Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo

  1. Emmanuel Hasivirwe Vakaniaki
  2. Cris Kacita
  3. Eddy Kinganda-Lusamaki
  4. Áine O’Toole
  5. Tony Wawina-Bokalanga
  6. Daniel Mukadi-Bamuleka
  7. Adrienne Amuri-Aziza
  8. Nadine Malyamungu-Bubala
  9. Franklin Mweshi-Kumbana
  10. Léandre Mutimbwa-Mambo
  11. Freddy Belesi-Siangoli
  12. Yves Mujula
  13. Edyth Parker
  14. Pauline-Chloé Muswamba-Kayembe
  15. Sabin S. Nundu
  16. Robert S. Lushima
  17. Jean-Claude Makangara-Cigolo
  18. Noella Mulopo-Mukanya
  19. Elisabeth Pukuta-Simbu
  20. Prince Akil-Bandali
  21. Hugo Kavunga
  22. Ombotimbe Abdramane
  23. Isabel Brosius
  24. Eugene Bangwen
  25. Koen Vercauteren
  26. Nadia A. Sam-Agudu
  27. Edward J. Mills
  28. Olivier Tshiani-Mbaya
  29. Nicole A. Hoff
  30. Anne W. Rimoin
  31. Lisa E. Hensley
  32. Jason Kindrachuk
  33. Cheryl Baxter
  34. Tulio de Oliveira
  35. Ahidjo Ayouba
  36. Martine Peeters
  37. Eric Delaporte
  38. Steve Ahuka-Mundeke
  39. Emma L. Mohr
  40. Nancy J. Sullivan
  41. Jean-Jacques Muyembe-Tamfum
  42. Jean B. Nachega
  43. Andrew Rambaut
  44. Laurens Liesenborghs
  45. Placide Mbala-Kingebeni
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Abstract

Outbreaks of monkeypox (mpox) have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here we describe the epidemiological and genomic features of an mpox outbreak in a mining region in eastern Democratic Republic of the Congo, caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the Democratic Republic of the Congo. Of the 108 polymerase chain reaction-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission.

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  1. Version published to 10.1038/s41591-024-03130-3
  2. Version published to 10.1101/2024.04.12.24305195v2 on medRxiv
  3. Version published to 10.1101/2024.04.12.24305195v1 on medRxiv