June 10, 2025 – As mpox cases surge in Sierra Leone and Ethiopia reports its first death, East African communities are on high alert. The outbreak, driven by different strains of the mpox virus, is raising concerns about regional spread, particularly in densely populated areas and across borders. With Kenya, Uganda, and Rwanda already grappling with cases, this health crisis demands attention. Here’s a breakdown of the situation, tailored for East African readers, with insights into what’s happening, why it matters, and how communities can stay safe.
Sierra Leone: A Rapidly Escalating Crisis
Sierra Leone, a West African nation, is facing an explosive mpox outbreak that’s driving the majority of Africa’s cases. Since January 2025, the country has reported over 3,350 confirmed cases and 16 deaths, with 53% of Africa’s new cases in the past week alone, according to the Africa Centres for Disease Control and Prevention (Africa CDC). The outbreak, concentrated in the crowded capital, Freetown, is fueled by the clade IIb strain, the same variant that sparked a global outbreak in 2022, primarily among men who have sex with men (MSM). However, in Sierra Leone, cases are split evenly between men and women, suggesting broader transmission patterns, including sexual networks and possibly other unknown modes.
The country’s health system is overwhelmed, with only 60 isolation beds available for mpox patients, forcing many to isolate at home, which complicates containment efforts. High population density and tourism in Freetown are driving infections, with test positivity reaching 100% in seven districts, indicating that surveillance is struggling to keep up. Since January, Sierra Leone has vaccinated over 30,000 people, prioritizing healthcare workers and high-risk groups, but it has received only 61,300 vaccine doses out of the 1.3 million shipped to 11 African countries. An additional 20,000 doses from the United Arab Emirates are expected soon, but Africa CDC estimates a need for 6.4 million doses continent-wide to curb the outbreak.
Sierra Leone’s Health Minister, Dr. Austin Demby, has called for international support, drawing on the country’s experience with Ebola and COVID-19 to rally resilience. “We survived Ebola, we managed Covid, and we will overcome mpox too,” he told lawmakers, while requesting 100,000 more vaccine doses from partners like India. Enhanced border surveillance, testing, and public awareness campaigns are underway, but challenges like limited contact tracing—averaging just two contacts per case—persist.
Ethiopia: A Worrying New Front
In Ethiopia, the mpox outbreak is newer but alarming. The country confirmed its first three cases in late May 2025 in Moyale, a town in the Oromia region near the Kenyan border. By early June, cases had risen to 40, with 17 confirmed, and the country reported its first mpox death, an infant, likely linked to the more severe clade Ib strain circulating in neighboring Kenya. The rapid northward spread from Moyale underscores the risk of cross-border transmission, especially given Ethiopia’s proximity to Somalia and other vulnerable regions.
Ethiopia’s outbreak is part of a broader Central and East African epidemic, with clade Ia and Ib strains driving cases in countries like the Democratic Republic of Congo (DRC), Burundi, and Kenya. Unlike Sierra Leone’s clade IIb, clade Ib is believed to be more transmissible and potentially more severe, raising fears of wider spread in East Africa’s interconnected border regions. Limited vaccine availability and surveillance challenges in Ethiopia heighten the urgency for regional cooperation.
Why This Matters for East Africa
For East African readers, the mpox outbreaks in Sierra Leone and Ethiopia are a wake-up call. Kenya, Uganda, Rwanda, and Burundi are already reporting cases, with Kenya confirming clade Ib infections near Ethiopia’s border. The region’s history of cross-border movement—through trade, travel, and refugee flows—makes containment tricky. For instance, Moyale’s proximity to Somalia and Kenya’s porous borders heightens the risk of spread to cities like Nairobi or Kampala. High population density, as seen in Freetown, mirrors urban centers like Dar es Salaam or Addis Ababa, where mpox could thrive if unchecked.
The outbreak also highlights health inequities. Sierra Leone’s struggle with limited isolation beds and vaccine shortages reflects challenges familiar to East African nations, where healthcare systems often face resource constraints. The Africa CDC’s call for 6.4 million vaccine doses underscores the gap between need and supply, a concern echoed by East African health officials advocating for equitable access to vaccines and diagnostics.
What Is Mpox, and How Does It Spread?
Mpox, formerly known as monkeypox, is a viral disease caused by the monkeypox virus, related to smallpox. It presents with fever, headache, muscle aches, swollen lymph nodes, and a painful rash that progresses from macules to pustules over 2–4 weeks. The disease spreads through close contact with an infected person (skin-to-skin, sexual contact, or respiratory droplets during prolonged face-to-face interaction), contaminated materials (e.g., bedding), or infected animals. While usually mild, mpox can be severe or fatal, especially in immunocompromised individuals, such as those with HIV, who make up 7% of Sierra Leone’s cases.
In Sierra Leone, the clade IIb strain is spreading primarily through sexual networks but shows broader transmission patterns, while Ethiopia’s clade Ib cases are linked to cross-border movement. Both strains require urgent containment to prevent regional escalation.
How East Africans Can Stay Safe
East African communities can take practical steps to protect themselves:
i) Practice Good Hygiene: Wash hands frequently and avoid touching your face. Wear masks in crowded areas, as promoted by Gavi in Sierra Leone.
ii) Avoid Close Contact: Steer clear of people with visible rashes or mpox symptoms. Be cautious in high-risk settings, such as crowded markets or public transport.
iii) Seek Medical Help Early: If you develop fever, rash, or swollen lymph nodes, isolate yourself and contact a healthcare provider immediately. Early diagnosis via PCR testing can improve outcomes.
iv) Stay Informed: Follow updates from local health authorities, WHO, and Africa CDC. Sierra Leone’s awareness campaigns emphasize reporting suspected cases promptly.
v) Support Vaccination Efforts: Vaccines like JYNNEOS are effective for high-risk groups, including healthcare workers and contacts of confirmed cases. Advocate for vaccine access in your community, as Sierra Leone and DRC are doing.
The Road Ahead
The mpox outbreaks in Sierra Leone and Ethiopia are a stark reminder of the region’s vulnerability to infectious diseases. Sierra Leone’s skyrocketing cases and Ethiopia’s emerging threat highlight the need for swift action, from vaccination drives to cross-border surveillance. For East Africans, the proximity of clade Ib cases in Ethiopia and Kenya is particularly concerning, given the potential for rapid spread in urban hubs and border towns.
The Africa CDC, WHO, and partners like Gavi and UNICEF are mobilizing resources, but challenges like vaccine shortages and limited healthcare infrastructure persist. As Dr. Ngashi Ngongo of Africa CDC warned, “We need to be very bold and aggressive to control this outbreak at the source so it doesn’t expand further.” East African nations must strengthen surveillance, boost public awareness, and push for equitable vaccine distribution to prevent a wider crisis.
For now, staying vigilant and informed is key. By learning from Sierra Leone’s response and Ethiopia’s early warning signs, East African communities can work together to keep mpox in check and protect the region’s health.
