. https://cdn.who.int/media/docs/default-source/searo/whe/monkeypox/searo-mp-techbrief_priority- actions_300522.pdf?sfvrsn=ae7be762_1 ### Data management * Case and contact investigation form (CIF), 16 June 2022. https://www.who.int/publications/m/item/monkeypox- minimum-dataset-case-reporting-form-(crf) * WHO Monkeypox minimum dataset case reporting form (CRF), 14 June 2022. https://www.who.int/publications/m/item/monkeypox-minimum-dataset-case-reporting-form-(crf) * The WHO Global Clinical Platform for monkeypox, 14 June 2022. https://www.who.int/tools/global-clinical- platform/monkeypox * Global clinical data platform for monkeypox case report form (CRF), 14 June 2022. https://www.who.int/publications/i/item/WHO-MPX-Clinical-CRF-2022.1 * WHO Go.Data: Managing complex data in outbreaks. https://www.who.int/tools/godata ### Risk communication and community engagement * Monkeypox Q&A, 12 July 2022. https://www.who.int/news-room/questions-and-answers/item/monkeypox * Risk communication and community engagement (RCCE) for monkeypox outbreaks: Interim guidance, 24 June 2022. https://www.who.int/publications/i/item/WHO-MPX-RCCE-2022.1 * Interim advice for public health authorities on summer events during the monkeypox outbreak in Europe 2022. 14 June 2022. https://www.who.int/europe/publications/m/item/interim-advice-for-public-health-authorities--on-summer- events-during-the-monkeypox--outbreak-in-europe--2022 * Interim advice on Risk Communication and Community Engagement during the monkeypox outbreak in Europe, 2022. Joint report by WHO Regional office for Europe/ECDC, 2 June 2022. https://www.euro.who.int/ data/assets/pdf_file/0009/539046/ECDC-WHO-interim-advice-RCCE-Monkeypox-2-06- 2022-eng.pdf * WHO Monkeypox outbreak: update and advice for health workers, 26 May 2022. https://www.who.int/docs/default- source/coronaviruse/risk-comms-updates/update_monkeypox-.pdf?sfvrsn=99baeb03_1 * Monkeypox: public health advice for gay, bisexual and other men who have sex with men, 25 May 2022, https://www.who.int/news/item/25-05-2022-monkeypox--public-health-advice-for-gay--bisexual-and-other- men-who-have-sex-with-men * Risk communication and community engagement. Public health advice on the recent outbreak of monkeypox in the WHO European Region, 24 May 2022. https://www.euro.who.int/ data/assets/pdf_file/0004/538537/public-health- advice-monkeypox-eng.pdf ### Laboratory and genomic studies * WHO Laboratory testing for the monkeypox virus: Interim guidance, 23 May 2022. https://apps.who.int/iris/handle/10665/354488 * WHO Guidance on regulations for the transport of infectious substances 2021-2023, 25 February 2021. https://www.who.int/publications/i/item/9789240019720 * Genomic epidemiology of monkeypox virus. https://nextstrain.org/monkeypox?c=country ### Disease Outbreak News and situation reports * WHO Multi-country outbreak of monkeypox, External situation report #1 - 6 July 2022: https://www.who.int/publications/m/item/multi-country-outbreak-of-monkeypox--external-situation-report--1---6- july-2022 * WHO disease outbreak news: Monkeypox, all items related to multi-country outbreak: https://www.who.int/emergencies/emergency-events/item/2022-e000121 * WHO disease outbreak news: Monkeypox, all previous items including endemic countries and traveler-associated outbreaks: https://www.who.int/emergencies/emergency-events/item/monkeypox ### Training and Education * WHO monkeypox outbreak tool kit, June 2021. https://www.who.int/docs/default- source/documents/emergencies/outbreak-toolkit/monkeypox-toolbox-20112019.pdf?sfvrsn=c849bd8b_2 * WHO factsheet on monkeypox, publishing date, 19 May 2022. http://www.who.int/news-room/fact- sheets/detail/monkeypox * Health topics – Monkeypox: https://www.who.int/health-topics/monkeypox#tab=tab_1 * Open WHO. Online training module. Monkeypox: Introduction. 2020 English: https://openwho.org/courses/monkeypox-introduction Français: https://openwho.org/courses/variole-du-singe- introduction * Open WHO. Extended training. Monkeypox epidemiology, preparedness and response. 2021.English: https://openwho.org/courses/monkeypox-intermediate; Français: https://openwho.org/courses/variole-du-singe- intermediaire ### Other Resources * WHO AFRO Weekly Bulletin on Outbreaks and Other Emergencies, all previous items: https://www.afro.who.int/health- topics/disease-outbreaks/outbreaks-and-other-emergencies-updates * WHO 5 moments for hand hygiene. https://www.who.int/campaigns/world-hand-hygiene-day * WHO One Health. https://www.who.int/health-topics/one-health * World Organisation for Animal Health, founded as OIE: Monkeypox. https://www.woah.org/en/disease/monkeypox/ * Joint WHO Regional Office for Europe - European Centre for Disease Prevention and Control, Monkeypox surveillance bulletin, 13 July 2022. https://www.who.int/europe/publications/m/item/joint-ecdc-who-regional-office-for-europe- monkeypox-surveillance-bulletin--13-july-2022 * Joint WHO Regional Office for Europe - European Centre for Disease Prevention and Control, Monkeypox Resource toolkit to support national authorities and event organizers in their planning and coordination of mass and large gathering events. https://www.who.int/europe/tools-and-toolkits/monkeypox-resource-toolkit-for-planning-and- coordination-of-mass-and-large-gathering-events/ * WHO European Region Interim advice for public health authorities on summer events during the monkeypox outbreak in Europe, 2022 https://www.who.int/europe/publications/m/item/interim-advice-for-public-health-authorities--on- summer-events-during-the-monkeypox--outbreak-in-europe--2022 * Weekly epidemiological record (WER) no.11, 16 March 2018, Emergence of monkeypox in West Africa and Central Africa 1970-2017. http://apps.who.int/iris/bitstream/handle/10665/260497/WER9311.pdf;jsessionid=7AB72F28D04CFE6CE249961 92FC478FF?sequence=1 * Jezek Z., Fenner F.: Human Monkeypox. Monogr Virol. Basel, Karger, 1988, vol 17, pp 1-5. doi: 10.1159 isbn.978-3-318- 04039-5