A new strain of the mpox virus, rapidly spreading along the eastern border of the Democratic Republic of Congo, is causing significant concern among health officials.
Described as “incredibly worrying,” this strain can cause severe illness and potentially be fatal, with lesions appearing across the body.
Driven primarily by sexual transmission, there is also evidence that this strain can spread through close skin-to-skin contact.
Global health experts warn that this new variant poses a significant risk of cross-border and international spread, with one expert calling it the “most dangerous strain yet.”
While a global mpox epidemic in 2022 was controlled through vaccination of vulnerable groups, the Democratic Republic of Congo faces challenges with poor access to vaccines and treatments.
Local health officials fear the virus could spread to other countries. “The disease can go through airports.
A person with lesions can go through borders because there are no controls,” stated Leandre Murhula Masirika of the health department in South Kivu province, one of the worst-hit areas. “I’m very afraid it’s going to cause more damage.”
Risk of Spread
Mpox cases have been increasing in the Democratic Republic of Congo for decades.
According to World Health Organization (WHO) data, nearly 8,000 cases and 384 deaths have been reported this year, almost half of which involved children under 15.
The outbreak in South Kivu province, near the borders with Rwanda, Burundi, and Uganda, is particularly concerning.
Recent lab tests found the new mpox strain, which contains mutations that facilitate human transmission.
In Kamituga, a mining town where the strain likely originated among sex workers in September 2023, infections are rising. Those affected now include schoolchildren, healthcare workers, and entire households.
The new strain has also been detected in several border cities, including Goma, which borders Rwanda.
The WHO has highlighted the renewed risk of cross-border and international spread, which may increase severe illness risks.
Scientists warn that the new strain might spread more easily, cause more serious disease, and result in more deaths among children and adults. Asymptomatic spread, where individuals without symptoms unknowingly transmit the virus, is also a concern.
“The current case figures are ‘the tip of the iceberg,’” said Professor Trudie Lang from the University of Oxford. “It’s definitely the most dangerous strain yet. We don’t know how many non-severe cases are hidden.”
Uncertainty remains about the speed of the new strain’s spread and whether current vaccines offer protection against it. Trials are needed to determine this, but they will take time.
The global mpox outbreak that spread across Europe and America in 2022 was primarily sexually transmitted among men who have sex with men and was caused by the Clade II mpox virus.
The new strain, from the more deadly Clade I, is distinct from previous outbreaks in the region and can also spread through non-sexual contact, making it more dangerous.
Many children, including newborns, have been infected, and there have been reports of miscarriages in pregnant women. Some patients have suffered long-term complications with their eyes, skin, and genitals.
One healthcare worker reportedly lost her sight after contracting the virus from a patient.
In the Democratic Republic of Congo, the new strain has a mortality rate of 4% in adults and 10% in children.
Poor Access to Vaccines
John Claude Udahemuka, a lecturer at the University of Rwanda monitoring the outbreak, believes the first case likely involved a man who had sex with a woman in Kamituga and then with other women in different locations.
The disease initially appeared during the rainy season when road conditions limited movement, but the current dry season could see increased transmission, especially during school holidays.
“If we can vaccinate sex workers plus health workers, I think cases can be reduced,” said Mr. Masirika of the South Kivu health department.
African researchers are calling for urgent action to improve mpox research and accelerate vaccine distribution.
The WHO recently expressed concern over the ongoing outbreak, citing limited public awareness, lack of treatment kits and vaccines, and other health priorities in the country as factors in the emergence of the new strain.
The risk associated with mpox in the Democratic Republic of Congo “remains high,” the WHO stated.
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