Key Takeaways
- The new mpox variant, clade 1b, is more infectious and has spread to multiple countries since its emergence in the DRC.
- There is a significant risk of miscarriage associated with infections among pregnant women, highlighting the need for urgent health measures.
- Cross-border cooperation and increased public awareness are essential to control the spread of the virus in affected regions.
Emerging Concerns Over Mpox Variant Clade 1b
International researchers, including a team from DTU National Food Institute, are sounding alarms over a rapidly spreading mpox outbreak in the Democratic Republic of the Congo (DRC). The new variant, known as clade 1b, was first detected in September 2023 in Kamituga and has shown mutations that enhance its transmissibility among humans.
Genetic analyses have revealed that clade 1b is now more easily transmitted, with three subvariants identified—one of which has already spread beyond DRC borders to countries like Sweden and Thailand. Alarmingly, there is emerging data suggesting a heightened risk of miscarriage for pregnant women infected with this new variant.
Previously regarded as a zoonotic disease—transmitted primarily from animals to humans—mpox has evolved, particularly during the outbreak in 2022, which predominantly affected men who have sex with men. The landscape has shifted with clade 1b, now affecting both genders and showing an increase in cases among healthcare workers and children.
Professor Frank Møller Aarestrup from DTU National Food Institute highlights the similarity of clade 1b to the mutations seen in SARS-CoV-2. “One subvariant appears more adept at human transmission and has now been detected in several countries outside East Africa,” he noted. Additionally, high miscarriage rates have been identified among pregnant women in the study group.
The GREAT-LIFE project, spearheaded by DTU, led to both the identification of clade 1b and the development of a new PCR test specifically designed to detect it—something the original mpox tests could not accomplish.
Efforts to curb further transmission have become increasingly urgent, particularly in densely populated areas where heterosexual contact is prevalent. The current state of clade 1b’s spread is described as “uncontrolled” in eastern DRC and Burundi, though other East African countries are less affected. While international spread has occurred, experts do not anticipate significant outbreaks outside the East African epicenter at this time.
To effectively combat the situation, experts are calling for immediate action, emphasizing the importance of avoiding close contact, especially sexual contact, in high-risk regions. There is a strong call for enhanced cross-border collaboration to monitor disease transmission, treat infections, and educate communities—particularly sex workers—on routes of transmission.
Moreover, local health initiatives must prioritize increased vaccination efforts and public health awareness campaigns. On a global scale, travel advisories could help discourage visits to high-risk areas and intimate contact in those regions.
The GREAT-LIFE project’s focus on improving detection capabilities for viral outbreaks in East Africa coincided with the emergence of clade 1b. This timely initiative has empowered local researchers and healthcare personnel to respond swiftly to the outbreak, fulfilling a critical need for expertise and resources in the region.
Research from this project has analyzed samples from 670 mpox-infected patients, revealing that just over half of those infected were women, with the majority of cases linked to sexual contact. Tragically, seven patients have succumbed to the virus, and eight of 14 tested pregnant women experienced miscarriages. These studies underlined the urgency of addressing the outbreak, particularly in South Kivu province, where clade 1b originated.
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