DRC— Scientists from the Foundation for Innovative New Diagnostics (FIND) have reported an outbreak of mpox virus (MPXV) clade I (a variation) in the Democratic Republic of Congo’s (DRC) South Kivu province that shows no signs of abating.

An observational study (now being reviewed) has demonstrated that MPXV clade I can spread through both heterosexual and close community-level contact, with children accounting for the vast majority of MPXV cases and deaths.

Children are becoming a high-risk category, and new mpox viral transmission channels are emerging.

Inadequate testing capacity is impeding efforts to contain the outbreak, while a lack of comprehensive testing capability has an influence on outbreak understanding, response, and containment.

The 2022 MPVX clade II global outbreak raised concerns because of its larger geographical distribution and more mortality; however, this MPXV clade I outbreak represents a significant shift since transmission channels appear to be expanding.

 FIND believes that there is an urgent need for further in-depth research to better understand mpox transmission patterns in order to inform controls and response plans, as well as improved surveillance and equitable access to vaccines, diagnostics, and treatments for all impacted groups.

Without access to testing, it is unclear how comorbidities, particularly immunocompromised diseases such as HIV, may influence the virus’s intensity and transmission dynamics.

While making this statement, Dr Ayoade Alakija, Chair of the Board of FIND, stated that the mpox situation in the DRC is deeply concerning, and that the lack of tests for both mpox and HIV makes it unknown how terrible the mpox issue is and what the underlying comorbidities may be.

He went on to clarify that, similar to the COVID-19 pandemic, those being prioritized for diagnostics, treatment, and immunization are not in Africa’s outbreak countries.

He finished by urging for either mobilizing resources to combat the fatal mpox outbreak in the DRC or allowing the virus to spread and fighting it when it enters other nations.

Dr Sergio Carmona, acting CEO and Chief Medical Officer at FIND, on his part, stated that the DRC’s testing capability for mpox and HIV is severely limited, implying that many likely instances of mpox in the country are only treated as suspected cases.

He went on to state that, given the persisting disparities in testing capacity, FIND will engage with partners to expedite both the implementation of tests and the development of new diagnostic tools that can be utilized at the point of care to deliver results more quickly.

The Democratic Republic of the Congo reported the first mpox cases in humans in 1970, and the country had previously only identified MPXV clade I.

Clade I is the virus’s deadliest form, and the first documented heterosexual transmission and close community contact transmission signal a watershed moment in its history.

Due to limited diagnostic tools, only 16% of probable cases in the DRC are tested by PCR.

This testing gap has  resulted in a 60% positivity rate, indicating that the outbreak may be underestimated.

 Between the beginning of 2022 and January 2024, the country reported a startling 21,630 suspected MPXV cases and 1,003 deaths, with youngsters bearing the brunt of the burden: about 85% of deaths during this time were recorded as minors under the age of 15.

Closing the gap between suspected and confirmed cases is critical for customizing an appropriate response and halting the spread of MPXV.

Enhanced surveillance and increased access to testing are critical for gaining a thorough knowledge of the outbreak and effectively deploying targeted therapies.

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