A new strain of monkeypox (Mpox) is spreading in the Democratic Republic of Congo and worries experts because it is particularly virulent. Caused by the monkeypox virus (of the Poxviridae family), the disease it causes lesions throughout the body and can be lethal: It is generally spread through sexual intercourse, but the new strain has the ability to transmit through simple close contact between two people. Experts fear that the new variant could also spread outside Congo.
Vaccination
The good news is that There is a vaccine to prevent smallpox and monkeypox in people aged 18 and over, also available in Italy (MVA-BN, with modified and non-replicating live virus). In 2022 the risk of a global Mpox epidemic has been kept under control thanks to the vaccination of the most vulnerable groups. The situation in the Democratic Republic of Congo is worrying, because access to vaccines and therapies is difficult. «The disease can spread through airports. A person with injuries can cross borders because there are no controls” said Leandre Murhula Masirika, of the Health Department of the province of South Kivu, one of the most affected by the epidemic.
The new strain
Cases of monkeypox have been increasing in the African country for decades. According to the World Health Organization (WHO), there were only in 2024 almost 8 thousand cases (with 384 deaths), half in children under 15 years of age. The epidemic in South Kivu province, near the borders with Rwanda, Burundi and Uganda, is of particular concern. Laboratory tests on virus samples from the area have detected the new strain of Mpox, with mutations that appear to favor circulation between humans. In the mining town of Kamituga, where the strain is thought to have originated among prostitutes last September, cases are on the rise. Among those infected there are schoolchildren, healthcare workers who treat patients and entire families.
Asymptomatic people
The new strain has been detected in several cities along the border, including Goma, which borders Rwanda. For the WHO there is «the risk of cross-border and international spread which can lead to an increase in serious diseases.” There is also concern about spread between people who have no symptoms and are unaware they have the virus. It is unclear how quickly the new strain spreads or whether the vaccines available today can stop its spread entirely. There is also an antiviral drug (tecovirimat), approved for the treatment of monkeypox in 2022 by the European Medicines Agency and already available in Italy.
Clade I, the most lethal
The Mpox epidemic that spread to Europe and America in 2022 was sexually transmitted, especially from men who have relationships with other men. It was caused by the clade II virus. The new strain that is spreading in the Democratic Republic of Congo belongs to clade I, more lethal: it has a mortality rate of 4% in adults and 10% in children. As mentioned, it can also be spread through non-sexual contact. Many children have been infected, including some newborns, and a small number of infected pregnant women who have miscarried. Some patients have reported long-term complications, including eye, skin and genital complications.
Endemic countries
The WHO underlined that in the Democratic Republic of Congo the lack of awareness of the disease, the lack of treatment kits and vaccines and the many health problems contributed to the spread of the new strain. Monkeypox is endemic to central and western Africawhere outbreaks are regularly reported, especially in Democratic Republic of Congo. Other endemic countries are Benin, Cameroon, Central African Republic, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, Republic of Congo, Sierra Leone and South Sudan.
