RESUMO
Outbreaks of mpox have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here, we describe the epidemiological and genomic features of an mpox outbreak in a mining region in the Eastern Democratic Republic of the Congo (DRC), caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the DRC. Of the 108 PCR-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female, and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission.