Congo is facing its largest outbreak of mpox. Scientists have identified a new form of the disease in a mining town that may spread more easily among people.
Since January, Congo has reported over 4,500 suspected mpox cases and nearly 300 deaths, roughly triple the numbers from the same period last year.
Genetic mutations in mpox have been observed in patients hospitalized in Kamituga, eastern Congo, suggesting continued human-to-human transmission. These mutations occur in a town where contact with wild animals, the usual carriers of the disease, is limited.
Dr. Placide Mbala-Kingebeni, the study's lead researcher, notes that the new form of mpox presents with milder lesions on the genitals, making diagnosis more challenging. In previous African outbreaks, lesions were primarily on the chest, hands, and feet. The new form also seems to have a lower mortality rate.
WHO has acknowledged the possibility of a new testing strategy to detect these mutations. Mbala-Kingebeni emphasizes the need for individuals to come forward for testing, as a lack of testing can lead to silent transmission.
Sexual transmission is the primary mode of infection in Congo, with about a third of cases occurring in sex workers.
Clade 1 and Clade 2 are two types of mpox. Clade 1 is more severe, with a mortality rate of up to 10%. The 2022 outbreak was caused by Clade 2, and over 99% of infected individuals survived.
Mbala-Kingebeni and colleagues have identified a new form of Clade 1 that may be responsible for over 240 cases and at least three deaths in Kamituga. The region has a significant transient population with travel within Africa and beyond.
Dr. Boghuma Titanji, an infectious diseases expert, expresses concern about the new mutations. She believes they indicate that the virus is adapting to spread efficiently in humans and could lead to significant outbreaks.
Despite the containment of mpox epidemics in the West through vaccination and treatment, these resources are scarce in Congo. The country's health minister has authorized the use of vaccines in high-risk provinces, but efforts are underway to secure vaccines through donations.
Dr. Dimie Ogoina, a mpox expert, draws parallels between the new outbreak and the early stages of HIV. He notes the spread among sex workers and the reluctance to come forward for testing due to stigma associated with sexually transmitted infections.
WHO's emergencies chief, Dr. Michael Ryan, highlights the lack of financial support for mpox control in Africa despite the ongoing spread.