New deadly Mpox strain raises concerns about possible global spread

A new and highly dangerous strain of Mpox, previously known as monkeypox, has emerged in the Democratic Republic of Congo (DRC), causing worldwide alarm. This mutated variant, identified as clade 1b, is spreading rapidly and has a significantly higher fatality rate compared to other known strains. The World Health Organization (WHO) and scientists are urging immediate action to contain this outbreak and prevent its spread beyond Africa.

Warnings that also being sent out to countries that are major tourist and holiday destinations to be on their guard for the possible emergence and spread of this new Mpox strain in their respective countries.

Discovery and transmission

First detected in February 2024, the new clade 1b strain is described by experts as the most dangerous strain of Mpox to date. Unlike previous variants that primarily spread through sexual contact among men who have sex with men, clade 1b does not require sexual contact for transmission. This new strain spreads through touch and close contact, making it much harder to contain.

Researchers have reported cases of clade 1b spreading in schools, workplaces, and from mother to child. The disease has caused numerous miscarriages among pregnant women and presents with symptoms that are more severe and widespread than earlier strains. Lesions and blistering cover the entire body rather than being confined to specific areas, and patients frequently experience whole-body rashes, eye problems, and high fever.

Fatality rates and spread

The fatality rates associated with clade 1b are particularly concerning, with an estimated 5% mortality rate in adults and 10% in children. To date, roughly 8,600 Mpox cases have been reported in the DRC this year, resulting in 410 deaths. Health officials are warning that these numbers could rise significantly if the outbreak is not contained.

Dr Cris Kacita, who oversees the DRC’s Mpox control program, highlighted the gravity of the situation, noting that 24 out of the country’s 26 provinces are affected. South Kivu, a hard-to-reach province in the DRC, has been particularly impacted, with the mining town of Kamituga reporting around 20 new cases each week. Given the proximity of South Kivu to Rwanda and Burundi, there are serious concerns about the virus crossing borders and spreading to neighbouring countries.

Urgent calls for action

The WHO and other health organizations are calling for urgent international support to address the outbreak. Dr Rosamund Lewis, the WHO’s technical lead for Mpox, emphasised the critical need for a coordinated response to manage the surge in cases. Efforts are underway to secure vaccines and treatments, but access remains limited, particularly in affected regions of the DRC.

Dr John Claude Udahemuka, a researcher from the University of Rwanda working on the ground in South Kivu, stressed the importance of studying the new strain’s transmission routes. Evidence suggests that clade 1b is spreading through non-sexual close contact, including caregiver-to-child transmission and within educational settings. The disease also appears to be causing longer-term symptoms, with patients experiencing persistent rashes and other lingering effects.

Potential for global spread

Experts fear that the new strain could follow a similar trajectory to clade IIb, which spread globally in 2022. Given the interconnectedness of the region and the movement of people, particularly sex workers who travel between the DRC and neighbouring countries, the potential for international spread is high. Goma, a major city in the DRC with an international airport, has already reported a significant outbreak, raising concerns about the virus reaching Europe and beyond.

Researchers believe that the initial outbreak in Kamituga can be traced back to a man who travelled to the town and had contact with multiple sex workers, thereby facilitating the spread of the virus. However, the exact mechanisms behind the virus’s mutation and increased transmissibility remain unclear, adding to the list of unknowns about this dangerous new strain.

The need for enhanced surveillance and research

The current outbreak highlights the need for improved surveillance and research to better understand and combat the new strain. PCR tests designed for diagnosing Mpox are not effective against clade 1b, meaning many cases may go undetected. This lack of effective diagnostic tools hampers efforts to track and control the spread of the virus.

Health authorities in the region are overwhelmed, and there is an urgent need for international assistance. The WHO, Coalition for Epidemic Preparedness Innovations (CEPI), and the governments of the DRC and Rwanda are in discussions to secure vaccines and other resources. However, the efficacy of existing vaccines against clade 1b remains uncertain, complicating the response efforts.

The emergence of clade 1b Mpox in the DRC is a stark reminder of the ongoing threat posed by infectious diseases and the need for global vigilance. As the situation evolves, coordinated international action is crucial to prevent a widespread outbreak. The WHO and scientists are urging immediate support to contain the virus, protect vulnerable populations, and prevent the new strain from becoming a global health crisis.