A novel monkeypox virus has caused a large outbreak in the Kamituga mining region of the Democratic Republic of the Congo , which has highly mobile populations that could spread the disease to neighboring countries.Researchers and public health officials in Africa are intensifying their battle against mpox, a neglected infectious disease that long has circulated on the continent and suddenly gained notoriety in 2022 when it started to spread rapidly in Europe and North America.
The sexual spread of mpox surprised many. Dimie Ogoina, a clinician at Niger Delta University in Nigeria, was the first to see mpox patients with genital lesions 7 years ago. Now sexual transmission has been shown to occur in the DRC as well. The outbreak in Kamituga, which started in October 2023, involved 250 suspected cases in the first 5 months, and of 108 people with a confirmed infection, 85% had genital lesions and 29% were sex workers, according to the medRxiv preprint.
Elsewhere in the DRC, most mpox infections occur in children, who for unclear reasons are also more likely to die from the disease than other age groups, infectious disease modeler Lilith Whittles from Imperial College London told the meeting. This year, the case fatality was 13.4% in the under-5 range, versus 5.9% in 5- to 15-year-olds and 4.3% in those older than 15.
Offering shots to sex workers and MSM may seem an obvious choice, but stigma and antihomosexuality laws make it difficult to target those groups. “This requires a nuanced and culturally sensitive approach,” says Jean Nachega, an epidemiologist at the University of Pittsburgh of Congolese origin who co-authored the preprint about the Kamituga outbreak.
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