Mpox Outbreak in Côte d'Ivoire during 2024: Epidemiological, Clinical, Virological and Outcome Features of Hospitalised Cases in Abidjan
Adama Doumbia *
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Moutarda Wardatine Dine
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Frederic Nogbou Ello
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Bernice Corinne Akpovo
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Pacôme Sakre
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire.
Zelica Diallo
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Salif Diawara
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
N’daw-Attri Sarah Kane
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Souleymane Aziz Coulibaly
Department of Dermatology and Venereology, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire.
Herman Faitey
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Nicole Konan
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Raphaël Amani
National Institute of Public Health, Abidjan, Côte d'Ivoire.
Syndou Meite
Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire and Institute Pasteur of Côte d’Ivoire, Abidjan, Côte d'Ivoire.
Aristophane Koffi Tanon
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
Serges Paul Eholie
Department of Infectious and Tropical Diseases, University Teaching Hospital of Treichville, Abidjan, Côte d’Ivoire and Felix-Houphouët Boigny University of Abidjan, Côte d'Ivoire.
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe the epidemiological, clinical, virological and outcome features of Mpox patients hospitalised at the referral centre in Abidjan during the 2024 outbreak in Côte d'Ivoire, which totalled 89 confirmed cases nationwide.
Study Design: Descriptive observational study.
Place and Duration of Study: Department of Infectious and Tropical Diseases (SMIT), Treichville University Hospital, Abidjan, Côte d'Ivoire, between June and October 2024.
Methodology: We included all patients hospitalised at the SMIT with Mpox confirmed by real-time polymerase chain reaction (PCR) on skin lesion samples. Sociodemographic, clinical, virological (subclade typing by genomic sequencing at the Institut Pasteur de Côte d'Ivoire) and outcome data were collected using a standardised questionnaire. Qualitative variables were described as counts and percentages, and quantitative variables as medians with interquartile range (IQR). The in-hospital case fatality rate was estimated with its exact 95% confidence interval (CI).
Results: Twenty-three patients were included (median age: 20 years [IQR: 11–40]; 18 males, sex ratio: 3.6), originating from four geographical clusters: Dianra in the north (n = 11), Abidjan in the south (n = 6), Sakassou in the centre (n = 4) and Iboké in the south-west (n = 2). No patient had been vaccinated against smallpox. The main features were skin rash (100%), fever (95.7%), headache (91.3%) and arthralgia (82.6%). Lesions were of moderate grade (10–99 lesions) in 19 patients (82.6%). Subclade IIa was identified in 22 patients (95.7%) and subclade IIb in one patient (4.3%). The median hospital stay was 13 days (IQR: 7–15). Bacterial superinfection was the main complication (21.7%). The in-hospital case fatality rate was 4.3% (95% CI: 0.1–21.9).
Conclusion: In one of the first descriptions from Côte d'Ivoire, the outbreak was both rural and urban, affected young unvaccinated patients, was dominated by subclade IIa and had a generally favourable outcome. Surveillance, decentralised diagnosis and access to vaccination all need strengthening.
Keywords: Mpox, monkeypox virus, clade IIa, clade IIb, epidemiology, outbreak, hospitalised patients, genomic sequencing