"This epidemiological bulletin aims to provide the situation of key infectious diseases in the WHO South-East Asia Region to inform risk assessments and responses. The bulletin uses information from publicly available sources and will be published every two weeks. For feedback or suggestions, please write to [email protected]. Key events and updates Upsurge of mpox as a public health emergency of international concern Key messages WHO Director-General has determined that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC), concurring with the advice offered by the International Health Regulations (IHR)(2005) Emergency Committee. The detection and rapid spread of a new strain of mpox (Clade 1b) in eastern DRC, its detection in neighboring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond are the major concerns. Situation overview (as of 17 August 2024) Growing outbreaks in the DRC: Since the beginning of this year, the DRC has been experiencing a severe outbreak of mpox, with more than 15 600 reported suspected (clinically compatible) cases and 537 related deaths. This represents a 160% increase from the same period last year in DRC. The increased case reporting is driven by two concomitant outbreaks, including (1) outbreaks in historically endemic parts of the DRC, affecting primarily children, and (2) a rapidly expanding outbreak of a new strain of MPXV clade I (clade Ib) which appears to be spreading predominantly through sexual networks, expanding geographically in DRC’s eastern provinces, and affecting neighboring countries. New countries affected in Africa: Four countries neighboring the DRC reported their first mpox cases in the past one month: Burundi, Kenya, Rwanda and Uganda. In total, 12 countries in Africa have reported mpox this year, with 9 countries with active outbreaks. New virus strain behind recent cases: The current outbreak in the Eastern DRC is triggered by a new variant of the Clade I, called clade Ib. Clade I (Clade Ia) has been historically circulated in DFC, while Clade II was responsible for the global outbreak that began in 2022. Clade I is known to cause more severe disease than clade II. It is unknown if the two clade I variants, clade Ia and Ib, differ in disease severity. Clade Ib is spreading among people, driven by sexual contact but also involving other type of contact. Clade Ib has now been detected in countries in East and Central Africa (i.e. DRC, Burundi, Kenya, Rwanda and Uganda) and Sweden. There are many scientific uncertainties and evidence gaps (e.g., modes of disease transmission, transmission dynamics, risk factors, and disease severity associated with the different mpox virus clades). Continued spread of mpox globally: mpox remains a global public health concern, with cases and outbreaks still being reported worldwide. In June 2024, 26 countries reported over 930 cases and 4 deaths globally. Please see regular mpox section where mpox situation in WHO South-East Asia Region is summarized. The first case of the mpox Clade Ib outside Africa: On August 15, the Public Health Agency of Sweden reported the first case of the mpox Clade Ib outside Africa. The infected individual has travel history to Central Africa, where a mpox outbreak is ongoing..."