Though the political leadership of DRC has declared their Mpox outbreak at an end… it seems the politicians are referring only to the more benign clade II, unmutated. Clade IIb lineage A2.2, which shows markers of both I and II, is no doubt still circulating — as a mutated form — in DRC, and now Sierra Leone — according to the Journal of Nature authors, here.
We will keep out eye on this, but without strong vaccination protocols, this will likely hop across country borders — and eventually, across continents. As we’ve seen in at least the NYC area, last month, in one case. Here’s the journal abstract, and a bit more:
…In 2022, monkeypox virus (MPXV) clade IIb emerged resulting in a global epidemic driven by human-to-human transmission, mostly through sexual contact mainly among the population of men who have sex with men. To date, published data on the circulation of MPXV clade IIb in the central African region are absent. Here we describe a case of laboratory-confirmed mpox clade IIb lineage A2.2 in Pointe-Noire, the second largest city of the Republic of the Congo. Whole-genome phylogenetic analysis placed the MPXV in clade IIb, lineage A.2.2 currently emerging in West Africa, in particular Sierra Leone. An additional 16 cases of clade Ia, 32 cases of clade Ib and one additional introduction of clade IIb were identified by passive surveillance in the Republic of the Congo in 2025.
The detection of clade IIb mpox marks the third distinct MPXV clade and lineage co-circulating in the human population, together with clade Ia and Ib. This underscores the need for improved surveillance and diagnostic strategies to identify the respective clade and lineage circulating in the human population. Strengthening of regional capacity for case detection, contact-tracing, public health measures and affordable vaccines are urgently needed to reduce the global risk for both clade I and clade II MPXV…
In August 2024, because of the rapidly rising number of mpox cases caused by clade Ia and Ib in the DRC and neighboring countries, Africa CDC listed mpox as a Public Health Emergency of Continental Security. Subsequently, the World Health Organization declared mpox a Public Health Emergency of International Concern for the second time since 2022.
Currently West Africa, and in particular Sierra Leone, is facing a major mpox clade IIb outbreak of a new clade IIb lineage A.2.2.1 virus derived from Nigerian A.2.2 viruses. Similar to what has been observed for clade Ib, transmission by heterosexual contact appears to be one of the drivers of this epidemic. . . .
Do be very careful out there [and the lower graphic is a reference to the 1970s sci-fi clunker “The Andromeda Strain” — when live smallpox was found in an abandoned fridge storage container at NIH. . . yikes]. Onward.
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