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Clade Ib Mpox in the Democratic Republic of the Congo (DRC): clinical and virological report of the first case in Kinshasa, the capital city
MPXV
Sep 5
1 / 1
Sep 5
1d
Eddy_K.Lusamaki
1d
Since 2005, there have been eight public health emergency of international concern (PHEIC) declarations. The tow last are related to mpox outbreaks, the first one from 2022-2023with clade IIb that spread globally in more than 100 countries and more recently since 14th august 2024 an outbreak with clade Ib (WHO, 2024). The current declaration followed the declaration of a Public Health Emergency of Continental Security (PHECS) by Africa CDC on August 13th and both were consecutive to the concerning expansion of outbreaks with clade in DRC, especially clade Ib, firstly described in September 2023 in Kamituga, a mining city in the South Kivu province and driven by transmission through sexual contact (Masirika et al., 2024; Vakaniaki et al., 2024; WHO, 2023). Since 2023, the number of mpox cases in DRC peaked above 14000 and were reported from new foci in large urban areas and transportation hubs, including Kinshasa (the capital city of the DRC). The first cases described in 2023 in the capital were all clade Ia which were linked to strains circulating in Equateur, Sud-Ubangi and Maindombe’s provinces (Kinganda Lusamaki et al., 2024). Here, we present a first case of mpox infection with clade Ib in Kinshasa, DRC.
On July 1st, 2024, we investigated a young adult woman in Ngiri-Ngiri health zone who presented mpox like lesions. The patient reported no contact with living or death animals nor consumption of meat (smoked). However, she reported an occasional sexual contact with a long-time friend in Kinshasa prior the start of the lesions. The casual partner who lives in Matadi, 360 kilometers west of Kinshasa, reported a rash 3 days after the lesions appeared on the young adult woman while he was already in South Africa where he received treatment.
The patient (young adult women) showed a polymorphism of dermatological lesions, with at least 300 counted, dominated by pustular and papular lesions, apart from a few bullous lesions on the soles of the feet. Rashes started to appear around the genital area and upper limb, and gradually spread throughout the body. The lesions were predominantly on the face, upper limbs, trunk and a particularly aspect in genital area. On the face and lower limbs, the lesions were pustular, umbilicated and mostly surmounted by crusty lesions; on the other hand, the same lesions were more or less tense on the extremities of the upper limbs. In the anogenital region, there were a few isolated opalescent bullous lesions on the inner surfaces of the labia majora, associated with a swelling mimicking lymphedema of the labia majora, slightly tender to palpation; while on the pubis, bullous lesions overhung the labia majora, extending slightly towards the left labia majora. An erythematous scaly placard covered almost the entire perineo-inguinocrural region, marked by whitish coatings at the bottom of two inguinocrural folds.
In general, mucous membranes were affected, except the oral mucosa. Eyes were affected, mainly the left eye which showed mucopurulent secretions adherent to the eyelashes. Diffuse conjunctival hyperemia was more marked on the left and discrete on the right. Palpebral statics were conserved; loupe examination of the right eye showed diffuse conjunctival hyperemia inferiorly, and a clear cornea; whereas on the left eye, mucopurulent secretions were abundant in the conjunctival dead end and adherent to the eyelashes. In addition, there was a subconjunctival para-limbic nodule, located in the supero-nasal quadrant, and two others in the supero- and infero-nasal quadrants. The Fluorescein test was positive on peri-limbal mucocorneal lesions and submucosal nodules. Fundus examination was normal in both eyes, after observation by a specialist ophthalmologist.
more.....
MPXV
Sep 5
1 / 1
Sep 5
1d
Eddy_K.Lusamaki
1d
Since 2005, there have been eight public health emergency of international concern (PHEIC) declarations. The tow last are related to mpox outbreaks, the first one from 2022-2023with clade IIb that spread globally in more than 100 countries and more recently since 14th august 2024 an outbreak with clade Ib (WHO, 2024). The current declaration followed the declaration of a Public Health Emergency of Continental Security (PHECS) by Africa CDC on August 13th and both were consecutive to the concerning expansion of outbreaks with clade in DRC, especially clade Ib, firstly described in September 2023 in Kamituga, a mining city in the South Kivu province and driven by transmission through sexual contact (Masirika et al., 2024; Vakaniaki et al., 2024; WHO, 2023). Since 2023, the number of mpox cases in DRC peaked above 14000 and were reported from new foci in large urban areas and transportation hubs, including Kinshasa (the capital city of the DRC). The first cases described in 2023 in the capital were all clade Ia which were linked to strains circulating in Equateur, Sud-Ubangi and Maindombe’s provinces (Kinganda Lusamaki et al., 2024). Here, we present a first case of mpox infection with clade Ib in Kinshasa, DRC.
On July 1st, 2024, we investigated a young adult woman in Ngiri-Ngiri health zone who presented mpox like lesions. The patient reported no contact with living or death animals nor consumption of meat (smoked). However, she reported an occasional sexual contact with a long-time friend in Kinshasa prior the start of the lesions. The casual partner who lives in Matadi, 360 kilometers west of Kinshasa, reported a rash 3 days after the lesions appeared on the young adult woman while he was already in South Africa where he received treatment.
The patient (young adult women) showed a polymorphism of dermatological lesions, with at least 300 counted, dominated by pustular and papular lesions, apart from a few bullous lesions on the soles of the feet. Rashes started to appear around the genital area and upper limb, and gradually spread throughout the body. The lesions were predominantly on the face, upper limbs, trunk and a particularly aspect in genital area. On the face and lower limbs, the lesions were pustular, umbilicated and mostly surmounted by crusty lesions; on the other hand, the same lesions were more or less tense on the extremities of the upper limbs. In the anogenital region, there were a few isolated opalescent bullous lesions on the inner surfaces of the labia majora, associated with a swelling mimicking lymphedema of the labia majora, slightly tender to palpation; while on the pubis, bullous lesions overhung the labia majora, extending slightly towards the left labia majora. An erythematous scaly placard covered almost the entire perineo-inguinocrural region, marked by whitish coatings at the bottom of two inguinocrural folds.
In general, mucous membranes were affected, except the oral mucosa. Eyes were affected, mainly the left eye which showed mucopurulent secretions adherent to the eyelashes. Diffuse conjunctival hyperemia was more marked on the left and discrete on the right. Palpebral statics were conserved; loupe examination of the right eye showed diffuse conjunctival hyperemia inferiorly, and a clear cornea; whereas on the left eye, mucopurulent secretions were abundant in the conjunctival dead end and adherent to the eyelashes. In addition, there was a subconjunctival para-limbic nodule, located in the supero-nasal quadrant, and two others in the supero- and infero-nasal quadrants. The Fluorescein test was positive on peri-limbal mucocorneal lesions and submucosal nodules. Fundus examination was normal in both eyes, after observation by a specialist ophthalmologist.
more.....
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