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The new strain of the mpox virus, clade Ib, is evolving faster than anticipated, raising global concern as it spreads from the Democratic Republic of Congo. Scientists warn that limited resources and equipment in Africa are hindering efforts to track the virus, complicating response strategies and urgent research needs read more
 "New strain mutating faster than expected, resource shortage an issue")
A child under treatment for Mpox, an infectious disease caused by the Mpox virus that causes a painful rash, enlarged lymph nodes and fever, at a health centre in Munigi, Nyiragongo territory, near Goma in North Kivu province of the Democratic Republic of Congo on August 19, 2024. Reuters
The new strain of the mpox virus, clade Ib, which has been rapidly spreading out of the Democratic Republic of Congo, is evolving faster than expected. Scientists have pointed warned that limited resources and equipment are hampering efforts to properly track the virus.
The strain caught the world’s attention after the World Health Organization (WHO) declared a new health emergency.
Global spotlight on mpox
The virus typically causes flu-like symptoms and pus-filled lesions and can be fatal.
The virus, which has been a public health issue in parts of Africa since 1970, saw a resurgence in global concern in 2022, leading the WHO to declare, and later end, a global health emergency.
Now, clade Ib, a mutated version of the endemic clade I, is raising alarms as it spreads across Africa and into other countries.
Congo has reported over 18,000 suspected cases of clade I and clade Ib mpox and 615 deaths this year, according to the WHO.
In the last month, there have been 222 confirmed clade Ib cases in four African countries, as well as isolated cases in Sweden and Thailand linked to travel in Africa.
Limited information a concern
Reuters, citing scientists in Africa, Europe, and the United States, expressed concern over multiple unknowns surrounding the virus, including its severity and transmission dynamics.
Dr Dimie Ogoina, an infectious disease expert in Nigeria and chair of the WHO’s mpox emergency committee, voiced concerns about the limited understanding of the outbreak. “We don’t understand our outbreak very well,” Ogoina said.
“If we don’t understand our outbreak very well, we will have difficulty addressing the problem in terms of transmission dynamics, the severity of the disease, [and] risk factors.”
New strain has fast-transmission
Ogoina noted that while it took clade IIb in Nigeria over five years to evolve enough to sustain human-to-human transmission, sparking the 2022 global outbreak, clade Ib has achieved similar capabilities in less than a year.
Mpox, an orthopoxvirus related to smallpox, has traditionally been slow to mutate. However, genetic sequencing of clade Ib infections, which the WHO estimates emerged in mid-September 2023, revealed a mutation known as APOBEC3, indicative of the virus adapting to human hosts.
This mutation is driving faster viral evolution, said Dr Miguel Paredes from Fred Hutchinson Cancer Center in Seattle. Paredes said that the response is complicated by several simultaneous mpox outbreaks.
Previously, mpox was primarily spread through human contact with infected animals, but the mutated versions, clade Ib and IIb, are now largely considered sexually transmitted diseases. The virus has also spread through close contact, contributing to clusters of infections among children in Burundi and in eastern Congo’s displacement camps, where crowded living conditions may exacerbate the spread.
Need for further research
Further research is urgently needed, but African scientists say they are struggling to access essential chemicals and equipment for diagnostic tests. Planning an effective response, including vaccination strategies, is difficult without reliable data, they said.
Many African laboratories are facing shortages of necessary supplies, said Dr Emmanuel Nakoune of the Institut Pasteur in the Central African Republic, where clade Ia cases are also present. “This is not a luxury,” Nakoune stressed. “It is necessary to track deadly outbreaks.”
With inputs from Reuters
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English (US) ·