As the mpox outbreak in the Democratic Republic of the Congo continues to escalate, with nearly 20,000 suspected cases and over 650 deaths reported in 2024 alone, U.S. officials are intensifying efforts to combat the spread of the virus. The outbreak, driven by the more virulent Clade I strain, has sparked concerns beyond the DRC, as neighboring countries, including the CentralAfrican Republic, Burundi, and Rwanda, are reporting increasing cases.
Several weeks ago, the World Health Organization declared the outbreak a global public health emergency, marking the second time mpox has reached this status in two years.
A more severe strain
Unlike the Clade II strain, which primarily affected communities during the 2022 global mpox outbreak, Clade I has a higher mortality rate and causes more severe illness. Although Clade I was previously confined to Central and West Africa, it has begun to spread beyond these regions, raising global concerns.
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In a press call Friday morning, senior Biden administration officials emphasized the seriousness of the situation in the DRC. One official outlined the gravity of the outbreak: “In 2023, [the DRC] reported more than 14,000 suspected cases and more than 650 deaths. In 2024, so far, they have reported nearly 20,000 suspected cases and more than 650 deaths.”
Clade I presents a greater threat due to its high fatality rate, in contrast to Clade II, which was responsible for the 2022 outbreak. The official also noted that neighboring countries such as Rwanda and Uganda have reported smaller numbers of Clade I cases.
U.S. response and vaccine donations
The U.S. government has committed $55 million in additional funding to support mpox response efforts in Central and Eastern Africa. According to senior administration officials, this comes in addition to the $2.65 billion in bilateral health support the U.S. already provides to the region. The U.S. is also donating 50,000 doses of the Jynneos vaccine to the DRC.
“The first delivery of vaccine doses arrived in DRC yesterday, [and] the full shipment of around 250,000 doses in this first full delivery should be completed by early next week,” a senior official confirmed.
The Jynneos vaccine, used during the Clade II outbreak in 2022, effectively prevents mpox. The administration officials said the U.S. has been working closely with international partners to encourage further donations from countries with vaccine stockpiles, alongside efforts to address logistical challenges in delivering vaccines to affected regions.
Booster guidance and case numbers in the U.S.
Officials addressed concerns regarding whether those who received the two-dose Jynneos vaccine during the 2022 outbreak would need a booster dose. “At this time, if you’ve received both doses of the Jynneos vaccine, we do not recommend a booster,” one official said, emphasizing that the Centers for Disease Control and Prevention is continuing to review data. Anybody who would like to receive a vaccine can do so at a commercial pharmacy.
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Although Clade I has yet to spread to the U.S., Clade II cases persist. “There is circulation of about three cases per day of [Clade] IIb in the United States currently,” another official noted. Despite these cases, U.S. health agencies have reassured the public that the risk from Clade I remains low for now, with no cases detected in the U.S. Outside of Africa, a few cases have been reported in Sweden and Thailand, an official noted.
High-risk communities on alert
While the current mpox outbreak in Africa primarily affects children and vulnerable populations,LGBTQ+ communities in the U.S. remain cautious. During the 2022 outbreak, mpox disproportionately affected gay andbisexual men, othermen who have sex with men, and sometransgender people, and health officials have maintained strong communication with LGBTQ+ organizations to ensure that those at risk are informed and have access to vaccines.
“We remain deeply engaged with LGBTQ+ communities, particularly men who have sex with men, who were most vulnerable during the last mpox outbreak,” an official noted. The official added that the CDC has not expanded its vaccination recommendations beyond high-risk groups for now.
The U.S. is not alone in its response to the mpox outbreak. The WHO, Africa CDC, and other international partners are working together to combat the virus. However, estimates suggest that between 2 million and 10 million vaccine doses will be required over the next six months to control the outbreak in the DRC and surrounding countries.
“We are working closely with WHO, Africa CDC, and Ministries of Health throughout the region to quickly identify and respond to additional needs to make sure that we can protect the health of those living in the region and work to limit the further spread of this outbreak,” one U.S. official explained.