世界卫生组织快速风险评估-猴痘，全球第5版

Dateandversionof current assessment:Date(s)and version(s)of previous assessment(s): Overallriskand confidence * All mpox outbreaks must be considered in their local contextto gain a comprehensiveunderstanding oftheepidemiology,modes of transmission,risk factors for severe disease, viral origins and evolution, and relevance of strategies andcountermeasures for prevention and control. **The situation inKinshasa,however,requiresparticular attention.The riskassociated withthe clade IaMPXV outbreak thereis deemed higher than inclade Ia MPXV-endemic areas, with currently no evidenceto suggest thatclade Ia MPXVand cladeIb MPXVin the Kinshasa contextareepidemiologically distinct. Note: For MPXV naming conventions andamore detailed description of the risk groups, please refer toAnnex 1. Overall GlobalRisk statement This global rapid risk assessment (RRA) aims toevaluatethe current public health risk associated with the 2024 upsurgeof mpox in the Democratic Republic of theCongo (DRC)and other countries in Africa, with a focus on updates since theprevious RRA inJune2025. Global OverviewAs of31July2025,the monkeypox virus (MPXV) continues to spreadglobally, causingbothlocalizedandextended outbreaksdriven byvariousMPXV clades(Ia, Ib, IIa, and IIb) indiversesettings. From1January 2022 to31 July2025,138countries and territoriesacrossall WHO regionshavereported158425confirmedcases, including399deaths(CaseFatalityRatio[CFR]–0.3%).Thismarksan increaseoffiveadditionalreporting countries(Ethiopia, Gambia,GuineaSenegal,and Togo),along withan additional16274confirmed cases and71deaths(as of31 July2025)since the lastRRA. Clade Ib MPXV SinceAugust 2024, whenthepublic health emergency of international concern (PHEIC)was declared, and as of24August2025, clade Ib MPXV has spreadbeyondDemocratic Republic of the Congo (DRC), where it wasfirst detected,to33othercountriesglobally.Twelve countries, alllocated incentral, eastern, and southern Africa,were reportingcommunitytransmission as of24August 2024, withDRC (29 070confirmed cases, including58deaths; CFR–0.2%),Uganda(7905confirmed cases, including 48 deaths; CFR–0.6%), and Burundi(4384confirmed cases, including onedeath; CFR–0.02%)still reporting the highest burdenof confirmed cases,both since 1 January 2024 and in the last sixweeks.Cases in DRC are a mix ofclade Ia and clade Ib MPXV, and the CFR in theareas most affected by clade Ib MPXVis reported to be 0.2%. All the three countries(DRC, Uganda, and Burundi)with the highest burden of confirmed caseshave observed asustaineddownward trendin confirmed cases in recent months. DRCis reporting about 200 confirmed cases per week,down from over 800 confirmed cases per week attheoutbreak peak–with downward trends also reported inclade IbMPXV-affected areas.Uganda is reporting under 100 confirmed cases per week,down from about 400 confirmed casesper week attheoutbreak peak, andBurundi isreporting under 50confirmed cases per week, down from 200 confirmedcases per week at the outbreak peak. The characteristicsof clade Ib MPXVoutbreaks inthese threehigh-burdencountries have remained largely the same.DRC continuesto observemost cases in young children and young adultsin clade Ib MPXV-affected areas,and theemergingdisproportionate burden in young childrenfirst reported in the previous RRApersists. The reasons for thisare unclear.Burundi also continues to report most cases among youngchildren and young adults.Uganda continues toreport most cases among young adults,reflecting the continuedimportance of sexual contact as a driver of spread inthat context. Other countries reporting communitytransmission(Ethiopia,Kenya,Malawi, Mozambique,Republic of Congo,Rwanda,South Sudan,United Republic of Tanzania,andZambia)have observed relatively smaller outbreaks.These countrieshave typically reported about 10 or less confirmed cases per week in recent weeks, exceptKenya,whichis of particularconcern,reporting a consistent upward trend that has been sustained throughout 2025 and currently observing over35 confirmed cases per week, up from less than 10 confirmed cases per week in June 2025. Sexual contact transmissioncontinues to be implicated as a major amplifier of disease spreadin these countries, with young adults remaining themost disproportionately affected group.Among thecountriesreporting community transmission,onlyEthiopia andMozambique have reporteditfor the first time since the last RRA. Atotal of109confirmedcases linked to travelto clade IbMPXV-affected countries have beencumulativelyreportedin22countriesnotcurrentlyreporting community transmission, an increase of32confirmedcases since the last RRA.Some of these importation eventshave led toonwardtransmission amonghouseholdand/or sexualcontacts, buttheestablishment ofsustained community transmission has not been reported.Inthe six weeks ending24August2025,sixcountrieshave reported travel-related casesincludingAustralia(twoconfirmedcases),the United Kingdom(twoconfirmed cases),andChina,Germ