Geneva, Switzerland — Limited capacity is keeping mpox testing coverage low in the DR Congo — the epicenter of the international emergency — the World Health Organization said Saturday in its latest situation report. 

“Testing coverage in the Democratic Republic of the Congo remains low, due to limited testing capacity,” the United Nations health agency said in its update. 

It said the mpox case fatality ratio in the DRC in 2024 was 0.5% among confirmed cases — or 25 deaths from 5,160 cases — and 3.3% among suspected cases, both tested and untested — or 717 deaths among 21,835 cases. 

“Due to limited access to laboratory testing in remote areas, only about 40% of all suspected cases have been tested in 2024 (up from 9% in 2023), and among these, around 55% tested positive,” the WHO said. 

It said the three countries reporting the most suspected cases in the year up to September 8 were the DRC, followed by Burundi (1,489 suspected cases, no deaths), and Nigeria (935 suspected cases, no deaths). 

There are two clades of mpox, each with a and b subclades. 

The WHO said the clades and their subclades were circulating in different geographic areas and were affecting different populations — and therefore needed “tailored and locally adapted outbreak responses.” 

The WHO declared an international emergency over mpox on August 14, concerned by the surge in cases of the new Clade 1b strain in the DRC that spread to nearby countries. 

In the DRC, Clade 1b has been detected chiefly in the eastern South Kivu and North Kivu provinces, with additional cases in the Kinshasa capital province. 

Current sequencing capacity in the DRC “is limited, and clade distribution might be broader than what is currently known” the WHO said. 

Clade 1b has also been detected in the DRC’s eastern neighbors Burundi, Rwanda and Uganda, plus Kenya. Additionally, a single case has been detected in Sweden and another in Thailand. 

Looking at global vaccine availability, the WHO said more than 3.6 million doses had been pledged for the global response, including more than 620,000 doses of the MVA-BN vaccine by European countries, the United States and manufacturer Bavarian Nordic. 

Meanwhile Japan has pledged 3 million doses of the LC16 vaccine. 

To date, 265,000 MVA-BN doses have been delivered to Kinshasa, while 10,000 have gone to Nigeria. 
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