- Vakaniaki, Emmanuel;
- Kacita, Cris;
- Kinganda-Lusamaki, Eddy;
- OToole, Áine;
- Wawina-Bokalanga, Tony;
- Mukadi-Bamuleka, Daniel;
- Amuri-Aziza, Adrienne;
- Malyamungu-Bubala, Nadine;
- Mweshi-Kumbana, Franklin;
- Mutimbwa-Mambo, Léandre;
- Belesi-Siangoli, Freddy;
- Mujula, Yves;
- Parker, Edyth;
- Muswamba-Kayembe, Pauline-Chloé;
- Nundu, Sabin;
- Lushima, Robert;
- Makangara-Cigolo, Jean-Claude;
- Mulopo-Mukanya, Noella;
- Pukuta-Simbu, Elisabeth;
- Akil-Bandali, Prince;
- Kavunga, Hugo;
- Abdramane, Ombotimbe;
- Brosius, Isabel;
- Bangwen, Eugene;
- Vercauteren, Koen;
- Sam-Agudu, Nadia;
- Mills, Edward;
- Tshiani-Mbaya, Olivier;
- Hoff, Nicole;
- Rimoin, Anne;
- Hensley, Lisa;
- Kindrachuk, Jason;
- Baxter, Cheryl;
- de Oliveira, Tulio;
- Ayouba, Ahidjo;
- Peeters, Martine;
- Delaporte, Eric;
- Ahuka-Mundeke, Steve;
- Mohr, Emma;
- Sullivan, Nancy;
- Muyembe-Tamfum, Jean-Jacques;
- Nachega, Jean;
- Rambaut, Andrew;
- Liesenborghs, Laurens;
- Mbala-Kingebeni, Placide
Outbreaks of monkeypox (mpox) have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here we describe the epidemiological and genomic features of an mpox outbreak in a mining region in eastern Democratic Republic of the Congo, caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the Democratic Republic of the Congo. Of the 108 polymerase chain reaction-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission.
