A new strain of monkeypox (or monkeypox) identified in the Democratic Republic of Congo (DRC) and then reported in several neighboring countries raises fears of a spread of this virus, two years after the previous global epidemic.
This strain, detected in the DRC in September 2023 and named “Clade Ib”, is more deadly and more transmissible than the previous ones and is transmitted from person to person, worries the World Health Organization (WHO).
Its director-general, Tedros Adhanom Ghebreyesus, decided on Wednesday to convene an emergency committee for a meeting “as soon as possible” to “determine whether the outbreak constitutes a public health emergency of international concern,” the highest level of alert that the WHO had triggered during a global outbreak of monkeypox in 2022.
“Clade Ib” causes rashes all over the body, while previous strains were characterized by localized rashes and lesions on the mouth, face or genitals.
In the DRC, as of August 3, the African Union health agency Africa CDC (Africa Centers for Disease Control and Prevention) counted 14,479 confirmed and suspected cases and 455 deaths, representing a lethality rate of approximately 3%.
According to researchers in the central African country, the mortality rate of this strain can reach 10% in children and the number of cases is “increasing exponentially”, the Congolese government acknowledged in July.
“The disease has been recorded in the displaced persons camps around Goma, in North Kivu, where the extreme density of the population makes the situation very critical. The risks of explosion are real given the enormous population movements” in this conflict region bordering several countries, specifies the medical coordinator of Médecins Sans Frontières (MSF) in this country, Louis Albert Massing.
Or “Ib” has already crossed borders: in the last two weeks, cases have been observed in Uganda, Burundi, Rwanda and Kenya, Rosamund Lewis, head of the fight against mpox at the WHO, told AFP.
Better screening
Authorities in these four countries have confirmed the existence of cases on their territory, notably in Burundi where 127 have been recorded, without specifying the strain concerned, while the East African Community (EAC) urges governments to “educate their citizens on how to protect themselves and prevent the spread” of the virus.
“This is the first time that these countries in the east of the DRC have reported cases of monkeypox. Rwanda, Burundi, Uganda, these are countries that do not have this disease in an endemic way. […] This means that it is an extension of the epidemic that is raging in the DRC and in Central Africa in general,” explains Rosamund Lewis.
Africa CDC also reports 35 suspected and confirmed cases including two deaths in Cameroon, 146 cases including one death in Congo-Brazzaville, 227 cases in the Central African Republic, 24 in Nigeria, 5 in Liberia and 4 cases in Ghana.
And in West Africa, Ivory Coast recently reported six confirmed non-fatal cases, including five in the economic capital Abidjan, without identifying the strain.
The mpox (for monkeypox) was first discovered in humans in 1970 in what is now the DRC (formerly Zaire), with the spread of the “Clade I” subtype (of which the new variant is a mutation), mainly limited since then to countries in western and central Africa, with patients generally being contaminated by infected animals.
In May 2022, MPOX infections occurred worldwide, via another subtype of the virus that mainly affects gay and bisexual men and has caused some 140 deaths out of about 90,000 cases in 111 countries. The culprit was the “Clade II” subtype.
This epidemic “is still raging” recalls Rosamund Lewis, particularly in South Africa where 24 cases have been recorded, including three deaths, but it is “controlled” and circulating less. MPOX “remains a threat to global health”, Tedros Adhanom Ghebreyesus added at the beginning of July.
“Countries are able to detect them,” Lewis notes, thanks to a disease surveillance system, laboratories and communication with affected communities.
This better surveillance of mpox may explain the recent increase in the number of cases, adds the director of epidemic prevention at the WHO, Maria Van Kerkhove, who nevertheless confirms a concern around “Clade Ib”.
While “there aren’t many vaccines,” some can still be used for MPOX, she adds. Negotiations are underway between the WHO and the countries concerned to authorize some, says Lewis.