CASES of Mpox in the Democratic Republic of Congo (DCR) have surged at an ‘exponential’ rate, health officials have warned.
The clade I strain detected in the DRC causes more severe illness and deaths than the clade II virus that is known for triggering the global outbreak in 2022.
A new deadly strain of mpox has been discovered in the Congo
Symptoms associated with monkeypox
Since the beginning of 2024, a total of 11,166 suspected cases, including about 450 deaths have been reported in the country, according to a new report.
Many children have been infected, including newborn babies during pregnancy.
Patrick Muyaya, a Congolese government spokesperson, said the report revealed “an exponential increase in the number of cases”.
It comes just days after the World Health Organisation (WHO) warned of the threat of a new strain of mpox described as “the most dangerous yet”.
The latest outbreak shows “no sign of slowing down”, said WHO head Tedros Adhanom Ghebreyesus.
Cases are being driven by sexual transmission but there is evidence this particular strain can also be passed on through close skin-to-skin contact, which makes it more dangerous.
Clade I is also more deadly than clade II, with a fatality rate of around five per cent in adults and 10 per cent in children, compared to three per cent for its predecessor.
A worldwide epidemic of mpox two years ago was brought under control by vaccinating vulnerable groups, which were mostly men who slept with men.
But there is poor access to vaccines and medications in DR Congo and local health officials are warning the virus could reach other countries.
“The disease can go through airports,” said Leandre Murhula Masirika, at the health department in South Kivu province – one of the worst affected areas in DR Congo.
“A person with lesions can go through borders because there are no controls.
“I’m very afraid it’s going to cause more damage.”
The third person who died was a 40-year-old man from the KwaZulu-Natal province who had mpox-like symptoms, including a rash all over his body.
“He passed away at home and the results came back positive for mpox on June 23, 2024,” it added in a statement.
In South Africa, three people have died, with at least 16 laboratory-confirmed cases, the country’s health ministry said.
The current case figures are “the tip of the iceberg”, said Prof Trudie Lang, professor of global health research at the University of Oxford.
“It’s definitely the most dangerous strain yet.
Mpox lesions go through four stages, from flat spots to raised spots, to blisters to scabs
“We don’t know how many non-severe cases are hidden.”
‘Horrendous’ symptoms
Jean Claude Udahemuka, from the University of Rwanda, who has been studying the outbreak, said there is also evidence of transmission in schools and from mums or carers to children.
The disease appears to be causing miscarriages among pregnant women, as well as “horrendous whole body rashes” and other lingering symptoms.
Previously, it caused lesions more limited to the genital area.
These significant differences from previous mpox strains are “incredibly worrying,” Prof Lang said.
She added: “There is definitely the opportunity for this to get on a plane,” so countries around the world – including those in Europe – could be at risk through travel.
“We need to be really vigilant now and try to move to contain it.”
All countries should be preparing for this new strain “before it spreads to other places, before it is too late,” Udahemuka added.
In April, researchers warned: “Without intervention, localised outbreaks harbour the potential to spread nationally and internationally.
“Given the recent history of mpox outbreaks in Congo, we advocate for swift action by endemic countries and the international community to avert another global mpox outbreak.”
What is Mpox?
Mpox, formally known as monkeypox, is a viral infection that spreads through close contact, causing flu-like symptoms and pus-filled lesions.
A milder version of mpox sparked a global epidemic in 2022 when it spread to more than 100 countries – including the UK.
Symptoms of mpox include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion.
A rash can develop, often beginning on the face, which then spreads to other parts of the body, including the genitals.
The rash can look like chickenpox or syphilis, and scabs can form which then fall off.
The incubation period is usually from six to 13 days but can range from five to 21 days.
Mpox in the UK
Government data has shown 3,553 cases of mpox were recorded in the UK in 2022.
The Department for Health has said: “The outbreak has mainly been in gay, bisexual, and other men who have sex with men without documented history of travel to endemic countries.”
But cases have fallen sharply in the past six months as a result of vaccination and testing.
At the time of writing, only 20 cases have been recorded in the UK in 2023.
The mpox symptoms that have nothing to do with spots
The most obvious mpox symptom is the hallmark spots.
According to the NHS, these lesions go through four stages, from flat spots to raised spots, to blisters to scabs.
But people are also likely to experience flu-like symptoms, which will begin between five and 21 days after infection.
The symptoms often get better by themselves over two to four weeks.
The NHS says these include:
Inflammation of the rectum (proctitis) – for example, pain or bleeding from your back passage
High temperature (fever)
Headache
Flu-like symptoms, including muscle and back aches, shivering and tiredness
Swollen glands that feel like new lumps (in the neck, armpits or groin)
If you have some of these symptoms and believe you could have monkeypox, you should stay at home, avoid close contact with others and get medical help by phone until you’re assessed.
There are some complications associated with mpox, such as bacterial infection from skin lesions, mpox affecting the brain (encephalitis), heart (myocarditis) or lungs (pneumonia),