Post Reply - New emerging Monkeypox strain in Congo

the city of Kamituga

   https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html or https://afludiary.blogspot.com/2024/06/who-multi-country-outbreak-of-mpox.html ;
Last week the CDC held a COCA Call : Mpox - Clinical Management & Outbreaks, as reports of sporadic infections (clade IIb) continue across the nation (see CBS News S.F. officials monitor rise in domestic mpox cases as global outbreak spreads)
At the same time a far more dangerous clade I mpox virus continues to rage in the DRC, which over the past 18 months has been blamed for more than 20,000 suspected mpox cases and more than 1,000 deaths.

The changing epidemiology and genetic evolution of mpox clade I in central Africa has sparked a number of risks assessments over the past six months, including:
CDC HAN Advisory #00501: Mpox Caused by H-2-H Transmission with Geographic Spread in the Democratic Republic of the Congo

ECDC Risk Assessment On Transmission & Spread of Clade I Mpox From The DRC
Last March a study was published Eurosurveillance: Ongoing Mpox Outbreak in South Kivu Province, DRC Associated With a Novel Clade I Sub-lineage, describing the first genomic analysis of samples from a previously unaffected region of the DRC (the city of Kamituga). 
That study revealed a novel clade I sub-linage had emerged - most likely from a zoonotic introduction - with changes that may render current CDC tests unreliable.
A month later, in Preprint: Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo, we saw a further analysis, which called for this new lineage to be named Clade Ib, and warned of its potential to spread globally.  
While that doesn't appear to have happened yet (based on limited reporting), we have been watching the incursion of Mpox into new regions, including a spike in cases recently reported in South Africa. 
As we've seen with COVID, and other infectious disease reporting around the globe, surveillance and reporting on Mpox is often limited, or sometimes missing entirely.  The WHO describes this situation below:
WHO continues to encourage all countries to ensure that mpox is a notifiable disease and to report mpox cases, including reporting when no cases have been detected (known as ‘zero-reporting’, as outlined in the Standing Recommendations on mpox issued by the WHO Director General).
This report does not highlight non-reporting countries. Therefore, it should be noted that an absence of reported cases from a country may be due to the country not reporting, rather than having no cases. Reporting to WHO has been declining, therefore, the decline in reported cases should be interpreted with caution.    
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Report highlights
In May 2024, a total of 646 new laboratory-confirmed cases of mpox and 15 deaths were reported to WHO from 26 countries, illustrating continuing transmission of mpox across the world. The most affected WHO regions, ordered by number of laboratory-confirmed cases, were the African Region, the European Region, the Region of the Americas, the Western Pacific Region and the South-East Asia Region. The Eastern Mediterranean region did not report any cases in May 2024.
As reporting from countries to WHO has been declining, the current reported global data most likely underestimate the actual number of mpox cases.
Within the African Region, the Democratic Republic of the Congo reported most (99%) of the confirmed mpox cases in the reporting month. With limited access to testing in rural areas, 18% of clinically compatible (reported as suspected) cases in the country are tested, therefore the confirmed case counts are underestimates of the true burden.
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Nearly every WHO DON or disease Situation Report contains diplomatic reminders to member nations of their `duty to report' these types of cases under the IHR 2005 agreement, but compliance remains spotty at best. 
Increasingly, the `political' solution to the rise of inconvenient emerging infectious diseases - like Mpox, COVID, MERS-CoV, and novel influenza - is to limit testing, surveillance, and the reporting of cases, and even deaths.  
Like asking your doctor to `touch up your X-rays', this is a strategy that only works for the short term. 

DJ...So-yes-lots of countries failing to even do the basics to avoid pandemics...(I am not going that crazy...)