A dangerous strain of MPox that is killing children and causing miscarriages in the Democratic Republic of Congo is the most transmissible yet and could spread internationally, scientists warn.
The virus appears to spread from person to person through both sexual and non-sexual contact, in places ranging from brothels to schools.
Hundreds of people with the disease, formerly known as monkeypox, have gone to hospital in the mining town of Kamituga, South Kivu province, in what is likely to be the “tip of the iceberg” of a larger outbreak, doctors say.
Mpox is a virus from the same family as smallpox and causes flu-like symptoms and pus-filled lesions.
Two years ago, an outbreak in Europe and the US centered on the gay community led the World Health Organization to declare a public health emergency. It was the first time MPox was reported to spread through sexual contact.
That outbreak was caused by clade II of the virus, one of the three recognized groups of mpox and one with a relatively low mortality rate.
The new DRC outbreak is a mutated form of clade I mpox. Doctors report a mortality rate of about 5% in adults and 10% in children, as well as high rates of miscarriage in pregnant women.
Clade I has historically been found in people eating infected bushmeat, with transmission largely confined to the affected household.
Researchers believe the current outbreak started in a bar used by sex workers. At a briefing for journalists, Trudie Lang, professor of global health research at the University of Oxford, said that when the DRC outbreak was discovered last September, scientists had assumed it would be clade II, due to sexual transmission, until genetic testing showed that this belonged to the group of the more virulent species.
It was an “incredibly concerning” situation, Lang said. Although smallpox vaccines and treatments helped control the 2022 outbreak, they are not available in the DRC so far.
South Kivu is located on the borders with Burundi and Rwanda and close to Uganda, and locals travel across the border regularly.
Lang said it was unclear how many asymptomatic or mild cases there were, with the virus’s long incubation period increasing the risk of transmission before people realized they were sick.
John Claude Udahemuka, a lecturer at the University of Rwanda, who is involved in the medical response to MPox, said: “It is undoubtedly the most dangerous of all known types of MPox, given the way it is transmitted, how it is spread and also the symptoms.”
He said countries must prepare for the spread of the virus. “Everyone has to prepare. Everyone should be able to detect the disease as early as possible. But more importantly, everyone must support local research and response so it doesn’t spread.”