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International researchers, including experts from DTU National Food Institute, have raised concerns about the rapid spread of a new mpox variant in the Democratic Republic of the Congo (DRC). The virus, identified as clade 1b, has mutated to become more infectious, increasing the risk of cross-border transmission.
Mutations Increase Infectiousness
Genetic analyses of clade 1b, first detected in Kamituga, DRC, in September 2023, reveal multiple mutations enhancing its ability to spread among humans. Scientists have identified three subvariants, one of which has already extended beyond Kamituga to other cities in the DRC, neighboring countries, and even internationally to Sweden and Thailand.
Alarmingly, early data suggest that clade 1b may also pose a higher risk of miscarriage among infected pregnant women. This new research has been published in Nature Medicine under the title Epidemiological and Genomic Evolution of the Ongoing Outbreak of Clade 1b Mpox Virus in the Eastern Democratic Republic of the Congo. The study was conducted by 16 researchers from six countries, including DRC, Rwanda, Denmark, the United Kingdom, Spain, and the Netherlands.
New Trends in Mpox Transmission
Originally, mpox was considered a zoonotic disease, primarily transmitted from animals to humans. However, a significant outbreak in 2022 mainly affected men who have sex with men. The new clade 1b variant is exhibiting a different pattern, as it is now spreading among both men and women, as well as health care workers and children.
Professor Frank Møller Aarestrup from DTU National Food Institute, who leads the GREAT-LIFE project, explains, “Similar to SARS-CoV-2, the mpox virus mutates as it spreads. Clade 1b has developed into a highly transmissible strain, now detected in multiple countries outside East Africa. Additionally, our research indicates a high miscarriage rate among infected pregnant women.”
Urgent Call for Cross-Border Collaboration
The study highlights that mpox is spreading predominantly through heterosexual contact in densely populated regions. Scientists stress the need for cross-border cooperation to contain the outbreak, emphasizing early detection, patient treatment, and public health education, particularly among high-risk groups such as sex workers.
Professor Aarestrup advises, “Uncontrolled transmission is occurring in eastern DRC and Burundi, though cases remain limited in other parts of East Africa. While a global outbreak is not yet expected, urgent measures are required to prevent further spread. Avoiding close contact, particularly sexual contact, in high-risk areas is crucial.”
The GREAT-LIFE Project’s Role in Outbreak Response
The GREAT-LIFE project, coordinated by DTU National Food Institute, aims to enhance disease detection capacity in East Africa. By developing a specialized PCR test, researchers were able to identify clade 1b early and track its spread.
The project’s key contributions include:
- Identification of the new mpox variant in South Kivu province, DRC.
- Development of a PCR test capable of detecting clade 1b.
- Monitoring transmission into neighboring countries, including Burundi.
- Detailed genomic and epidemiological analysis of infected individuals.
Key Findings
As of January 5, 2025, over 9,500 confirmed mpox cases have been reported in the DRC, with a fatality rate of 3.4%. The rapid rise in infections in South Kivu province remains a major concern. The research highlights several critical trends:
- Mpox is becoming more transmissible, increasing its spread.
- The virus is predominantly spreading through heterosexual contact.
- Transmission is significant among sex workers in urban areas.
- Underreporting of cases remains a major challenge.
- Infected pregnant women may have a higher risk of miscarriage.
Among 670 analyzed cases, 52.4% of infections were recorded in women and 47.6% in men. While sexual contact remains the primary transmission route, cases among health care workers are also rising. Alarmingly, out of 14 infected pregnant women, eight suffered miscarriages.
Conclusion
The emergence of clade 1b in the DRC underscores the need for urgent international action. Public health authorities are calling for increased vaccination, surveillance, and education to curb the spread of this more infectious mpox variant. While the current outbreak remains centered in East Africa, global health agencies remain on high alert to prevent further international transmission.
Disclaimer: This article is based on current research findings and expert opinions. Public health recommendations may change as more data becomes available. Readers are encouraged to stay informed through official health authorities such as the World Health Organization (WHO) and national health agencies.
