A new and potentially more infectious variant of mpox Clade 1A has been identified in the Democratic Republic of the Congo (DRC) according to Dr Ngashi Ngongo, head of the mpox incident management team at the Africa Centre for Disease Control and Prevention (Africa CDC).

The termination of USAID funding and violence in eastern DRC are hampering mpox testing and reporting, with test results being reduced to a trickle.

Only 35% of mpox cases are currently being tested in DRC, both because of conflict and the ending of USAID funds to transport mpox tests to laboratories.

The DRC finally started to vaccinate people in Kinshasa this week, and uptake was swift with over 24,800 people vaccinated over four days, said Ngongo.

Mpox is continuing to spread in Uganda, which has seen case increases for three weeks in a row ​​– 278 new cases in the past week.  Mpox cases are overwhelming health facilities. For example, a treatment centre in Entebbe with 80-bed capacity currently has 102 patients.

“Because of this, the leadership in the [Ugandan] Ministry of Health has now opted also to introduce home-based care for non-severe cases,” said Ngongo.

Meanwhile, South Africa reported three mpox cases after being free of the disease for over 90 days.

The World Health Organization resolved this week to keep mpox as a public health outbreak of international concern “based on the continuing rise in numbers and geographic spread, the violence in the eastern DRC, which hampers the response, as well as a lack of funding to implement the response plan”, according to the WHO.

Febrile disease in DRC

DRC health authorities are investigating a febrile disease outbreak in five villages in the Basankusu and Bolomba health zones in Equateur province. This has tripled deaths over the past three weeks, according to WHO.

A total of 943 cases and, 52 deaths have been reported, with symptoms including fever, chills, sweating, headache and muscle pain.\, said Ngongo.

There are no haemorrhagic symptoms and Ebola and Marburg tests are negative, making malaria the most likely cause, he added.

“Children below five years make about 18% of cases with a case fatality of 5.3%. Children ages five to 15 years make up 20% of all cases, with a case fatality of 6.4%,” said Ngongo.

“The diagnostic is pointing towards malaria. Rapid tests that were conducted on over 500 samples gave a positivity rate of 55% but there are also blood smears that were also conducted, around 70 samples, that also gave a positivity rate of almost 78%,” said Ngongo.

“Further tests are to be carried out for meningitis. Food, water and environmental samples will also be analysed, to determine if there might be contamination,” according to the WHO.

“Basankusu and Bolomba are about 180 kilometres apart and more than 300 kilometres from the provincial capital, Mbandaka. The two localities are reachable by road or via the Congo River from Mbandaka. This remoteness limits access to health care, including testing and treatment. Poor road and telecommunication infrastructure are also major challenges,” saif the WHO in a statement.