Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC

Leandre Murhula Masirika; Luca M. Zaeck; Pacifique Ndishimye; Jean Claude Udahemuka; Saria Otani; Frank M. Aarestrup; Leonard Schuele; Babs E. Verstrepen; Scott Jones; Ashley Otter; Corine H. GeurtsvanKessel; Jean Pierre Musabyimana; Justin Bengehya Mbiribindi; Jules Minega Ndoli; Bas B. Oude Munnink; Freddy Siangoli Belesi; Marion P. G. Koopmans; Rory D. de Vries

doi:10.1038/s41467-025-62064-7

Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC

Leandre Murhula Masirika^*
, Luca M. Zaeck
, Pacifique Ndishimye
, Jean Claude Udahemuka
, Saria Otani
, Frank M. Aarestrup
, Leonard Schuele
, Babs E. Verstrepen
, Scott Jones
, Ashley Otter
, Corine H. GeurtsvanKessel
, Jean Pierre Musabyimana
, Justin Bengehya Mbiribindi
, Jules Minega Ndoli
, Bas B. Oude Munnink
, Freddy Siangoli Belesi
, Marion P. G. Koopmans
, Rory D. de Vries^*

^*Corresponding author for this work

University of Castilla-La Mancha
Erasmus University Medical Center
African Institute for Mathematical Sciences
University of Rwanda
UK Health Security Agency
Stansile
Division Provinciale de la Santé
University Teaching Hospital of Butare

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

Understanding secondary attack rates is a key knowledge gap in the ongoing clade Ib mpox virus (MPXV) outbreak in the Democratic Republic of the Congo. Here, we report the first cross-sectional serological study to investigate local MPXV clade Ib transmission in South Kivu, DRC. Seropositivity was defined as a detectable titer in a cell lysate-based screening ELISA and confirmation by virus neutralization test. Sera were collected in November and December 2023 (n = 120), and in May 2024 (n = 48) from professional sex workers (PSW) and visitors of 25 bars with reports of mpox cases. We detected serological evidence for MPXV infection in 18% and 17% of these sera, respectively, indicating that PSW played an important role in MPXV clade Ib transmission in this region. Additionally, sera from 108 direct contacts of mpox cases from 34 households were collected between September 2023 and May 2024. Serological evidence for MPXV infection was found in at least one serum sample in 50% of households, including in nine households with seropositive minors, providing evidence for close-contact household transmission. Serological studies are needed to comprehend the extent and severity of the ongoing MPXV outbreak, and may be used to guide targeted vaccination strategies, particularly for high-risk groups.

Original language	English
Article number	7056
Journal	Nature Communications
Volume	16
Issue number	1
Number of pages	8
ISSN	2041-1723
DOIs	https://doi.org/10.1038/s41467-025-62064-7
Publication status	Published - 2025

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SDG 3 Good Health and Well-being

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Masirika, L. M., Zaeck, L. M., Ndishimye, P., Udahemuka, J. C., Otani, S., Aarestrup, F. M., Schuele, L., Verstrepen, B. E., Jones, S., Otter, A., GeurtsvanKessel, C. H., Musabyimana, J. P., Mbiribindi, J. B., Ndoli, J. M., Oude Munnink, B. B., Siangoli Belesi, F., Koopmans, M. P. G., & de Vries, R. D. (2025). Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC. Nature Communications, 16(1), Article 7056. https://doi.org/10.1038/s41467-025-62064-7

@article{2c856c2a09ee4c628336a3ec45fc21b5,

title = "Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC",

abstract = "Understanding secondary attack rates is a key knowledge gap in the ongoing clade Ib mpox virus (MPXV) outbreak in the Democratic Republic of the Congo. Here, we report the first cross-sectional serological study to investigate local MPXV clade Ib transmission in South Kivu, DRC. Seropositivity was defined as a detectable titer in a cell lysate-based screening ELISA and confirmation by virus neutralization test. Sera were collected in November and December 2023 (n = 120), and in May 2024 (n = 48) from professional sex workers (PSW) and visitors of 25 bars with reports of mpox cases. We detected serological evidence for MPXV infection in 18\% and 17\% of these sera, respectively, indicating that PSW played an important role in MPXV clade Ib transmission in this region. Additionally, sera from 108 direct contacts of mpox cases from 34 households were collected between September 2023 and May 2024. Serological evidence for MPXV infection was found in at least one serum sample in 50\% of households, including in nine households with seropositive minors, providing evidence for close-contact household transmission. Serological studies are needed to comprehend the extent and severity of the ongoing MPXV outbreak, and may be used to guide targeted vaccination strategies, particularly for high-risk groups.",

author = "Masirika, \{Leandre Murhula\} and Zaeck, \{Luca M.\} and Pacifique Ndishimye and Udahemuka, \{Jean Claude\} and Saria Otani and Aarestrup, \{Frank M.\} and Leonard Schuele and Verstrepen, \{Babs E.\} and Scott Jones and Ashley Otter and GeurtsvanKessel, \{Corine H.\} and Musabyimana, \{Jean Pierre\} and Mbiribindi, \{Justin Bengehya\} and Ndoli, \{Jules Minega\} and \{Oude Munnink\}, \{Bas B.\} and \{Siangoli Belesi\}, Freddy and Koopmans, \{Marion P. G.\} and \{de Vries\}, \{Rory D.\}",

year = "2025",

doi = "10.1038/s41467-025-62064-7",

language = "English",

volume = "16",

journal = "Nature Communications",

issn = "2041-1723",

publisher = "Nature Research",

number = "1",

}

Masirika, LM, Zaeck, LM, Ndishimye, P, Udahemuka, JC, Otani, S , Aarestrup, FM, Schuele, L, Verstrepen, BE, Jones, S, Otter, A, GeurtsvanKessel, CH, Musabyimana, JP, Mbiribindi, JB, Ndoli, JM, Oude Munnink, BB, Siangoli Belesi, F, Koopmans, MPG & de Vries, RD 2025, 'Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC', Nature Communications, vol. 16, no. 1, 7056. https://doi.org/10.1038/s41467-025-62064-7

TY - JOUR

T1 - Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC

AU - Masirika, Leandre Murhula

AU - Zaeck, Luca M.

AU - Ndishimye, Pacifique

AU - Udahemuka, Jean Claude

AU - Otani, Saria

AU - Aarestrup, Frank M.

AU - Schuele, Leonard

AU - Verstrepen, Babs E.

AU - Jones, Scott

AU - Otter, Ashley

AU - GeurtsvanKessel, Corine H.

AU - Musabyimana, Jean Pierre

AU - Mbiribindi, Justin Bengehya

AU - Ndoli, Jules Minega

AU - Oude Munnink, Bas B.

AU - Siangoli Belesi, Freddy

AU - Koopmans, Marion P. G.

AU - de Vries, Rory D.

PY - 2025

Y1 - 2025

N2 - Understanding secondary attack rates is a key knowledge gap in the ongoing clade Ib mpox virus (MPXV) outbreak in the Democratic Republic of the Congo. Here, we report the first cross-sectional serological study to investigate local MPXV clade Ib transmission in South Kivu, DRC. Seropositivity was defined as a detectable titer in a cell lysate-based screening ELISA and confirmation by virus neutralization test. Sera were collected in November and December 2023 (n = 120), and in May 2024 (n = 48) from professional sex workers (PSW) and visitors of 25 bars with reports of mpox cases. We detected serological evidence for MPXV infection in 18% and 17% of these sera, respectively, indicating that PSW played an important role in MPXV clade Ib transmission in this region. Additionally, sera from 108 direct contacts of mpox cases from 34 households were collected between September 2023 and May 2024. Serological evidence for MPXV infection was found in at least one serum sample in 50% of households, including in nine households with seropositive minors, providing evidence for close-contact household transmission. Serological studies are needed to comprehend the extent and severity of the ongoing MPXV outbreak, and may be used to guide targeted vaccination strategies, particularly for high-risk groups.

AB - Understanding secondary attack rates is a key knowledge gap in the ongoing clade Ib mpox virus (MPXV) outbreak in the Democratic Republic of the Congo. Here, we report the first cross-sectional serological study to investigate local MPXV clade Ib transmission in South Kivu, DRC. Seropositivity was defined as a detectable titer in a cell lysate-based screening ELISA and confirmation by virus neutralization test. Sera were collected in November and December 2023 (n = 120), and in May 2024 (n = 48) from professional sex workers (PSW) and visitors of 25 bars with reports of mpox cases. We detected serological evidence for MPXV infection in 18% and 17% of these sera, respectively, indicating that PSW played an important role in MPXV clade Ib transmission in this region. Additionally, sera from 108 direct contacts of mpox cases from 34 households were collected between September 2023 and May 2024. Serological evidence for MPXV infection was found in at least one serum sample in 50% of households, including in nine households with seropositive minors, providing evidence for close-contact household transmission. Serological studies are needed to comprehend the extent and severity of the ongoing MPXV outbreak, and may be used to guide targeted vaccination strategies, particularly for high-risk groups.

U2 - 10.1038/s41467-025-62064-7

DO - 10.1038/s41467-025-62064-7

M3 - Journal article

C2 - 40750592

SN - 2041-1723

VL - 16

JO - Nature Communications

JF - Nature Communications

IS - 1

M1 - 7056

ER -

Serological evidence of clade Ib Mpox transmission by sex workers and within household in South Kivu, DRC

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