2024-09-24 12:00:14
The Public Health Emergency of International Concern was declared in August by the World Health Organization (WHO) due to an unprecedented outbreak of mpox in the eastern Democratic Republic of Congo (DRC), in Kivu, and in border countries previously free of the disease. A new subclade 1b of the virus has appeared in the area, confirming the now strictly human-to-human transmission of this disease, formerly called “monkey pox”. Since September 2023, the start of the current epidemic, the DRC has reported more than 15,000 suspected cases of mpox, far from the 4,000 cases reported in previous years.
Although this epidemic worries the international community, it is not the first time that mpox, a hitherto neglected disease, has emerged from its African cradle.
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In 2003, cases appeared in children in the United States, with lesions on the hands and a case of encephalitis. The investigation made it possible to trace the chain of contamination back to prairie dogs, themselves contaminated in a pet store by Gambian rats coming from Ghana. The virus was therefore identified in animals coming from a country where no animal or human cases of mpox had been reported. A revealing of the involvement of the live animal trade in the occurrence and dissemination of viruses.
Crossing the barrier between species
The global mpox epidemic of 2022 surprised the international community, then convinced that it was a primarily zoonotic disease, occurring in forested areas of Africa. This time, the epidemic was spreading within the Western homosexual community. Since 2017, in Nigeria, genital forms of this disease have also appeared in young men in urban areas: an epidemiological change insufficiently taken into account internationally.
In 2017, a first case was detected in Port Harcourt, a southern palm oil producing city, thirty-nine years after the last human case of mpox occurred in this country. Genomic studies suggest that the crossing of the barrier between species would have taken place in 2014 in two Nigerian regions characterized by oil palm plantations. This intensive exploitation causes a massive simplification of ecosystems, with extinctions of specialist species and proliferations of opportunistic species such as rodents. Palm nuts are indeed very popular with small tree squirrels suspected of being the reservoir of mpox.
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