Two distinct strains of monkeypox virus have triggered global health emergencies since 2022, and researchers are now racing to understand why one kills far more people than the other. The problem is urgent. The milder clade IIb strain infected at least 15,000 people globally and more than 4,000 in the UK. But a newer clade Ib strain, which emerged in the Democratic Republic of Congo and spread to neighbouring countries, has infected around 30,000 people and caused at least 800 deaths. Four imported cases have already reached the UK. This clade carries a higher case fatality rate, yet scientists do not understand the biological mechanisms behind that difference. This consortium will investigate those mechanisms directly. If the research succeeds, it could reveal why clade Ib is more lethal and identify viral targets for treatments or vaccines. That knowledge would help public health agencies prepare for future outbreaks and potentially save lives in affected regions. The work is applied and urgent: it addresses an immediate threat to UK public health posed by an evolving virus that has already crossed borders.
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Mpox (MPX) is a zoonotic disease caused by infection with monkeypox virus (MPXV), an orthopoxvirus. Two large outbreaks since 2022 have been declared by WHO to be public health emergencies of international concern (PHEICs) under the International Health Regulations (2005)[1-10]. The first global outbreak of clade IIb disease (2022 to present) resulted in infection of at least 15,000 people in multiple countries. UKHSA reported more than 4000 cases of clade IIb mpox in the UK with a peak during 2022.The emergence of a new clade I strain in DRC (clade Ib) resulting in spread to neighbouring countries, including Uganda during 2023 and 2024 has infected around 30,000 people and caused at least 800 deaths. Four cases of imported infection have occurred to date in the UK. This clade is associated with a higher case fatality rate than clade II mpox, although the mechanisms underlying this difference are not well understood, and presents a threat to UK public health
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