Researching (Re-)Emerging Infections and Outbreaks

Mpox: the epidemic of 2022

In spring 2022, an outbreak of mpox (formerly monkeypox) took the world by surprise, causing more than 85,000 infections worldwide, especially among men who have sex with men. Mpox is caused by the mpox virus, of which two types are known. Clade I has been most frequent and has caused several outbreaks in Central Africa, especially in the DRC. Clade II, on the other hand, occurs mainly in West Africa and causes a less severe disease than clade I. The 2022 global outbreak was caused by clade II and was the first time mpox has spread widely outside of Central and West Africa.

Belgium was particularly affected by the epidemic, with over 780 confirmed cases. Because of its large sexual health clinic, ITM played a vital role in managing the outbreak, while conducting crucial research to better understand the epidemic. In May 2022, the first Belgian mpox patient was diagnosed at ITM. Soon after, researchers at ITM found evidence of asymptomatic infections among individuals visiting ITM’s sexual health clinic for STI testing. These findings, published in Nature Medicine, were of international importance. In the MPX-ASSESS study (Monkey_Pox ASymptomatic Shedding – Evaluation by Self Sampling), ITM researchers were able to do an in-depth follow-up of high-risk contacts of mpox patients and show that the transmissible virus is often present before the patient has any symptoms. To curb the spread of the virus and speed up the new vaccination campaign, the institute passed on its expertise in the intradermal vaccination technique to other HIV centres in Belgium, where the vaccinations began. By introducing this technique, they could make 2.5 times more use of their vaccine stock and help more people at risk.

Meanwhile, ITM has also been active in mpox research in the DRC and has investigated several mpox outbreaks in the country. To this end, the institute collaborates closely with its Congolese partner, the National Institute for Biomedical Research, on a large multidisciplinary research project on mpox transmission in rural settings in the DRC.

De Baetselier, I. et al. Retrospective detection of asymptomatic monkeypox virus infections among male sexual health clinic attendees in Belgium, Nature Medicine, 2022