New mutant mpox strain discovered in the DRC
March 3, 2025
A new variant of Clade 1a mpox with the APOBEC3 mutation, which may enhance human-to-human transmission, has been identified in the Democratic Republic of Congo (DRC). This raises major public health concerns, as Clade 1a has historically caused more severe disease than other variants. Ongoing conflict in the DRC has further disrupted response efforts, forcing over 500 patients to flee clinics. Testing coverage has plummeted to 35%, and Uganda’s rising cases have overwhelmed hospitals, prompting at-home treatment initiatives. Amid these challenges, the first large-scale vaccination campaign in the DRC has begun, delivering 24,800 doses in four days.
A highly transmissible new variant of Clade 1a mpox, carrying the APOBEC3 mutation, has been identified in the Democratic Republic of Congo (DRC). This discovery signals an alarming shift, as Clade 1a was previously linked to sporadic spillovers from animals with limited human-to-human transmission. While historically more severe than Clade 2 and Clade 1b, the current mortality rate in Kinshasa remains below 1%, likely influenced by factors such as malnutrition and co-infections.
The World Health Organization (WHO) has extended its public health emergency declaration, citing the worsening crisis, ongoing conflict, and inadequate funding. The DRC remains the epicenter, but 14 out of 22 affected African nations are still experiencing active outbreaks, including Uganda and South Africa, where cases are increasing. Uganda alone reported 278 new cases last week, pushing health systems to the brink, forcing the adoption of at-home treatment strategies for less severe cases.
The conflict in eastern DRC has exacerbated the crisis, with over 500 mpox patients fleeing health centers in Goma and Bukavu after the M23 rebels seized control. Healthcare facilities have been looted, equipment destroyed, and testing capacity reduced to just 35% due to the freeze on USAID funding.
Despite these setbacks, the DRC launched its first large-scale mpox vaccination campaign, administering 24,800 doses in just four days. Africa CDC has refined its strategy, focusing both on high-risk areas and contact tracing to curb transmission. However, with testing shortages, ongoing violence, and funding disruptions, the outbreak remains difficult to control, threatening further regional and global spread. Immediate international intervention is needed to prevent further destabilization.