a new, more dangerous strain that appeared in the DRC worries the WHO and researchers

More transmissible and more dangerous than the previous ones, a new strain of the mpox virus called “Ib”, responsible for the deaths of children in the Democratic Republic of Congo (DRC), could spread to other countries, warn researchers and the World Health Organization (WHO) Wednesday June 26. All States should prepare before it is 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 DRC in 1970, mpox – also known as monkeypox or monkeypox – has caused regular outbreaks, mainly in Africa, under the effect of strain I of the virus.

But in 2022, a global epidemic carried by strain II, ten times less fatal, had spread to more than a hundred countries where the disease was not endemic, mainly affecting homosexual and bisexual men. In two and a half years, 97,208 cases, including 186 deaths, were reported to the WHO. The United States, Brazil, Spain, Colombia, France, Mexico, United Kingdom, Germany, Peru and China account for more than 80% of confirmed reported cases. The epidemic had rapidly decreased thanks to vaccination in pharmacies in particular.

“Incredibly disturbing”

In endemic areas of Africa where strain I is prevalent, outbreaks have until now mainly resulted from contact with infected animals, for example by eating bush meat. But “something appeared different” in an outbreak of mpox detected in September 2023 among sex workers in the isolated mining town of Kamituga, in the DRC, explained John Claude Udahemuka during an online press conference on Monday.

Unlike previous epidemics in this central African country, the virus was transmitted during contact between heterosexual people. Tests identified a mutation in the original strain, “undoubtedly the most dangerous to date”according to John Claude Udahemuka.

More than 1,000 cases of mpox strain Ib have been reported in South Kivu province since then, said Leandre Murhula Masirika, who is leading local research, 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 body”while strain II causes lesions normally more limited to the genital area, explained Trudie Lang, from the University of Oxford.

Another major change: the Ib strain has also spread through non-sexual contact, within families or among 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”.

“We are very afraid”

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.

While the new strain has not yet been reported outside the DRC, it is possible that it is already circulating in neighboring countries, Murhula Masirika said. 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.

Scientists point out that one of the response tools remains the 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 yet been made available in Kamituga, deplores John Claude Udahemuka. However, if the current strain spreads further, it will cause “really big damage”warned Murhula Masrika : “We are very afraid. »

“Under exceptional circumstances”

An emergency meeting was held in Kinshasa in mid-April at the instigation of the Center for Disease Surveillance and Prevention (Africa CDC), the public health agency of the African Union, which resulted in the decision to urgently approve two vaccines which have already proven themselves for both children and adults. Regarding the treatment of the disease, the Congolese health authorities had also announced that a specific antiviral would obtain marketing authorization. “under exceptional circumstances” within three months.

A vast project for the distribution of prevention equipment and essential medicines decided at the Kinshasa conference also began in mid-June in the Congolese regions most affected by strain I of the virus: Equateur, South Ubangi. , Sankuru and South Kivu. Finally, Africa CDC has created, on occasion, a steering committee including the countries of Central and West Africa affected by the epidemic or likely to be affected.

In the DRC, the number of contaminations by the original virus has tripled since the start of the year compared to the same period in 2023, with 4,500 cases including more than 300 deaths, according to the WHO.

The United Nations health agency was concerned in mid-December about the risks of rapid spread on the continent. In mid-June, South Africa declared its first two deaths in less than twenty-four hours, while France confirmed, on June 22, a third case of contamination on the neighboring island of Reunion. of Mauritius and Madagascar, in the Indian Ocean.