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JUA KIVU: Overview of the proposal, showing 5 research work packages, project management, and the foundational work for locally embedded outbreak research, with training of local researcher (grey shaded area) and direct involvement of local public health actors (blue shared area). A small part of the studies will be performed in the expert reference labs outside the region.

The WHO declared mpox (formerly known as monkeypox) a public health emergency of international concern for the second time in August 14, 2024. The reason for this is the increase of cases in the Democratic Republic of the Congo (DRC) and the newly reported clade Ib spreading to neighboring countries (Mpox outbreak). Mpox is a viral disease that primarily spreads through close (sexual) contact with an infected person and can cause severe illness. Symptoms include a painful rash, swollen lymph nodes, and fever.

We recently discovered a new strain of the virus (Link to article), now known as Clade Ib, which is spreading rapidly across Central Africa, including DRC, Uganda, and Burundi. Furthermore, we have developed a novel PCR-based assay capable of detecting this new strain (Link to article). However, many open questions remain, necessitating the urgent need for more research. We need more information about how this new clade spreads, where it came from, how it adapts, what the risk population is, and how to detect outbreaks early.

In JUA KIVU, five local African partners from the Democratic Republic of Congo (DRC), Burundi, Rwanda, and Tanzania collaborate with three European partners from the Netherlands, Denmark, and Spain. We aim to:

  1. Study how the virus is spreading by on-site whole-genome sequencing.
  2. Investigate the origin of the virus by examining bush meat and serum samples from hunters.
  3. Investigate the potential role of viral and/or bacterial co-infections.
  4. Determine the extent of the outbreak through serology and wastewater surveillance in the cross-border regions.
  5. Set up antibody assays and study the immune response to the virus in selected populations.
  6. Assess household-level transmission dynamics and risk factors.

We have the skills and permissions needed to conduct this research, and we are working with health authorities across borders. Ultimately, our goal is to understand virus evolution and spread, to determine the extent of the outbreak among risk groups, and to develop new methods for early detection, including for secondary infections. Most of the data collection and analysis will be done locally, helping to build capacity for future epidemics.