New strain of MPOX found in Congo's biggest outbreak raises concerns

KINSHASA, Congo — Congo is struggling to contain an uprising. Largest MPX outbreakAnd scientists say a new disease detected in a mining town could spread more easily among people.

Since January, more than 4,500 suspected cases of mpox have been reported in Congo. Nearly 300 people diedAccording to WHO, the number has increased by almost three times compared to the same period last year. Congo recently declared the national outbreak a health emergency.

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, the study's principal investigator, who said the study will 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.

Mbala-Kingeveni said most patients report lesions that are milder and occur on the genitals, making the disease more difficult to diagnose. In previous outbreaks in Africa, lesions were primarily found on the chest, hands, and feet. He also said the new version appears to have a lower death rate.

in Report on this week's global mpx situationThe WHO said new versions of the disease may require new testing strategies to detect mutations.

Experts say fewer than half of people with mpox in Congo have been tested, but Mbala-Kingeveni said: “The risk is that the disease can spread silently unless patients come forward.'' , no one will notice.''

Mbala Kingebeni said most people are infected through sexual activity, and about a third of mpox cases were found among sex workers. It wasn't until 2022 global emergency Scientists established this disease in mpox spread through sexin most cases, gay or bisexual men. Confirmed by WHO in November Sexual transmission of mpox in the Congo first time.

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 may die. Clade 2 was the trigger for the 2022 outbreak. 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.

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

“This suggests that the virus is adapted to spread efficiently in humans and has the potential to cause fairly significant outbreaks,” she said.

Although the mpox epidemic in the West has been contained, vaccine help Little treatment is available in Congo. Chris Kasita-Osako, Congo's Monkeypox Task Force Coordinator, said Congo's Minister of Health 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.

Dimmy Ogoyina, MBBS, an mpox expert at the Niger Delta University in Amassoma, Nigeria, said the new study is 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, citing concerns about stigma against treatment of sexually transmitted infections and the reluctance of people infected with mpox to come forward. explained.

WHO's emergencies chief, Michael Ryan MPH, said last week that despite the continued spread of mpox in Africa and elsewhere, “not a penny has been invested by donors”.