Sierra Leone Grapples with Escalating Mpox Outbreak: Health System Overwhelmed
sierra Leone is currently battling a significant Mpox epidemic, marked by a rapid surge in infections since the beginning of January 2025. the nation’s healthcare infrastructure is struggling to cope with the increasing demands of the outbreak. As of today, a total of 1387 confirmed cases, including 10 fatalities, have been reported, yielding a case fatality rate (CFR) of 0.7%. The situation is particularly alarming given the exponential growth observed in recent weeks [[2]].
rapid Case Increase and Geographic Distribution
The past four weeks have witnessed an unprecedented spike in Mpox cases, with over 500 new confirmations reported in a single week (S18 of 2025), translating to approximately 100 new cases daily. This rapid escalation underscores the urgent need for enhanced containment measures [[2]].
The outbreak has spread across all regions of Sierra Leone, with the Western area Urban and Western area Rural, encompassing the capital Freetown, bearing the brunt of the infections. These areas account for approximately 90% of all confirmed cases.This concentration highlights the potential for densely populated urban centers to act as hotspots for disease transmission.
Demographic Trends and suspected Transmission Routes
The distribution of cases is relatively even between sexes, with males accounting for 52% of confirmed infections. age-wise,individuals aged 35-39 constitute the largest affected group,followed by those aged 25-29 and 30-34. This demographic pattern suggests specific transmission dynamics within these age brackets.
While comprehensive data on transmission modes remains limited, available demographic information points towards sexual contact among adults in urban areas as a primary driver of the epidemic. Further inquiry is crucial to confirm this hypothesis and tailor intervention strategies accordingly.
Early genomic sequencing of samples collected during the initial phase of the epidemic identified the circulating strain as clade iib you mpxv. Efforts are currently underway to conduct genomic sequencing on more recent samples to monitor potential viral evolution and inform public health responses. Understanding the genetic characteristics of the virus is essential for developing effective diagnostics, treatments, and vaccines.
WHO and Africa CDC Deploy Support Mission
Recognizing the severity of the situation, a joint mission team from the continental African team for supporting incidents related to MPXV (IMST), co-led by the world Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC), was deployed to Sierra Leone from April 28 to May 5. The purpose of this mission was to provide on-the-ground technical assistance, evaluate the effectiveness of the national response, and contribute to the planning of the next phase of epidemic control.
Overwhelmed Health System and Resource Constraints
The IMST assessment revealed that Sierra Leone’s health system is severely strained,with treatment centers facing critical bed shortages. With only 60 isolation beds available for Mpox patients,the vast majority are receiving home care,which poses significant challenges for ensuring adherence to isolation protocols. This lack of adequate isolation facilities increases the risk of further transmission within communities.
Furthermore, contact tracing efforts have been limited, with only a fraction of confirmed cases (less than one in six) benefiting from contact identification. Genomic sequencing rates also fall far short of the recommended 5%, hindering efforts to track viral evolution and transmission patterns. Despite these challenges,nearly 24,000 individuals have been vaccinated,with health professionals comprising approximately 60% of vaccine recipients. scaling up vaccination efforts, particularly among high-risk populations, is crucial for curbing the spread of the virus.
Sierra Leone is scaling up its mpox response amid rising cases [[3]].
