The first Mpox case in Zambia: a case report.

Abstract

BACKGROUND: Mpox, a viral infection caused by an Orthopoxvirus, has reemerged outside its historically endemic regions in Central and West Africa. This geographical expansion introduces a potential risk of transmission in Zambia, where geographic proximity and active trade routes increase vulnerability. We report the first confirmed case of Mpox in Zambia, involving a 32-year-old Tanzanian cross-border truck driver who presented to Mukando Health Post in Central Province, on 4 October 2024. CASE PRESENTATION: We present a 32-year-old male patient of African descent whose symptoms included a history of 3-day fever, itchy rash, joint pains, fatigue, and sore throat. Physical examination revealed a papular rash over the face, trunk, and extremities with extension to the palms but spared the soles of the feet. No lesions were noted in either the mucosal or genital areas. However, enlarged lymph nodes were palpable in the cervical region. Biological specimens were collected and submitted to Zambia National Public Health Reference Laboratory. Samples collected, including oral swabs in transport media, whole blood, skin scrapping from lesions, swabs from lesions, and urine samples. Analytics conducted on the samples included testing for polymerase chain reaction for Mpox, human immunodeficiency virus, rapid plasma reagin for syphilis, and hepatitis B and C. Contact tracing identified both primary and secondary contacts. Polymerase chain reaction confirmed Mpox DNA in initial whole blood, with persistent detection in skin lesions and throat swabs. The patient was commenced on symptomatic treatment with benzyl benzoate, paracetamol, ibuprofen, chlorpheniramine, and phenoxymethylpenicillin and continued the same treatment after the confirmation of Mpox diagnosis. He was advised to continue good hygiene practice and remain in isolation to prevent transmission to others. None of the 22 traced contacts reported any symptoms nor tested positive. CONCLUSION: Our report emphasizes the transmission risk for Mpox in traditionally nonendemic areas resulting from cross-border movement. This highlights the need for countries to strengthen surveillance systems resulting in increased sensitivity, specificity, and timeliness required for early detection and response to Mpox. A multifaceted collaborative approach is required between countries to ensure formalized cross-border collaboration, strengthening health-seeking behavior through deployment of mobile clinics, and utilization of digital platforms risk communication and community engagement. Improved supply chain management for laboratory reagents, sample collection, and personal protective equipment coupled with training of health workers is crucial for adequate preparedness and successful containment of outbreaks. These initiatives, collectively undertaken, will result in a robust response system safeguarding public health and preventing emerging threats such as Mpox from becoming endemic.