New species of mpox discovered in Congo's biggest outbreak that may spread more easily

Congo, Kinshasa — Congo is struggling to contain its largest mpox outbreak, and scientists say a new strain of the disease detected in a mining town could spread more easily among the population. .

More than 4,500 suspected smallpox cases and nearly 300 deaths have been reported in Congo since January, according to the World Health Organization, nearly tripling the number from the same period last year. Congo recently declared a health emergency over the nationwide outbreak.

Analysis of patients hospitalized between October and January in Kamituga, eastern Congo, suggests that recent mutations in the mpx gene are the result of continued transmission to humans. The disease is occurring in towns where people have little contact with wild animals that are thought to naturally transmit the disease.

“We are entering a new phase of mpox,” said Dr. Placido Mbala-Kingeveni, principal investigator of the study, who said the study would soon be submitted to a journal for publication. Mbala-Kingeveni heads a lab at Congo's National Institute of Biomedical Research that studies disease genetics.

Dr. Mbala Kingeveni said the disease is more difficult to diagnose because the lesions most patients report are mild and located on the genitals. In previous outbreaks in Africa, lesions were primarily found on the chest, hands, and feet. He also said the new form appears to have a lower mortality rate.

In this week's report on the global mpox situation, the WHO said new versions of the disease may require new testing strategies to detect mutations.

Experts point out that fewer than half of mpox patients in Congo are tested, but Mbala-Kingeveni said: “The danger is that unless patients themselves come forward, the disease can spread silently. It's something that no one will notice.”

Mbala Kingebeni said most people are infected through sex, and about a third of mpox cases were found among sex workers. It was not until the 2022 mpox global emergency that scientists proved that the disease is spread through sexual activity and that most cases are among gay or bisexual men. In November, WHO confirmed the first sexually transmitted case of mpox in Congo.

There are two types, or clades, of mpox, which are related to smallpox and are endemic in central and west Africa. Clade 1 is more severe, and up to 10% of infected people can die. Clade 2 was the trigger for the 2022 epidemic. More than 99% of infected people survived.

Mbala-Kingeveni and colleagues identified a new clade 1 strain that may be responsible for more than 240 infections and at least three deaths in Kamituga, a region with high levels of travel into and out of Africa. said.

Dr. Bogma Titanji, an infectious disease expert at Emory University who was not involved in the study, said the new variant is concerning.

“This suggests that the virus has adapted to spread efficiently in humans and could potentially cause quite significant outbreaks,” she said.

The mpox epidemic in the West was contained with the help of: vaccine Little treatment is available in Congo. Chris Kasita-Osako, Congo's monkeypox task force coordinator, said Congo's health minister had authorized the use of the vaccine in high-risk provinces. He said authorities were in talks with donor countries like Japan to help purchase vaccines.

“Once sufficient vaccine is available…vaccination will be carried out as part of the response,” Osako Kashita said.

Dr. Dimmy Ogoyina, an mpox expert at Niger Delta University, said the new study was a worrying addition to an earlier, but different, outbreak.

“The significant prevalence among sex workers is reminiscent of the early stages of HIV,” he said, adding that stigma against treatment of sexually transmitted infections and the reluctance of people infected with MPOX to come forward are worrying. He explained that it was the right thing to do.

WHO emergencies chief Dr. Michael Ryan said last week that despite the continuing spread of mpox in Africa and other parts of the world, “not a penny of donated money is being invested.”

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Chen reported from London. Mark Banchereau in Dakar, Senegal contributed to this report.

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