[Isolation and Whole Genome Analysis of Monkeypox virus from a Patient with Mpox]

Monkeypox virus (MPXV), a zoonotic pathogen that causes mpox (monkeypox), was endemic to Africa with sporadic outbreaks. However, since May 2022, outbreaks of mpox have occurred in non-endemic regions, including the USA and Asian countries. Between May and June 2022, the mpox test (developed in 2016 by Korea Disease Control and Prevention Agency) was precisely reevaluated for provision against the import and outbreak of MPXV-2022. Furthermore, on 11 July 2022, we completed the expansion of laboratory capacity for the diagnosis of mpox to 18 regional laboratories through education regarding the mpox test protocol and distribution of test reagents. The first case of mpox in the Republic of Korea was confirmed on 22 June 2022 using the mpox test, and the virus was isolated from the specimens of the first identified patient with mpox for electron microscopic imaging and whole genome analysis. Electron microscopic images revealed that the isolated virus had a mulberry-like appearance, which is the typical morphology of poxviruses. Moreover, whole genome sequencing confirmed that the isolated virus belonged to clade IIb lineage B.1.1 of West African origin, the currently prevalent MPXV. The isolated viruses and their genetic information may be useful not only in understanding the pathogenesis of mpox but also in developing vaccines, therapeutic reagents, and diagnostic tools against it.