Joint Understanding and Analysis of clade I monkeypox epidemiology, evolution and immunology in South Kivu

Projektinformationen

JUA KIVU

ID Finanzhilfevereinbarung: 101195116

DOI

10.3030/101195116

Projekt abgeschlossen

EK-Unterschriftsdatum 4 Dezember 2024

Startdatum 1 Oktober 2024

Enddatum 30 September 2026

Finanziert unter

• Health

Gesamtkosten

€ 1 250 000,00

EU-Beitrag

€ 1 250 000,00

Koordiniert durch

ERASMUS UNIVERSITAIR MEDISCH CENTRUM ROTTERDAM
Netherlands

Periodic Reporting for period 1 - JUA KIVU (Joint Understanding and Analysis of clade I monkeypox epidemiology, evolution and immunology in South Kivu)

Berichtszeitraum: 2024-10-01 bis 2025-09-30

Zusammenfassung vom Kontext und den Gesamtzielen des Projekts

JUA KIVU is an international collaboration of partners in Central Africa and Europe, addressing key knowledge gaps on mpox clade Ib. Mpox clade Ib is a newly recognized variant of mpox virus, viruses that have been present in animal reservoirs in Central and Western Africa from where they occasionally cause outbreaks of human disease when humans get in contact with infected animals or animal products. As part of a collaborative outbreak research capacity building program, the team involved in JUA KIVU found that there was a novel spillover in Eastern DRC, in South Kivu province, in a mining region from where the virus seems to have originated. As this virus spread fast in and beyond the region, we designed a series of linked studies to address critical knowledge that will help support public health initiatives to contain the outbreak. Key questions addressed are; who are getting infected and how does the novel sublineage spread, what drives the main spread? how can the epidemic be tracked nationally and internationally? Is there transmission into the community? Where did the virus originate from? What is the role of co-infections in severity of disease and can that be used to guide development of treatment? All studies aim to develop the capacity for continued independent follow-up studies of the key partners in DRC, Rwanda and Burundi as the tools and expertise needed to answer these questions are also applicable in case of other disease outbreaks. By doing so, we expect impact well beyond the current project. Not only has the consortium managed to provide some of the first global data on this problem, as can be seen from the high impact publications, but also the researchers from DRC, Rwanda and Burundi collaboratively have developed protocols to address these questions, despite the sometimes challenging political situation.

Arbeit, die ab Beginn des Projekts bis zum Ende des durch den Bericht erfassten Berichtszeitraums geleistet wurde, und die wichtigsten bis dahin erzielten Ergebnisse

WP1
• A two-week capacity building workshop was given in Butare which was open to all consortium members and focussed on both wet lab and dry lab analysis.
• The results of this sequencing and data analysis capacity building workshop are currently being collated and most probably will result in several peer-reviewed publications.

WP2
• We explored potential animal sources of the Clade Ib outbreak by integrating wildlife surveillance with genomic analysis of patient samples from Kamituga.
• We screened around 50 wildlife samples (rodents, squirrels, mice, shrews, and a bat) using generic orthopoxvirus PCR; all tested negative.
• We conducted metagenomic sequencing on five pigs with pox-like lesions; results identified swinepox virus, not Mpox.
• Current evidence suggests no wildlife reservoir was identified, indicating that the Clade Ib sub-lineage likely originated from undetected human-to-human transmission chains.

WP3
• We performed metagenomic sequencing on 19 mpox lesion swabs of hospitalized patients in South Kivu province (eastern DRC) to characterize bacteria, antimicrobial resistance genes, mpox virus (MPXV), and viral co-infections.
• We detected frequent viral and bacterial co-infections in Mpox lesions, many with antimicrobial-resistance genes.
• We also identified multiple non-Mpox infections (especially VZV) among suspected cases, showing major diagnostic gaps.

WP4
• We prepared and organized population-level serosurveys in key high-risk groups.
• First evidence of Clade Ib transmission among professional sex workers and household contacts (published in Nature Communications).
• We developed and piloted wastewater and pit latrine sampling protocols.
• We trained field teams on harmonized serology and environmental surveillance methods.
• We worked on the ethics approvals and coordinated with national stakeholders for rollout.
• Wastewater from selected bars in our of the study cities (Kamituga) tested RT-PCR positive for Mpox Clade Ib. Metagenomic sequencing of high-load samples confirmed Clade Ib and validated environmental surveillance as an early detection tool.

WP5
• Isolation, propagation, and characterization of clade Ib MPXV from a local patient material from DRC.
• Setup and publication of a clade Ib MPXV-specific immunological assay to measure humoral immune responses.
• Extension of task 5.3 on the breadth of infection- and vaccination-induced immune responses include a broader panel of viruses; all necessary neutralizing antibody assays have been set up and validated.

Fortschritte, die über den aktuellen Stand der Technik hinausgehen und voraussichtliche potenzielle Auswirkungen (einschließlich der bis dato erzielten sozioökonomischen Auswirkungen und weiter gefassten gesellschaftlichen Auswirkungen des Projekts)

• We gave training in amplicon-based sequencing of mpox virus during a 2-week workshop in Butare in Rwanda to partners from Burundi, Tanzania, the DRC and Rwanda. During this two-week training also training in bioinformatic analysis was given starting from raw sequence data until the generation of phylogenetic trees.
• A field sequencing hub was established in Huye (Rwanda) with real-time genomic data generation and rapid data sharing through the DTU platform.
• We published a manuscript on the epidemiology and genomic evolution of the ongoing outbreak in the eastern part of the DRC, highlighting the need for extended cross-border collaboration, health education strategies focusing on sex workers, contact tracing, clinical care and surveillance.
• We published a manuscript on the epidemiology and genomic evolution of the ongoing outbreak of the Clade Ib virus in Burundi, suggesting there is sustained circulation of mpox MPXV Ib in Burundi, largely driven by human-to-human transmission.
• We identified multiple non-Mpox infections (especially VZV) among suspected cases, showing major diagnostic gaps.
• First evidence of Clade Ib transmission among professional sex workers and household contacts (published in Nature Communications).
• Setup and validation of local mpox serology on-site.
• Setup and publication of a clade Ib MPXV-specific immunological assay to measure humoral immune responses.