In recent months, the Democratic Republic of Congo (DRC) has been battling its largest mpox outbreak yet, with scientists now warning of a new variant of the disease that may pose a greater risk of human-to-human transmission. According to the World Health Organization (WHO), there have been over 4,500 suspected mpox cases and nearly 300 deaths reported in Congo since January, a significant increase compared to the same period last year.

The discovery of a new form of mpox in the mining town of Kamituga, located in eastern Congo, has raised concerns among experts. A study conducted by Dr. Placide Mbala-Kingebeni, the lead researcher at Congo's National Institute of Biomedical Research, suggests that recent genetic mutations in mpox are the result of its continued transmission among humans in a town where contact with wild animals, believed to be natural carriers of the disease, is limited.

Dr. Mbala-Kingebeni explained that the new form of mpox presents milder lesions primarily on the genitals, making it more challenging to diagnose. Previously, outbreaks in Africa mainly exhibited lesions on the chest, hands, and feet. However, the new variant appears to have a lower death rate.

In their report on the global mpox situation, WHO stated that the new form of the disease may require a revised testing strategy to detect the mutations. Alarmingly, less than half of the mpox cases in Congo are currently being tested, leading Dr. Mbala-Kingebeni to highlight the risk of silent transmission if patients do not come forward for testing.

Sexual transmission seems to be the predominant mode of infection, with roughly a third of mpox cases found in sex workers. It was not until the 2022 global emergency that scientists confirmed sexual transmission of the disease, with most cases affecting gay or bisexual men. The current outbreak in Congo has now amplified the importance of addressing sexually transmitted infections, alongside the reluctance of individuals with mpox to seek medical attention due to social stigma.

The mpox virus belongs to two clades, or types, with Clade 1 being more severe, leading to up to a 10% fatality rate, while Clade 2 triggered the ongoing outbreak and has a survival rate of over 99%. Dr. Mbala-Kingebeni and his team have identified a new form of Clade 1 in Kamituga, which is responsible for over 240 cases and at least three deaths in the region. This area is home to a significant transient population, which increases the risk of further spread throughout Africa and beyond.

The growing number of cases and the emergence of a more transmissible mpox variant have raised concerns among infectious diseases experts. Dr. Boghuma Titanji of Emory University expressed alarm about the virus adapting to efficiently spread among humans and potentially causing significant outbreaks.

While mpox outbreaks in the West have been contained with the help of vaccines and treatments, Congo has faced a scarcity of such resources. However, the Congolese Ministry of Health has authorized the use of vaccines in high-risk provinces and is in talks with donor countries, including Japan, to procure the necessary doses. Vaccination will be implemented as part of the response once an adequate quantity of vaccines becomes available.

Dr. Dimie Ogoina, an mpox expert, compared the spread of the disease among sex workers to the early stages of HIV, highlighting the urgent need to address prejudices surrounding sexually transmitted infections and encourage individuals to come forward for testing and treatment.

Despite the ongoing spread of mpox both in Africa and elsewhere, there has been a lack of financial support from donors, according to WHO's emergencies chief, Dr. Michael Ryan. This has further increased the challenges faced by Congo in combating the outbreak.

The situation in Congo highlights the pressing need for international support, adequate testing, and access to vaccines in the affected regions to effectively contain and control the mpox outbreak.