The World Health Organization (WHO) has officially classified monkeypox (mpox), an infectious disease caused by the monkeypox virus (MPXV), as a sexually transmitted disease (STD). Mpox is endemic to densely forested regions of West, Central, and East Africa, particularly in the northern and central regions of the Democratic Republic of the Congo.
The WHO’s recognition of monkeypox as a sexually transmitted disease coincides with the Democratic Republic of the Congo’s largest-ever outbreak, raising concerns among African scientists that the disease will become more challenging to eradicate. This development is further compounded by the case of a Belgian citizen who contracted monkeypox shortly after visiting the Congo in March 2023.
What is mpox disease?
The monkeypox virus, which causes mpox disease, is transmitted through close contact with infected humans or animals, as well as via materials such as contaminated sheets. It was first discovered in humans in 1970 in the Democratic Republic of the Congo. It can cause a painful rash, enlarged lymph nodes, and a fever. Most people fully recover, but some get very sick.
According to the WHO, since 2022, an epidemic of clade IIb MPXV has been ongoing globally, affecting many countries outside the African continent that had never reported mpox previously. The spread of this epidemic was mainly driven by transmission via sexual contact among men who have sex with men.
The Democratic Republic of the Congo has not reported cases of mpox linked to clade IIb MPXV during the global outbreak to date; only MPXV clade I has been detected in the country. Before April 2023, no formally documented cases of sexual transmission of clade I MPXV were registered globally. The first known cases were reported when a man, resident in Belgium and with connections to the Democratic Republic of the Congo, tested positive for clade I in Kenge, Kwango province, during a visit to the Democratic Republic of the Congo.
Thereafter, sexual contacts in this case in the Democratic Republic of the Congo also tested positive for clade I MPXV, with closely related viral sequences. This is the first time that a reported clade I MPXV infection is linked to sexual transmission within a cluster.
Mpox has long been prevalent in central and west Africa, primarily transmitted to humans from infected rodents, resulting in isolated outbreaks. However, in 2022, an unprecedented surge in cases, primarily driven by sexual contact among men who have sex with men (MSM) in Europe, spread to over 100 countries. The World Health Organization (WHO) declared the outbreak a global health emergency, with over 91,000 cases reported to date.
