While the World Health Organization (WHO) officially ended the “health emergency of international concern” status for mpox in September 2025, West Africa is facing a more complicated and concerning reality.
Several countries in the region are reporting new outbreaks or hotspots, underscoring the fragile state of epidemiological control.
Since the beginning of 2025, Africa has recorded 24,272 mpox cases, including 6,034 confirmed infections and around 260 deaths. Fifteen countries are experiencing active transmission, while seven are considered to be in the control phase.
Sierra Leone remains a persistent epicenter, with over 4,000 confirmed cases and 25 deaths reported by mid-June.
Epidemiologist Jia Kangbai of Njala University in Freetown warned, “It is possible that the current outbreak was imported from another West African country or that cryptic transmission is underway.” The country’s porous borders and intense migratory flows complicate surveillance efforts.
Guinea has emerged as a new hotspot, with 271 confirmed cases across 15 health districts as of late July.
The Guinean National Agency for Health Security reports 55 recoveries and one hospital death, while 241 contacts remain under monitoring.
Neighboring Mali has heightened surveillance along its 858-km border with Guinea. “The Ministry of Health and Social Development is closely monitoring the situation of the resurgence of monkeypox in a neighboring country,” a statement said.
Senegal is also witnessing local transmission. After a first imported case in August, a second infection was confirmed in Dakar on September 22 in a resident without recent travel history.
Mamadou Ndiaye, Director of Prevention, noted, “The virus is circulating, at least in certain areas of the country and particularly in Dakar.”
Around twenty contacts are under medical observation, and no link has been identified between the two cases, suggesting independent transmission.
Ghana, previously cited for effective management, has reported 21 new cases, while Côte d’Ivoire presents a complex profile with co-circulation of MPXV clades IIa and IIb. Although officially in a “control phase,” the situation raises questions about the virus’s evolution and calls for increased surveillance.
Vaccination efforts are ongoing, with over 950,000 doses administered across nine African countries, primarily in the Democratic Republic of Congo, which accounts for 69% of doses. The WHO stresses that, despite the lifted global alert, the threat has not disappeared, particularly in regions where the virus continues to circulate.
West Africa’s experience highlights the limits of cross-border surveillance and the rapidity with which localized outbreaks can escalate, reinforcing the need for vigilance and coordinated regional response.
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