MOMBASA, Kenya, July 12 -A quiet but concerning escalation of mpox infections is gripping Mombasa County, signalling an urgent public health crisis that demands immediate and robust intervention.
The recent surge in cases here is not an isolated event, but a critical component of a larger, ongoing Clade Ib mpox epidemic.
It is affecting Kenya and the wider East African region, driven by complex transmission dynamics and systemic challenges.
Significant Increase
According to the Director of Clinical Services, Mombasa County, Mohamed Hanif, during the months of June and July, they have witnessed a significant increase in mpox infections.
As of recent reports, a total of 98 individuals have been confirmed to be infected with the Mpox virus, with 24 patients currently admitted and receiving specialised treatment at the Utange Isolation Centre in Kisauni Sub-county.
In a proactive measure to contain further potential spread, an additional 86 individuals have been placed under quarantine, and their health status is under continuous monitoring by public health authorities.
“As of the 10th of July, we tested 159 patients, with 98 testing positive. This translates to 75 to 78 percent of cases resulting in positive outcomes, which led to two deaths,” Hanif said.
He said that they have admitted 98 patients, out of which 24 are admitted to the isolation centre, which is Utange hospital.
The active local transmission is happening across all sub-counties, with high prevalence recorded in sub county areas such as Nyali (23 percent) and Changamwe with 19 percent.
Hanif confirmed the severity of the outbreak as tragically underscored by two fatalities, one recorded in June and another in July.
These deaths serve as a stark reminder of the disease’s potential for severe outcomes, even though the overall case-fatality ratio for the circulating Clade Ib variant has recently been observed at less than 3.3 percent. (1, 2)
First Case
The first case of mpox in Mombasa was identified on September 3 of 2024, indicating that the current surge is an intensification of an existing viral presence rather than a new introduction.
This suggests a period of low-level, undetected transmission preceding the recent spike.
The majority of confirmed cases fall within the age range of 26 to 45 years, a demographic concentration that points to a primary impact on the economically active adult population.
Notably, a 12-year-old child is also among the confirmed infections, indicating potential household transmission and highlighting the vulnerability of younger populations.
This spatial clustering suggests specific localised transmission hotspots within these urban areas, likely linked to factors such as population density, specific social networks, or commercial activities that facilitate viral spread.
While these reported figures offer a snapshot, the true extent of mpox infections in Mombasa is likely considerably higher.
Kenya has conducted only about 500 tests for mpox in the first seven months of the Clade Ib outbreak, which indicates notably low overall testing numbers.
Furthermore, there is a recognised deficit in public and healthcare worker awareness regarding Mpox symptoms, often leading to misdiagnosis.
This, however, occurs particularly with conditions like chickenpox, necessitating multiple healthcare visits before Mpox is even suspected.
According to Hanif, many patients visited health care providers multiple times before mpox was suspected.
“The median delay between the onset of symptoms and laboratory confirmation is 7.5 days, which makes timely case identification more challenging. Additionally, some individuals may be infected without showing any symptoms, leading to silent transmission within the community,” stated Hanif.
The confluence of these factors limited testing, diagnostic delays, and asymptomatic cases.
Epidemiological Assessment
It suggests that the reported figures in coastal county represent only a fraction of the true burden, complicating accurate epidemiological assessment and hindering effective containment efforts.
The mpox outbreak in Mombasa appears to be driven by a complex, dual dynamic affecting different segments of the population.
The concentration of cases among individuals aged 26-45 years aligns with sexually active adults and those engaged in mobile or transactional occupations, such as truck driving or sex work, which have been identified as key drivers of the national outbreak.
The presence of a 12-year-old child among confirmed cases strongly indicates secondary household transmission, typically following an initial introduction of the virus into a household by an adult.
The geographic clustering is likely to reflect areas of high population density, increased mobility, and the presence of social networks or commercial activities that facilitate both sexual and household transmission.
