Dangerous Monkeypox Virus Strain Spreads Through Sex, Raises Fears of a Global Outbreak

On July 23, 2022, officials from the World Health Organization (WHO) declared monkeypox as a public health emergency of international concern. At the time, the majority of reported cases were in the European region. Just recently, a new discovery has alarmed experts who fear a reprise of this global outbreak.

Dangerous Monkeypox Strain

New data suggests that a virulent strain of the monkeypox has developed the ability to spread through sexual contact. Also known as clade I, this strain is more lethal than the other strain that sparked the 2022 outbreak.

For several decades, clade I has caused small outbreaks, but they were often limited to a few households of communities, particularly in Central Africa. Before last year, sexually acquired clade I infections had not been reported.

Beginning in late 2023, however, a clade I strain showed potential of getting spread through sexual contact, causing a cluster of infections in the Democratic Republic of the Congo (DRC). It was reported that 241 suspected and 108 confirmed infections are connected to this outbreak. Since the testing capacity is limited, experts assume that there are probably many more cases. Nearly 30% of the confirmed infections were found in sex workers.

Adding to these challenges is the fact that the conflict-ridden region is currently facing a humanitarian crisis, and the country is struggling with the aggressive spread of other diseases, like cholera. According to epidemiologist Anne Rimoin from the University of California, this combination means that there is a considerable risk of outbreak elevation beyond the current area.

Disregarded Warnings

Monkeypox is considered a zoonotic disease, which means that it can spread between humans and animals. Its exact source in nature is not known, although scientists believe that small mammals, like rope and sun squirrels, African dormice and giant-pouched rats may transmit the virus in the regions of West and Central Africa. In 2022, the disease was renamed mpox in order to prevent stigma.

The mpox virus can cause painful, fluid-filled lesions on a person's skin. In severe cases, it can ultimately lead to a person's death.

It was in 2017 when experts received the first large reported outbreak in Nigeria with human-to-human transmission. It was caused by clade II strain which is less virulent than clade II. The outbreak caused over 200 confirmed and 500 suspected cases. At the time, scientists warned that this strain might have adapted to spread through sexual contact. Unfortunately, their cautions were not heeded. As a result, the outbreak is still ongoing, and has infected over 95,000 people and killed more than 180.

Mpox infections have decreased globally since 2022, but they have shown a rising trend in the DRC. In 2023, the country reported over 14,600 suspected cases and over 650 deaths. In September, a new cluster of suspected clade I infections arose in the South Kivu province in DRC. According to virologist Nicaise Ndembi from AFrica Centres for Disease Control and Prevention, this trend could lead to faster human-to-human spread, likely with few symptoms.

In response to this, representatives of the DRC and 11 nearby nations met earlier this month to plan a response and to commit to stepping up virus surveillance. The WHO and the CDC have also committed to help procure equipment which will enable rapid diagnosis of the disease.