For the second time in 2 years, a long-overlooked virus poses a global threat. Can it be contained? In late September 2023, a 33-year-old man who co-owned a bar in Kamituga, a remote mining city in the Democratic Republic of the Congo (DRC), developed lesions on his genitals and a fever. He first sought help from a doctor, who gave him an injection, and then from a traditional healer, who applied ointments and performed an enema. But the lesions kept spreading, eventually appearing on most of his body.
His relatives convinced the man to come to the family home in the city of Bukavu—a trip that takes 6 hours on a good day and twice as long during the rainy season, when much of the road turns to mud. Health workers there swabbed his lesions, and a lab in Kinshasa, the capital, confirmed the man had something rarely seen in that part of DRC: mpox, a painful and occasionally fatal disease caused by a relative of the smallpox virus.
A January report from the Bukavu branch of the DRC’s Ministry of Public Health, obtained by Science, called this man the “index case”—the first known patient—in the epidemic of mpox now sweeping the country. The report said he fell ill after visiting Kisangani, a city a few provinces away. It did not explain how he might have become infected, but the genital lesions suggested it was through sexual contact.