Health Affairs October 8, 2025
In Sierra Leone, a nation of nearly 9 million people, mpox has been spreading rapidly, putting enormous strain on an already fragile health system. As of September 14, 2025, 5,291 cases have been reported this year in Sierra Leone, including 56 deaths. A newly opened hospital with 400 beds has already been overwhelmed, forcing many patients to return to home isolation, without treatment, where they risk getting sicker or spreading the virus to others.
This crisis isn’t limited to Sierra Leone. In Malawi and the Democratic Republic of the Congo (DRC), cases are rising rapidly and, given the considerable surveillance limitations, including significant resource constraints, experts fear the real numbers are much higher than what’s being reported. In fact, outbreaks...
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