A new form of MPOX that may spread more easily was discovered during Congo’s largest outbreak

File photo by Dado Ruvic/Reuters

KINSHASA, Congo (AP) — Congo is struggling to contain its largest MPox outbreak, and scientists say a new form of the disease discovered in a mining town could spread more easily among people.

Since January, Congo has reported more than 4,500 suspected cases of MPOX and nearly 300 deaths, figures that have roughly tripled from the same period last year, according to the World Health Organization. Congo recently declared the countrywide outbreak a public health emergency.

An analysis of patients hospitalized in Kamituga, eastern Congo, between October and January suggests that recent genetic mutations in mpox are the result of its ongoing transmission to humans; it’s happening in a city where people have little contact with the wild animals that are thought to naturally transmit the disease.

“We are in a new phase of MPox,” said Dr Placide Mbala-Kingebeni, the lead researcher on the study, who said it will soon be submitted to a journal for publication. Mbala-Kingebeni heads a laboratory at the Congolese National Institute for Biomedical Research, which studies the genetics of disease.

READ MORE: What you need to know about mpox and how it spreads

The lesions reported by most patients are milder and located on the genitals, Mbala-Kingebeni said, making the disease more difficult to diagnose. In previous outbreaks in Africa, lesions were mainly seen on the chest, hands and feet. He also said the new form appears to have a lower mortality rate.

In a report on the global MPox situation this week, the WHO said the new version of the disease may require a new testing strategy to pick up the mutations.

While experts pointed out that less than half of people in Congo are being tested with MPox, Mbala-Kingebeni said: “The risk is that unless patients themselves come forward, we will have a silent transmission of the disease and no one will know.”

Mbala-Kingebeni said most people became infected through sex, with about a third of MPox cases found in sex workers. It wasn’t until the 2022 mpox global emergency that scientists determined the disease was spread through sex, with most cases occurring in gay or bisexual men. In November, the WHO confirmed the sexual transmission of MPOX in Congo for the first time.

There are two species, or clades, of mpox, which are related to smallpox and endemic to Central and West Africa. Clade 1 is more serious and can kill up to 10 percent of infected people. Clade 2 caused the 2022 outbreak; more than 99 percent of infected people survived.

Mbala-Kingebeni and colleagues said they have identified a new form of clade 1 that may be responsible for more than 240 cases and at least three deaths in Kamituga, a region with a significant transient population that travels elsewhere in Africa and beyond.

Dr. Boghuma Titanji, an infectious disease expert at Emory University who was not involved in the study, said the new mutations are concerning.

READ MORE: Why aid groups warn of a new humanitarian crisis in eastern Congo

“This suggests that the virus is adapting to spread efficiently among people and could cause some quite consistent outbreaks,” she said.

Although MPox epidemics have been brought under control in the West with the help of vaccines and treatments, few cases have emerged in Congo. The Congolese Minister of Health has authorized the use of vaccines in high-risk provinces, said Cris Kacita Osako, coordinator of the Congolese Monkeypox Response Committee. He said officials are in talks with donor countries like Japan to help buy the shots.

“Once sufficient vaccines are available… vaccination will be implemented as part of the response,” Kacita Osako said.

Dr. Dimie Ogoina, an MPox expert at Niger Delta University, said the new research is a disturbing reminder of an earlier – but different – ​​outbreak.

“The remarkable spread among sex workers is reminiscent of the early stages of HIV,” he said, explaining that prejudices about the treatment of sexually transmitted infections and the reluctance of people with MPOX to come forward were worrying.

WHO emergencies chief Dr. Michael Ryan said last week that despite the continued spread of mpox in Africa and elsewhere, “not a single donor dollar has been invested.”

Cheng reported from London. Mark Banchereau from Dakar, Senegal, contributed to this report.