Mpox crossing borders in east Africa, new variant amid DRC conflict worrying – experts

The DRC, Rwanda and Burundi have detected cases of a new mpox variant (NIH-NIAID/IMAGE POINT FR/BSIP/Universal Images Group via Getty Images)

• The DRC, Rwanda and Burundi have detected cases of a new mpox variant.
• Conflict in the eastern DRC is adding to the difficulty in containing it.
• Post-exposure vaccine trials for mpox are set to start in the DRC, Uganda, and Nigeria.

Public health experts are concerned a new variant of mpox, the clade I virus that emerged last year in the eastern Democratic Republic of the Congo (DRC), could spread further into the East African Community (EAC) and SADC.

So far, Burundi and Rwanda have recorded cases linked to North Kivu in the DRC.

Last week, health officials in Burundi said they had detected two cases in Bujumbura and one in Isare.

In Rwanda, two cases among refugees that were traced back to the conflict-hit North Kivu were detected.

The Rwanda Biomedical Center’s public health surveillance and emergency preparedness and response head, Edson Rwagasore, told journalists Rwanda could trace, contain and test communities.

But there is concern of it spreading throughout the region.

Burundi, Rwanda, and Tanzania are tightly connected, and Uganda and South Sudan could also be at risk.

READ | Hammanskraal pupil tests negative for mpox, Dept of Health confirms

EAC deputy secretary-general Andrea Aguer Ariik Malueth said in a statement member states should share information about Mpox and assist each other.

“The EAC partner states must provide necessary information about the disease and take preventive measures,” he added, saying “factual risk communication, community engagement and enhanced surveillance were crucial steps to managing the disease”.

The Deutsche Gesellschaft für Internationale Zusammenarbeit, a German government public health development wing, and the Africa CDC have trained experts to be deployed to disease hot spots as needed.

DRC conflict a driver

The World Health Organisation (WHO) reported since 2022, the DRC documented more than 21 000 cases and more than 1 000 Mpox deaths. 

Last year, 14 626 cases and 654 deaths were reported. From January to May this year, 7 851 cases and 384 deaths had been recorded. 

Children under the age of five make up 39% of those infected, and they also account for some two-thirds of the deaths.

With the clade I virus increasingly seen, cases have been detected in communities displaced by an insurgency dominated by M23 rebels. 

The conflict also presents a challenge for surveillance and testing activities.

“Large-scale population movements, internally displaced population movements, insecure settings – these all bring associated risks, but also the facts that not all cases are reported, or not necessarily detected,” WHO mpox specialist Dr Rosamund Lewis said at a press briefing. 

New framework for mpox

A clinical trial of the post-exposure mpox vaccine, called the Bavarian Nordic mpox vaccine, is set to get under way soon.

Trials will be conducted mainly in the DRC, Uganda, and Nigeria. 

In a statement, Dr Richard Hatchett, the CEO of the Coalition for Epidemic Preparedness Innovations, which spearheads the research, explained why they were going for the post-exposure vaccine.

“While healthcare workers typically vaccinate somebody before they are at risk of infection, post-exposure vaccinations allow for a more targeted approach, minimising use of vaccine supply.

“Here, individuals in high-risk groups – such as household contacts of an index case – are vaccinated to potentially reduce the risk of infection, improve survival odds and stop onward chains of transmission,” he said.

Recent experience and studies have changed health experts’ understanding of mpox transmission.

It started as a zoonotic disease but there were a notable increase of cases passed from person to person.

The News24 Africa Desk is supported by the Hanns Seidel Foundation. The stories produced through the Africa Desk and the opinions and statements that may be contained herein do not reflect those of the Hanns Seidel Foundation.