Mpox Outbreak in the Democratic Republic of the Congo

Recent CDC reports confirm mpox is being spread globally.  Mpox a member of the Orthopoxvirus genus, related to smallpox. Mpox is further delineated into two clades, Clade I and Clade II, formerly named by the geographic location where each was found, Congo-Basin and West African clades, respectively. A large outbreak of Clade I has been confirmed in humans in the Democratic Republic of the Congo (DCR) and surrounding urban areas in 2023. This outbreak is of concern due to the higher mortality and treatment resistance as compared to Clade II.

Both clades can be transmitted from an infected animal to a human through contact, scratch, bite, or handling of infected tissues (squirrels, rats, monkeys, primates, prairie dogs, hedgehogs, pigs, and mice). Human-to-human transmission typically occurs through respiratory droplets, close contact with infected persons, and/or drainage from sores or lesions.  Initial signs and symptoms of mpox can be very vague such as headache, fever, cough, muscle aches, and summarized as a general flu-like illness. With an incubation period of 5-21 days, healthcare workers need to be educated on signs and symptoms as well as at-risk populations, especially those with recent travel to areas with known or suspected or confirmed outbreaks.

The potential risk of an mpox clade I global outbreak is a real-time concern. Areas like DRC, with limited health resources, face challenges with health education, appropriate diagnosis, and availability of treatments, including limited disease surveillance and control measures. The presence of mpox Clade I underscores the importance of strengthening world health systems in such regions to effectively detect, respond to, and manage emerging infectious diseases. With the modern ease and accessibility of intercontinental travel, public health officials need to be on alert at all times. 

Cases reported in the US have all belonged to mpox Clade II, and mostly been Clade IIb. The majority of cases have been community-acquired and control measures such as vaccination have been implemented. Proper awareness, education, and treatments are available and have been shown to have positive impacts on reducing cases.  First, community awareness must take place by assuring at-risk populations are educated on the facts of the virus and how it is transmitted. Currently, at-risk populations have been identified, but not limited to, immunocompromised males, between the ages of 31-45, who engage in same-sex relations, especially when no barrier protection is used. This is due to close contact with unprotected skin and possibly a lack of awareness of sores or lesions. Secondly, at-risk populations need to be made aware of the available preventative measures available. Currently, there is a vaccine that shows effectiveness after just two doses. Vaccines are available to the public through most county health systems. Outbreaks can be managed through proactive prevention, prompt identification, and effective medical interventions.

Malinda Ruelas is a Research Nurse with SPECTRE 







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