![Lushagala IDP camp near Goma, with Lake Kivu in the background](/https/www.telegraph.co.uk/content/dam/global-health/2024/07/12/TELEMMGLPICT000339554227_17207827488300_trans_NvBQzQNjv4Bq7PJn9ps4IyDNr2w-BoesQUR0e-G09U84CH96Aav6sp0.jpeg?imwidth=680)
‘Risk of cross border infection’ as dangerous new Mpox strain reaches major DRC city
Analysis suggests the variant with ‘pandemic potential’ – thought to be circulating widely since last year – has now spread further afield
![Lushagala IDP camp near Goma, with Lake Kivu in the background](/https/www.telegraph.co.uk/content/dam/global-health/2024/07/12/TELEMMGLPICT000339554227_17207827488300_trans_NvBQzQNjv4Bq7PJn9ps4IyDNr2w-BoesQUR0e-G09U84CH96Aav6sp0.jpeg?imwidth=680)
At least 25 people have contracted a dangerous new strain of mpox in a major city in the east of the Democratic Republic of Congo, raising fears that the virus could cross international borders.
Mpox – previously known as monkeypox – sparked a global epidemic in 2022, when it spread to more than 100 countries, predominantly affecting gay and bisexual men.
But the DRC is struggling to control a much deadlier form of the virus, known as “clade 1”, which kills up to 10 per cent of those infected. The country has reported over 11,000 cases so far this year, killing 443 people – the vast majority of them children.
But in April, alarm bells were raised when scientists identified a new strain of mpox with “pandemic potential” in Kamituga, a poor and densely packed gold mining town with a highly itinerant population and a substantial sex trade in the province of South Kivu.
Dubbed clade 1b, the virus appears to be better at spreading between people, predominantly through sexual contact, and has mutations that evade detection by some existing tests.
![Water is in scarce supply in all the IDP camps and regular deliveries are required](/https/www.telegraph.co.uk/content/dam/global-health/2024/07/12/TELEMMGLPICT000339554731_17207826703550_trans_NvBQzQNjv4BqpVlberWd9EgFPZtcLiMQf0Rf_Wk3V23H2268P_XkPxc.jpeg?imwidth=350)
Analysis now suggests that the strain has been circulating widely in South Kivu since October 2023. But there are also worrying signs that it has spread further afield – and closer to the border with Rwanda and Burundi – as health authorities this week confirmed 25 cases in the city Goma, a major hub in North Kivu.
“There is a risk that the outbreak could go outside the country, and that risk is increasing,” Dr Placide Mbala-Kingebeni, head of epidemiology and global health at the University of Kinshasa, told the Telegraph.
He added that he is especially concerned that more than a dozen of the cases in Goma were detected in displacement camps, where hundreds of thousands of people who have fled nearby conflict are living in cramped conditions.
“You know how people live in these camps, with poor sanitary conditions, these factors that can lead to a large outbreak in this area,” Dr Mbala said.
“As Goma is connected to other countries – not just Burundi, Rwanda, Kenya and Tanzania, but there are also flights to Europe – there’s also a potential risk of an outbreak outside the continent.”
At a press conference earlier this week Dr Tedros Adhanom Ghebreyesus, head of the World Health Organisation, reiterated that mpox “remains a global health threat” and that the outbreak in the DRC “shows no sign of slowing”.
“There is a risk of cross border, of the virus continuing to move, because borders are very porous with neighbouring countries,” added Dr Rosamund Lewis, the WHO’s technical lead for mpox, warning that she is “very concerned” about the situation.
Although the DRC recently approved mpox vaccines to combat the upsurge in infections, none are currently available outside of clinical trials and it is not clear when this will change, nor how many will be delivered.
But recent analysis by Dr Mbala’s consortium, published as a preprint on Virological, demonstrates just how difficult the virus is to control. At the start of the epidemic there were 10 cases each week in South Kivu but the number has now swelled to more than 160.
Dr Mbala said there have now been more than 2,000 cases across the region, which had never before seen widespread mpox outbreaks. While not all infections have been sequenced, he suspects the vast majority are clade 1b.
In the preprint, scientists also tracked three early cases in Goma detected in June. The individuals had no epidemiological links, showing there have been multiple spillovers from South Kivu and reiterating how closely connected the regions are.
Yet Dr Mbala stressed that focus should not be on clade 1b alone – although the strain appears highly contagious, clade 1 appears deadlier and is killing hundreds of children.
“While we are orienting to understand clade 1b, we should not be distracted from the worse situation in endemic regions, where we see a growing number of cases of clade 1 with high mortality,” he said.
“At the moment, clade 1b seems more transmissible and easier to go through sexual contact, but clade 1 remains more dangerous and associated with higher mortality.”
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