The time is now (again) for mpox containment and elimination in Democratic Republic of the Congo

Mpox, a zoonotic disease caused by monkeypox virus (MPXV), was first identified in humans in the Democratic Republic of the Congo (DRC) in 1970 [1–3]. MPXV is subclassified into clade I—formerly Congo Basin (Central Africa) clade, and clade II—formerly West African clade. Clade II comprises two subclades: IIa and IIb, the latter being responsible for the recent global epidemic [4, 5]. Several studies have suggested that clade I infections are associated with greater disease severity compared to clade II [6, 7].Rapid geographic expansion of MPXV across non-endemic regions of the globe resulted in the first global mpox epidemic from 2022–2023 and the declaration of a public health emergency of international concern by the World Health Organization (WHO). While zoonosis has historically been the primary driver of infections in humans with limited secondary infections through human-to-human contact, >90% of infections were linked to secondary transmission during the 2022 global epidemic, mainly through sexual contact among gay, bisexual, or other men who have sex with men (GBMSM). These observations could represent: i) a recent transition in MPXV transmission and clinical presentation from that seen historically; ii) greater diversity in clinical presentation and transmission than previously described; or iii) a combination thereof.