The Health Surveillance research group from the Visavet Centre at the Complutense University of Madrid organised a symposium this Friday entitled Mpox in Congo: A Global Health Emergency. The event, held at the university's Faculty of Dentistry, was co-organised by the Institute for Research in Game Resources (IREC) of the University of Castilla-La Mancha and the Lwiro Primate Rehabilitation Centre (Democratic Republic of the Congo).

Human mpox (formerly known as monkeypox) is an emerging zoonosis with clinical signs that resemble those of smallpox, a disease eradicated worldwide in 1980. The monkeypox virus (MPXV) originates in equatorial Africa, where it is maintained in squirrels and other rodents. The incidence of human infections has increased since the discontinuation of smallpox vaccination programmes.

The D.R. Congo is the only country to have continuously reported mpox cases over the past five decades, but global interest in supporting containment efforts has been limited. This changed with the onset of a global mpox outbreak in May 2022. This ongoing pandemic is caused by Clade II of the MPXV. Recently, in the South Kivu region, in eastern Congo near the borders with Uganda and Rwanda, a new sub-lineage of the Clade I virus has emerged. The number of cases is rising rapidly and spreading to multiple countries both within and outside Africa, and human-to-human transmission appears to be more effective. This is occurring amidst intensifying conflict in eastern Congo, compounding poverty, poor communications, and lack of infrastructure, all of which hinder efforts to monitor the epidemic and implement control measures.

We are still unaware of the potential impact this new MPXV lineage might have in Spain. It is urgent that we understand what is happening at the source and contribute to containment efforts.

The symposium began at 11:00 am with opening remarks from Víctor Briones, Vice-Rector for Studies at UCM; Consuelo Serres, Dean of the Faculty of Veterinary Medicine at UCM; Felipe Vilas, President of the Official
Association of Veterinarians of Madrid and José Miguel Rubio, Director of the National Centre for Microbiology at the Carlos III Health Institute.

The keynote address of the symposium, Monkeypox Virus: Immunity, Vaccination and Protection, was delivered by Margarita del Val, a renowned virologist at the Severo Ochoa Centre for Molecular Biology and a researcher at the Spanish National Research Council (CSIC).

Ana Isabel Negredo, a virologist at the National Centre for Microbiology (ISCIII), then spoke on the impact of mpox outbreaks in Spain.

Christian Gortázar, a veterinary researcher at IREC, delivered a presentation entitled "MPXV, Emerging Diseases and a World in Crisis", during which he held a live communication with Leandre Murhula, a researcher at the Lwiro Centre for Research in Natural Sciences, who presented the paper entitled "One year of the MPOX outbreak: Field-based findings in Kamituga, South Kiru, DR Congo". Gortázar emphasised the Central African origin of many current emerging diseases and the critical epidemiological role of factors such as diversity, poverty and armed conflict that are associated with these regions, context in which the European JUA-KIVU project is being developed.

The most moving intervention was given by Luis Flores, a veterinarian at the Lwiro Primate Rehabilitation Centre, in a presentation entitled "Experiencing Monkeypox in Congo: One Health for Conservation and Global Health". His talk highlighted how the Food Security becomes extremely important in these areas, as the presence of infectious diseases in livestock—though not initially zoonotic and not posing a direct public health risk—can lead to food shortages. This in turn drives the need to hunt wild animals in the forest and the hunting and handling of these animals presents a risk from a public health perspective. The presentation concluded by summarizing the objectives to be addressed: Improving epidemiological surveillance of African wildlife; Strengthening One Health programs; Reducing bushmeat consumption; Creating and implementing policies to regulate the wildlife trade; Improving community awareness and education; Conservationand; and integrating women into society through improved education.

The symposium concluded with a round table discussion, where the speakers answered questions from attendees, and the contributions made by Lucas Domínguez, Director of the Vigilancia Sanitaria research group (UCM), and Lucía de Juan, Vice-Rector for Research at the Complutense University of Madrid.