Monkeypox, which was declared a public health emergency on 23 July 2022, has spread has spread to 100 countries and, by 1 September 2022, there were 50,496 laboratory-confirmed cases. Yet only 1% of those cases are in Africa.

The first human monkeypox case was identified in Africa in the early 1970s and since then there there have been sporadic reports of the disease in remote tropical rainforest areas of West and Central Africa. Until 2022, very few cases had been reported outside the continent.

Twelve African countries had reported confirmed cases by 1 September. The three with the most are Nigeria (220), the DRC (195) and Ghana (56). South Africa has five confirmed cases. 

In comparison, the United States has 17,994 cases, followed by Spain (6,543), Brazil (4,693), France (3,547) and Germany (3,467).

In those countries 98% of the monkeypox cases are men, but in Africa 59% of the cases are men and 41% are women. 

In Europe and the United States the most affected age groups are between 31 and 40, whereas in Africa the average age of monkeypox cases is 21.

Nearly two-thirds 60% of the 15 reported deaths from monkeypox have been in Africa: Nigeria (4), Ghana (3), and the Central African Republic (2).

There are two distinct patterns of transmission in Africa, according to the WHO. The first is sporadic transmission in remote rural communities, mainly in Central Africa.

The other is sustained person-to-person transmission, similar to the outbreak in Europe and North America, which occurs in less remote and urban communities, mainly in Nigeria and Ghana.

Monkeypox is a zoonotic virus which is transmitted from animals to humans. The first case of human monkeypox was a nine-month-old boy in the DRC in 1970. Since then confirmed cases have been recorded in 15 African countries, particularly in the DRC.

There are two recognised strains of the virus in Africa – a West African one, which is associated with milder disease, and a Central African one, which is typically associated with more severe illness.

South Africa and Ghana reported their first cases of monkeypox this year.