Title : Mpox case investigation in Chitambo district, Zambia: Lessons from the first reported case in 2024
Abstract:
Background:
Mpox is a viral zoonotic disease with significant public health impact, especially in Africa. In October 2024, Zambia reported its first confirmed Mpox case in Chitambo district involving a foreign truck driver with suspected occupational and cross-border exposure. We hypothesized that community transmission of mpox was occurring, particularly among mobile populations. Given Chitambo district’s location along key transport routes, we investigated potential community transmission linked to the index case and assessed the district’s outbreak preparedness.
Methods:
We used a case report study design to investigate the Mpox outbreak in Chitambo district from October 14–19, 2024. The study population included the index case and close contacts. Data on demographics and clinical presentation were collected using a standard case investigation form during structured interviews. Genomic sequencing was performed to confirm the virus strain, and dermatological trends were assessed by plotting and comparing line graphs from two local health facilities to evaluate potential community transmission. The 7-1-7 framework was employed to assess case detection, notification, and response timelines.
Results:
The index case, a 32-year-old foreign male truck driver, presented with a rash on the face, trunk, and limbs. Among 24 contacts, 22 (91.7%) completed monitoring without symptoms. Most contacts (68.2%) were female, with a median age of 18.5 years (IQR: 12–28). Genomic sequencing confirmed the Mpox Clade 1b strain. Dermatological trends analysis revealed an increase in dermatitis. The 7-1-7 framework demonstrated rapid case detection within 2 days, notification within 1 day, and a full response within 6 days. However, gaps were identified in specimen handling (23.1% errors), delayed health-seeking behavior, and poor risk perception.
Conclusions:
Among those investigated, no community transmission was established. However, gaps in health-seeking behavior, risk perception, and specimen handling were identified. This case highlights the significant role of mobile populations in the spread of mpox. Strengthening surveillance, raising public awareness, and improving specimen transport are essential to preventing future outbreaks. Additionally, enhancing early detection and rapid response systems will be key to managing future mpox cases more effectively.
