Can A Deadly New mpox Strain in Africa Ignite Another Outbreak?

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The World Health Organisation (WHO) has issued warnings about a new, highly dangerous strain of mpox spreading in the Democratic Republic of Congo (DRC). This new strain, known as clade 1b, first emerged in September 2023 among sex workers in a DRC mining town. Unlike previous strains associated primarily with animal contact, clade 1b is now being transmitted through both sexual and non-sexual human contact, increasing its potential for widespread dissemination and raising fears of another global outbreak, reports First Post.

Differences from Previous Mpox Outbreaks

Mpox, formerly known as monkeypox, is a viral infection characterized by symptoms such as fever, chills, fatigue, and a distinctive pus-filled rash. The 2022 global outbreak was largely driven by clade 2b and primarily affected gay, bisexual, and other men who have sex with men. This outbreak was eventually controlled through vaccination efforts.

The current outbreak in the DRC, however, involves clade 1b, which has a significantly higher mortality rate—around 5% in adults and 10% in children—and is causing a worrying number of miscarriages among pregnant women. John Claude Udahemuka, a lecturer at the University of Rwanda, described this variant as “undoubtedly the most dangerous of all the known strains of mpox, considering how it is transmitted, how it is spread, and the symptoms.”

Scope and Impact of the Outbreak

Nearly 8,000 mpox cases have been reported in the DRC this year, including 384 deaths, with children under 15 accounting for almost half of these fatalities. Last year saw over 14,500 infections and 654 deaths in the country, the highest numbers ever reported and the highest among countries in the WHO’s African region. The outbreak is particularly severe in South Kivu province, near the borders with Rwanda, Burundi, and Uganda, where the virus has been detected in several cities, including Goma.

The virus is spreading rapidly in schools, healthcare settings, and households, with reports of asymptomatic spread among individuals unaware they are carrying the virus. According to Trudie Lang, a professor of global health at Oxford University, the current case figures likely represent “the tip of the iceberg,” with many non-severe cases remaining hidden.

Risk of Global Spread

Experts are divided on the likelihood of another global mpox outbreak. Infectious disease physician and researcher Jake Dunning acknowledges that while a global outbreak is “possible,” it is difficult to predict its likelihood. He emphasizes the need for a thorough understanding of international movement and contact networks that could facilitate human-to-human transmission. Although some cases in the DRC appear to spread through sexual contact, it is crucial to monitor all potential transmission routes.

Lang underscores the importance of monitoring vulnerable populations, such as pregnant women and young children, in Africa. She also stresses the urgent need for trials to determine the efficacy of existing vaccines against the new strain, a process that will require time.

Addressing the Crisis

The DRC faces significant challenges in combating the mpox outbreak, including limited access to vaccines and treatments, low public awareness, and numerous other health priorities. The WHO has highlighted the critical need to address the recent surge in mpox cases in Africa.

African researchers are calling for urgent action to improve research into the mpox virus and expedite the distribution of vaccines. The ongoing rainy season has hindered movement and response efforts, but the approaching dry season and school holidays could exacerbate transmission.

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Source: First Post