Global health authorities are sounding the alarm about a strain of mpox spreading across the Democratic Republic of the Congo, with little known about the mutation other than that it appears to spread more easily among humans.
The mpox virus circulating in the North and South Kivu provinces of Congo is believed to be a mutation of the lineage – clade I – which is endemic to Central Africa, distinct from the strain – descendant of clade II – that impacted the USA and other western countries. in 2022 in 2023.
According to the World Health Organization (WHO), the risk associated with mpox in Congo remains high, with the newly identified strain of mpox estimated to have emerged around September 2023.
Although more is still being learned, the virus appears to have some worrying characteristics.
“The main difference and what we see or can confirm with epidemiology is that there is sustained transmission between humans. This has been going on for months, and this is really new as far as my group is concerned,” said Sylvie Jonckheere, an emerging infectious disease consultant at Doctors Without Borders, currently based in Goma, Congo.
Clade I mpox is primarily transmitted from animals to humans as a zoonotic disease and is generally considered to have a higher mortality rate than clade II, causing death in up to 10% of infections.
The WHO noted that the clade I descendant strain has mutations that indicate “adaptation of the virus due to circulation between humans”. Unlike COVID-19, the mpox virus is not known to mutate rapidly.
William Schaffner, a spokesman for the National Foundation for Infectious Diseases, said mpox is more like measles — for which one vaccine is usually enough for a lifetime — in terms of how easily it mutates.
“Certainly, a big fuss, a big mpox outbreak like the one we are seeing now, has not been recorded before. There have been sporadic cases, of course, but nothing like this,” Schaffner said. “This is a very distinct outbreak. It doesn’t appear to be a virus that mutates easily, but we saw what I’m sure is the consequence of a mutation.”
Unlike the form of mpox that spread across Western countries in 2021, the new strain does not appear to have a strong link to sexual transmission or the social networks of men who have sex with men.
According to Jonckheere, around 25% of cases occur among children. But the mpox virus circulating in eastern Congo does not appear to cause more serious illness.
“In fact, the fatality rate is not more serious. Thus, the lethality of this disease, for now, in the eastern part of the Congo is still quite low compared to what we saw in the [Equatorial Guinea]historically or even recently,” Jonckheere said.
Media outlets like the BBC reported that this mpox mutation may be the “most dangerous strain yet”. Jonckheere said it depends on “how you define ‘dangerous,’” noting that the current lack of comprehensive information about this mutant strain warrants “a pinch of salt, maybe a little more than a pinch.”
“It appears that it is more likely to be transmitted from human to human. He will follow humans wherever he wants them to go,” she said. “In this part of Congo there is also a lot of movement between countries, so it could spread further afield. But if you look at case fatalities or mortality or that kind of thing, it’s not dangerous anymore. So it really depends on how you define it.”
One factor that is not helping the outbreak is the inability to socially distance enough.
“There is no option for distancing at all. People are living, you know, seven in a four square meter shelter, literally,” said Jonckheere, who noted the lack of clean water, as well as sexual or transactional contact, as other factors worsening the spread of MPox in the region. .
As of now, this mpox strain appears confined to the Congo, although the region in which it is located borders Burundi and Rwanda, providing opportunity for infections outside the country.
Jonckheere noted that its transmission is being assessed as a regional threat.
Vaccination efforts are underway in Congo. Schaffner noted that the smallpox vaccine deployed in the US during the 2022 mpox outbreak should still be effective against the mutant strain.
Although mpox is no longer considered a public health emergency in the US, the WHO still considers it a “moderate” threat in countries with historical transmission and in their neighbors. The general population in countries unaffected before the outbreak that began in 2022 is considered low risk.
A June WHO report listed 646 laboratory-confirmed cases of all types of mpox reported in 26 countries in May, an increase from the previous month.
As reports of the virus have declined since 2022, the current case estimate is believed to be an underestimate.
“It continues to be a concern. I mean, the epidemic curve started to rise, peaked, and went very, very low, but it never went away,” Schaffner said. “I don’t think there have been any reports from adjacent countries. And there are no reports so far of any exports to Europe, Canada, the United States or anywhere else. But, obviously, public health is following this very closely because it has this potential.”
This story originally appeared on thehill.com read the full story
