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. 2025 Nov 15;5(1):496.
doi: 10.1038/s43856-025-01203-z.

First imported cases of MPXV Clade Ib from Goma, Democratic Republic of the Congo

Daniel Mukadi-Bamuleka  1   2   3 , Eddy Kinganda-Lusamaki  4   5   6 , Noella Mulopo-Mukanya  7 , Adrienne Amuri-Aziza  5 , Áine O'Toole  8 , Sydney Merritt  9 , Brigitte Modadra-Madakpa  7 , Guy Mutombo-Ndongala  10 , Emmanuel Hasivirwe Vakaniaki  5 , Cris Kacita  11 , Gaston Lubambo Maboko  10 , Jean-Claude Makangara-Cigolo  4   5   12 , Michel Ngimba  7 , Emmanuel Lokilo-Lofiko  5 , Elisabeth Pukuta-Simbu  5 , Gradi Luakanda-Ndelemo  5 , Tavia Bodisa-Matamu  7 , Zephanie Paluku-Kalimuli  7 , Prince Akil-Bandali  5 , Sifa Kavira-Bapitani  5 , Daan Jansen  13 , Adèle Kavira-Kamaliro  7 , Emile Muhindo-Milonde  7 , Jeriel Mufungizi  7 , Yves Birindwa-Hamisi  7 , Hugo Kavunga  7 , Olivier Tshiani  5 , Sabin Sabiti Nundu  5 , Laurens Liesenborghs  13   14 , Nicole A Hoff  9 , Megan Halbrook  9 , Robert Shongo  11 , Ahidjo Ayouba  6 , Genay Pilarowski  15 , Alain Kakule Mangolopa  16 , Amos Kiuka Ebondo  16 , Nicola Low  17 , Souradet Y Shaw  18   19 , Sam Wilkinson  20 , Sofonias Kifle Tessema  21 , Lorenzo Subissi  22 , Eric Delaporte  6 , Koen Vercauteren  13 , Tony Wawina-Bokalanga  4   5   13 , Anne W Rimoin  9 , Lisa E Hensley  23 , Martine Peeters  6 , Nicholas Loman  20 , Andrew Rambaut  8 , Jean-Jacques Muyembe-Tamfum  4   5 , Jason Kindrachuk  24   25 , Placide Mbala-Kingebeni  26   27   28   29 , Steve Ahuka-Mundeke  4   5
Affiliations

First imported cases of MPXV Clade Ib from Goma, Democratic Republic of the Congo

Daniel Mukadi-Bamuleka et al. Commun Med (Lond). .

Abstract

Background: The ongoing mpox outbreaks in the Democratic Republic of the Congo (DRC) resulted in >71,000 suspected cases from 01 January 2024 to 02 February 2025. Clade Ib mpox virus (MPXV) emergence has heightened public health concern due to observed sustained human-human transmission and spread to multiple non-endemic East African countries. Clade Ib outbreaks have been marked by epidemiologic deviations from classic Clade Ia zoonotic transmission-Clade Ib instead has been observed among adult populations and transmission via sexual contact. With the continued expansion of Clade Ib across the region, containment and mitigation measures may need to be adapted to best fit this novel MPXV clade.

Methods: Case investigation and epidemiological assessment data as well as whole viral geonome sequencing was analyzed from confirmed mpox infected individuals in the Goma region. Case demographics and clinical presentation data was also assessed from suspected mpox cases in the region.

Results: We report the first introduction of Clade Ib into North Kivu province through close contact transmission. We also report limited human-human Clade Ib transmission chains among children <15 years in the Mudja internal displaced persons camp. We further present evidence of APOBEC3 mutations and genomic links between these North Kivu cases with the larger ongoing Clade Ib outbreak in Kamituga, South Kivu.

Conclusions: Given the expansion of regional mpox outbreaks and populations considered at-risk, these findings underscore how mpox case investigations and community messaging should include considerations for non-sexual human-human transmission of Clade Ib that includes children <15 years.

Plain language summary

Mpox virus, which is endemic in tropical, forested regions of Central and West Africa, has resulted in mpox outbreaks in the Democratic Republic of the Congo (DRC) with historic infections, including more than 71,000 suspected cases reported between January 2024 and February 2025. In recent years, shifting clinical and epidemiological characteristics have been reported for Clade I Mpox virus (MPXV), which is endemic in DRC. This includes the emergence of a new subclade, Clade Ib MPXV, first identified in South Kivu, DRC, in 2023. We report the first introduction of Clade Ib into North Kivu province through close contact transmission. This includes limited human-human transmission of MPXV among children in an internally displaced persons camp, raising concerns regarding undetected transmissions among these vulnerable groups. We further present evidence for links between these North Kivu cases with the larger ongoing outbreak in Kamituga, South Kivu. These findings underscore how mpox case investigations and community messaging should include considerations for non-sexual human-human transmission of Clade Ib that includes children and vulnerable populations.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Geographic locations of cases identified in North Kivu, including the Mudja displacement camp.
Map constructed using QGIS3.22.11. The fading red coloring on the inset signifies the three Goma health zones where the sequenced samples originated from. The star representing the Mudja (or Muja) camp location within the Nyiragongo health zone, utilizing coordinates from Google maps and OpenStreetMap.
Fig. 2
Fig. 2. Epidemiological linkages and suspected transmission chains among Clade Ib mpox cases identified in Goma, North Kivu, DRC.
Transmission chain at the Division Provincial de la Santé (DPS), North Kivu. Clade Ib MPXV has been confirmed for Cases 1–3, and results are pending for cases 4–9 at this time.
Fig. 3
Fig. 3. A maximum likelihood tree constructed using IQ-Tree 2 with the HKY substitution model.
We included a Clade Ia genome as an outgroup and then removed it after rooting. Single-nucleotide mutations are reconstructed and displayed, denoting whether they are APOBEC3-mediated (red bars) or other mutations (blue bars). Genomes from recent cases in Goma, North Kivu, are denoted with yellow circles. Patients 1 and 2 each have multiple genomes sequenced from different samples. Blue circles are genomes from Kamituga, South Kivu, from October and December 2023, and January 2024. Letters in parentheses are referenced in Table 2.
Fig. 4
Fig. 4. Clade Ib Timetree.
The Clade Ib Timetree was built with https://github.com/nextstrain/mpox, showing 174 genomes, including 18 from North Kivu in moderate cyan (6 from the first cases described in Fig. 3 and 12 generated later), 141 from South Kivu in moderate blue, 5 from Kinshasa in lime green, and 10 from other countries in other colors. To note that this is a subtree, and the overall tree has been built with 598 genomes.
Fig. 5
Fig. 5. Phylogeographic relationship between clade Ib genomes.
To note, South Kivu genomes have been filtered out for visualization purpose.
See this image and copyright information in PMC

Update of

  • First imported Cases of MPXV Clade Ib in Goma, Democratic Republic of the Congo: Implications for Global Surveillance and Transmission Dynamics.
    Mukadi-Bamuleka D, Kinganda-Lusamaki E, Mulopo-Mukanya N, Amuri-Aziza A, O'Toole Á, Modadra-Madakpa B, Ndongala GM, Vakaniaki EH, Merritt S, Kacita C, Maboko GL, Makangara-Cigolo JC, Ngimba M, Lokilo E, Pukuta-Simbu E, Luakanda G, Bodisa-Matamu T, Kalimuli ZP, Akil-Bandali P, Kavira S, Jansen D, Kamaliro AK, Muhindo-Milonde E, Mufungizi J, Hamisi YB, Kavunga H, Tshiani O, Nundu SS, Liesenborghs L, Hoff NA, Nachega J, Shongo R, Ayouba A, Pilarowski G, Mangolopa AK, Ebondo AK, Low N, Shaw SY, Wilkinson S, Tessema SK, Subissi L, Delaporte E, Vercauteren K, Wawina-Bokalanga T, Rimoin AW, Peeters M, Loman N, Rambaut A, Muyembe-Tamfum JJ, Hensley LE, Kindrachuk J, Mbala-Kingebeni P, Ahuka-Mundeke S. Mukadi-Bamuleka D, et al. medRxiv [Preprint]. 2024 Sep 16:2024.09.12.24313188. doi: 10.1101/2024.09.12.24313188. medRxiv. 2024. Update in: Commun Med (Lond). 2025 Nov 15;5(1):496. doi: 10.1038/s43856-025-01203-z. PMID: 39371169 Free PMC article. Updated. Preprint.

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