Placide Mbala 入選《自然》雜誌評選的 2024 年科學界十大人物之一。

馬克斯‧科茲洛夫 / 2024 年 12 月 9 日 / 新聞專題 / Nature

圖片來源：Ley Uwera for Nature

今年年初，中非各地爆發了mpox病例，造成數百人死亡。剛果民主共和國 (DRC) 首都金薩沙國家生物醫學研究所的流行病學家普拉西德·姆巴拉 (Placide Mbala) 表示，在2022 年後疫情仍在醞釀之中，眼看著事態擴展如此之快， 「感覺就像是科學失憶症」。

姆巴拉領導的研究小組在剛果民主共和國東部地區的年輕成人和性工作者中發現了一群聚可疑的mpox病例，對最新的疫情爆發發出了警報。研究小組預測這種疾病將迅速傳播，並敦促剛果民主共和國和鄰國的衛生官員制定計畫來遏制M痘病毒的傳播。

他和他的同事分析了該病毒的基因組（E. H. Vakaniaki et al. Nature Med. 30, 2791–2795; 2024），揭示了它是一種新毒株，能夠在人與人之間傳播，並且與在2022年引起爆發流行及先前在剛果爆發流行的病毒不同。此後，在瑞典、泰國、印度、德國、美國、英國和六個以前從未報告過mpox感染的非洲國家中也發現了這種病毒。

與姆巴拉合作的加拿大溫尼伯馬尼托巴大學病毒學家傑森·金德拉丘克 (Jason Kindrachuk) 表示，姆巴拉在領導這些研究計畫方面發揮了重要作用。此外，姆巴拉「一直在協調全國各地的應對措施和社區參與活動，並以最不自私、最外交和民主的方式開展這一切」，金德拉丘克補充道。

這是姆巴拉長期訓練的角色。 2006 年從醫學院畢業並在金薩沙擔任了一年臨床醫生後，他遇到了微生物學家 Jean-Jacques Muyembe-Tamfum，他是姆巴拉工作的中心的負責人。姆巴拉對Muyembe-Tamfum 的工作印象深刻，特別是他在1976 年共同發現了伊波拉病毒後，為尋找伊波拉動物宿主所做的不懈努力。Muyembe-Tamfum 將 Mbala 納入麾下，2008 年，他們致力於提高該國的 MPOX 檢測和治療能力。後來，姆巴拉透過基因定序幫助診斷並確認了 2014 年剛果民主共和國爆發期間的首次伊波拉病毒感染

位於亞的斯亞貝巴的非洲疾病管制與預防中心並負責協調該機構的2024 年mpox 應對工作的病毒學家尼凱斯·恩登比 (Nicaise Ndembi) 表示：「他留下了相當多的遺產，而且他確實非常適合當他的導師。。

對姆巴拉來說，他的個人使命是結束科學失憶症，這種失憶症導致mpox等疾病持續存在並重新出現。他說，全世界都知道mpox病毒的威力，然而，一旦非洲以外的感染率下降到一定水平以下，這種疾病就會再次被忽視。直到去年 9 月，許多高收入國家為控制 2022 年疫情爆發而部署的疫苗和治療藥物仍然是非洲國家無法承受的——而當時這種病毒已經在整個非洲大陸大肆傳播。

姆巴拉旨在更好地了解該疾病如何在剛果民主共和國及其鄰國傳播。他的團隊發現該病毒可以在流離失所者的營地中透過非性接觸廣泛地傳播。在此之前，中非的mpox僅引起了小規模的地區性疫情，並且已知只有透過接觸受感染的動物才能傳播給人類（D. Mukadi-Bamuleka et al. Preprint at medRxiv https://doi.org/g8dxrz; 2024）。

他也記錄了金薩沙多種病毒株的傳播（T. Wawina-Bokalanga 等人，預印本於medRxiv https://doi.org/nqpm；2024），這增加了該病毒很容易再次在全球傳播的威脅。他領導了一項國際合作，正在測試衛生官員與當地社區合作的策略（S. Merritt 等人，預印本於medRxiv https://doi.org/nqpn；2024 年），特別是針對包括性工作者在內的受污名族群以及男男性行為者，他們感染 MPOX 的風險很高。他希望這些發現不僅能讓人們專注於一種被忽視的疾病，也能為他的母國和該地區帶來實質的紅利。

姆巴拉在剛果民主共和國應對伊波拉和mpox疫情中發揮了至關重要的作用，「無論接下來出現什麼情況，他都會再次這樣做」，金德拉丘克說。

doi：https://doi.org/10.1038/d41586-024-03900-6

This doctor raised the alarm about a deadly mpox outbreak that went global

Placide Mbala is part of Nature’s 10, a list of people who shaped science in 2024.

Max Kozlov / 09 December 2024 / NEWS FEATURE /  Nature

Credit: Ley Uwera for Nature

Early this year, cases of mpox erupted across Central Africa, killing hundreds. Seeing the events unfold so soon after the still-simmering outbreak of 2022 “felt like scientific amnesia”, says Placide Mbala, an epidemiologist at the National Institute of Biomedical Research in Kinshasa, the capital of the Democratic Republic of the Congo (DRC).

Mbala led a team of researchers who sounded the alarm about the latest outbreak when they spotted a suspicious cluster of mpox cases among young adults and sex workers in an eastern region of the DRC. The team predicted that the disease would move quickly and urged health officials both in the DRC and in neighbouring countries to devise plans to contain the monkeypox virus’s spread.

He and his colleagues analysed the genome of the virus (E. H. Vakaniaki et al. Nature Med. 30, 2791–2795; 2024), revealing that it was a new strain, capable of passing from human to human and distinct from the virus that caused the 2022 outbreak and other previous outbreaks in the DRC. It has since been detected in Sweden, Thailand, India, Germany, the United States, the United Kingdom and six African countries that had never before reported mpox infections.

Mbala has been instrumental in leading these research projects, says Jason Kindrachuk, a virologist at the University of Manitoba in Winnipeg, Canada, who collaborates with Mbala. Furthermore, Mbala has “been coordinating response and community-engagement activities across the country, and doing all this in the least selfish, most diplomatic and democratic ways”, Kindrachuk adds.

It’s a role that Mbala has long trained for. After finishing medical school in 2006 and spending a year as a clinician in Kinshasa, he met Jean-Jacques Muyembe-Tamfum, a microbiologist who directs the centre where Mbala works. Mbala was impressed by Muyembe-Tamfum’s work — in particular his dogged efforts to find the animal reservoir of Ebola, having co-discovered the Ebola virus in 1976. Muyembe-Tamfum took Mbala under his wing, and in 2008 they worked to improve the country’s capacity for mpox testing and treatment. Later, Mbala helped to diagnose and confirm, through genetic sequencing, the first infections with the Ebola virus during the DRC’s 2014 outbreak.

“He’s leaving quite the legacy, and he’s really fitting the shoes of his mentor,” says Nicaise Ndembi, a virologist at the Africa Centres for Disease Control and Prevention in Addis Ababa, who is coordinating the agency’s 2024 mpox response.

For Mbala, it is his personal mission to put an end to the scientific amnesia that allowed conditions such as mpox to linger and re-emerge. He says that the world knew what the monkeypox virus was capable of, and yet, once infections outside Africa dropped below a certain level, the disease became neglected once again. Vaccines and therapeutics that many high-income countries deployed to control the 2022 outbreaks remained out of reach of African nations until last September — when the strain had already spread aggressively throughout the continent.

Mbala aims to better understand how the disease spreads in the DRC and neighbouring countries. His team has found that the virus can spread rampantly in displacement camps and through non-sexual contact; previously, mpox in Central Africa caused small, localized outbreaks and was known to spread to people only through contact with infected animals (D. Mukadi-Bamuleka et al. Preprint at medRxiv https://doi.org/g8dxrz; 2024).

He has also documented the circulation of multiple strains in Kinshasa (T. Wawina-Bokalanga et al. Preprint at medRxiv https://doi.org/nqpm; 2024), raising the threat that the virus could easily spread globally again. And he’s led an international collaboration that is testing strategies for health officials to work alongside local communities (S. Merritt et al. Preprint at medRxiv https://doi.org/nqpn; 2024) — in particular with stigmatized populations, including sex workers and men who have sex with men, who are at high risk of contracting mpox. He hopes that these findings can not only shine a spotlight on a neglected disease, but also pay tangible dividends in his home country and the region.

Mbala was crucial in the DRC’s response to Ebola and mpox — and “he will do it again for whatever emerges next”, Kindrachuk says.

doi: https://doi.org/10.1038/d41586-024-03900-6