More transmissible and more dangerous than previous strains, a new strain of the mpox virus, responsible for the deaths of children in the Democratic Republic of Congo, now presents a risk of spreading to other countries, researchers warn.
All countries should prepare for “this new strain before it spreads elsewhere, before it’s too late”Jean-Claude Udahemuka, a researcher at the University of Rwanda who studies this epidemic, told AFP.
Since the disease was first detected in humans in the Democratic Republic of Congo in 1970, mpox – formerly called monkeypox or monkeypox – has caused regular outbreaks, mainly in Africa, driven by strain I of the virus.
5% of adults and 10% of children contracting this strain of the disease die
In 2022, a global epidemic, carried by strain II, ten times less fatal, spread to around a hundred countries where the disease was not endemic, mainly affecting homosexual and bisexual men.
In endemic areas of Africa, outbreaks have previously mainly resulted from contact with infected animals, for example by eating bushmeat.
More “something appeared different” in an outbreak of mpox detected in September among sex workers in the isolated mining town of Kamituga, in the DRC, explained John Claude Udahemuka during an online press conference.
Unlike previous epidemics in this central African country, the virus was transmitted during intercourse between heterosexuals. Tests identified a mutation in the original strain, called Ib and “undoubtedly the most dangerous to date”according to John Claude Udahemuka.
More than 1,000 cases of mpox have been reported in South Kivu province since then, said Leandre Murhula Masirika, local research leader, citing more than 20 new cases every week in Kamituga alone.
However, according to researchers, 5% of adults and 10% of children contracting this strain of the disease die. It causes “horrible rashes all over my body”while strain II causes lesions that are normally more limited to the genital area, explained Trudie Lang, from the University of Oxford.
It is entirely possible that the virus could end up on a plane
Another major change: the Ib strain has also spread through non-sexual contact, among families or children at school. There was one “large number” of transmissions between mothers – or people caring for children – and children, pointed out Trudie Lang.
Many miscarriages have also been recorded, and researchers are studying possible effects on fertility.
These significant differences from previous mpox strains are “incredibly disturbing”, according to the Oxford expert. And the hospital cases are probably only “the tip of the iceberg”.
There remain significant unknowns about the new strain, which has spread to the towns of Bukavu, Uvira and Kamanyola, then this week to Goma, capital of the North Kivu province.
These towns are close to the borders with Rwanda, Burundi and Uganda. If the new strain has not been reported outside the DRC, it is possible that it is already circulating in neighboring countriess, Murhula Masirika said, that some infected sex workers originated there.
And Goma in particular has an international airport. “It is entirely possible that the virus could end up on a plane,” warned Trudie Lang, calling on the world to act quickly to stem the epidemic. One of the tools, according to scientists, is vaccination of local sex workers.
Researchers in Africa have pleaded for the DRC to have access to vaccines and treatments against mpox used in most countries affected by the 2022 epidemic, although their impact on the new strain is still unknown.
As for vaccines against smallpox, which are cheap, widely available in many countries and able to act against pox, they have not been made available in Kamituga, according to John Claude Udahemuka.
However, if the current strain spreads further, it will cause “really big damage”, opened Murhula Winter. “We are very afraid.” The World Health Organization expressed concern in mid-December about the risks of international spread of the mpox epidemic raging in the DRC, a month after a first alert.
