MONKEY VARIOLE: More dangerous, a new strain in DR CONGO worries about its potential spread

Saturday, August 10, 2024

Paris, France

More transmissible and more dangerous than its predecessors, a new strain of the mpox virus responsible for child deaths in the Democratic Republic of Congo now poses 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”, said Jean-Claude Udahemuka, a researcher at the University of Rwanda who is studying the epidemic.

Since the disease was first detected in humans in the Democratic Republic of Congo in 1970, mpox – formerly known as monkeypox – has caused regular outbreaks, mainly in Africa, due to the I strain of the virus.

In 2022, a worldwide epidemic, carried by the ten times less deadly II strain, spread to around a hundred countries where the disease was not endemic, mainly affecting homosexual and bisexual men.

In endemic areas of Africa, outbreaks had hitherto mainly resulted from contact with infected animals, for example by eating bushmeat.

But “something appeared different” in an outbreak of mpox detected in September among sex workers in the remote DRC mining town of Kamituga, John Claude Udahemuka explained in an online press conference.
Unlike previous epidemics in this Central African country, the virus was transmitted through heterosexual sex. Tests have identified a mutation of the original strain, called Ib and “without doubt 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.
According to researchers, 5% of adults and 10% of children contracting this strain of the disease die from it.
It causes “horrible rashes all over the body”, whereas strain II causes lesions normally more limited to the genital area, explained Trudie Lang, from Oxford University.
– “Incredibly worrying” –
Another major change: the Ib strain has also spread through non-sexual contact, among families or children at school.
There has been a “large number” of transmissions between mothers – or carers – and children, pointed out Trudie Lang.

Numerous miscarriages were also recorded, and researchers are investigating possible effects on fertility.
These significant differences from previous strains of mpox are “incredibly worrying”, says the Oxford expert. And hospital cases are probably just “the tip of the iceberg”.
There are still major unknowns about the new strain, which has spread to the towns of Bukavu, Uvira and Kamanyola, then this week to Goma, capital of North Kivu province.
These towns are close to the borders with Rwanda, Burundi and Uganda.
While the new strain has not been reported outside the DRC, it is possible that it is already circulating in neighboring countries, said Murhula Masirika, according to whom some of the infected sex workers are from there.
And Goma in particular has an international airport. “It’s 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 the vaccination of local sex workers.
Researchers in Africa have pleaded for the DRC to have access to the mpox vaccines and treatments used in most of the countries affected by the 2022 epidemic, even if their impact on the new strain is still unknown.

As for smallpox vaccines, which are inexpensive, widely available in many countries and capable of acting against mpox, they have not yet been tested.One of the tools, according to scientists, is the vaccination of local sex workers.
Researchers in Africa have called for the DRC to have access to the mpox vaccines and treatments used in most of the countries affected by the 2022 epidemic, even if their impact on the new strain is still unknown.
As for smallpox vaccines, which are cheap, widely available in many countries and able to act against mpox, they have not been made available in Kamituga, according to John Claude Udahemuka.
Yet, if the current strain spreads further, it will cause “really big damage”, warned Murhula Masirika. “We’re very scared.
The World Health Organization expressed concern in mid-December about the risk of international spread of the mpox epidemic raging in the DRC, a month after an initial alert.

Humaniterre with AFP