Understanding the current monkeypox outbreak

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The strain of monkeypox behind the current outbreak in several countries - with more than 2,500 confirmed cases worldwide as of 18 June - is closely related to the strain responsible for a 2018-19 outbreak in Nigeria, where the disease is endemic, according to Portuguese scientists. They say the strain behind the 2018-19 Nigerian outbreak probably represents recent evolution in the virus, allowing it to spread further and faster than previous strains. The team looked at the DNA of the current monkeypox strain and found the recent outbreak appears to have a single origin, and the new strain has 50 'letters' of DNA that differ from the 2018-19 strain. That suggests the new strain is evolving fast, and the scientist say their analysis shows it is continuing to evolve and change its DNA as it spreads from person to person. This is preliminary research, and the team stresses that further work is required to fully understand the current monkeypox outbreak.

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From: Springer Nature

Genomic data sheds light on the evolutionary trajectory of the monkeypox outbreak

The strain associated with the current monkeypox virus outbreak identified in May 2022 is a well-defined divergent branch from the monkeypox viruses of a 2018–2019 outbreak in an endemic country that probably represents recent evolutionary changes. This study, published in Nature Medicine, also highlights ongoing evolution during human-to-human transmission, which may explain increased transmission of this strain.

Monkeypox is a rare infectious disease that spreads between species, including from animals to humans, caused by the monkeypox virus (MPXV) of the Orthopoxvirus genus (which also includes smallpox virus). Monkeypox is endemic to West and Central African countries, and the infrequent reports of cases outside those regions are associated with importation from those countries. The first multi-country outbreak of monkeypox was identified in May 2022, with more than 2,500 confirmed cases worldwide, as of 18 June. 

To investigate how the 2022 outbreak began, João Paulo Gomes and colleagues reconstructed genome sequences of the MPXV associated with the outbreak. Their analysis revealed that this MXPV belongs to the MPXV clade 3 and that the ongoing outbreak most likely has a single origin. The 2022 MPXV diverges from the related 2018–2019 viruses by about 50 single-nucleotide polymorphisms, or genetic variations — far more than expected for orthopoxviruses. Such a divergent branch may represent ongoing accelerated evolution, according to the authors. Further analysis revealed the first signs of ongoing evolution — 15 single-nucleotide polymorphisms, minor variants and gene deletion — during human-to-human transmission within the ongoing outbreak.

Although further research is needed, these findings help elucidate the evolutionary trajectory of the 2022 MPXV outbreak strain by providing data on potential mechanisms underlying viral evolution and possible viral gene targets of human adaptation.

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Nature Medicine
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Organisation/s: National Institute of Health Doutor Ricardo Jorge (INSA), Portugal
Funder: The acquisition of WGS-associated equipment used in this study (including the Illumina NextSeq 2000) was funded by the HERA project (Grant/2021/PHF/23776) supported by the European Commission through the European Centre for Disease Control, and partially funded by the GenomePT project (POCI-01-0145-FEDER- 022184), supported by COMPETE 2020 – Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by the Portuguese Science and Technology Foundation (FCT). This study was also supported by the ERINHA-Advance project (funding from the European Union’s Horizon 2020 Research & Innovation program, grant agreement No. 824061) and also benefited from co-funding from the European Union’s Horizon 2020 Research and Innovation programme under grant agreement No 773830: One Health European Joint Programme (EJP), in particular by co-funding JSD and VM post-doc fellowships and INSaFLU development. We also thank Miguel Pinheiro (iBiMED/Universidade de Aveiro) for his continuous support on updating INSaFLU platform and the Infraestrutura Nacional de Computação Distribuída (INCD) for providing computational resources for testing it. INCD was funded by FCT and FEDER under the project 22153- 01/SAICT/2016.
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