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Highly efficient anogenital transmission of clade Ia monkeypox virus associated with increased shedding

Franziska K Kaiser1, Reshma K Mukesh2, Shane Gallogly2

  • 1Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Hamilton, MT, USA. franziska.kaiser@nih.gov.

Nature Communications
|June 25, 2026
PubMed

Insights

Mpox (monkeypox) transmission now spreads human-to-human, driven by sexual contact. This study shows anogenital mucosal exposure is key for mpox virus (MPXV) spread, highlighting the need for targeted prevention strategies.

Area of Science:

  • Virology
  • Epidemiology
  • Animal Models

Background:

  • Mpox (monkeypox) transmission has shifted to sustained human-to-human spread.
  • Sexual contact is a primary driver of recent mpox outbreaks.
  • Understanding mpox virus (MPXV) transmission determinants remains limited.

Purpose of the Study:

  • To investigate MPXV clade Ia pathogenesis, shedding, and transmission in a prairie dog model.
  • To determine the role of mucosal routes in mpox infection and spread.
  • To establish a relevant animal model for studying mpox transmission dynamics.

Main Methods:

  • Prairie dogs (Cynomys ludovicianus) were inoculated via various mucosal routes (urogenital, intranasal).
  • Virus shedding, pathogenesis, and clinical signs were monitored.
  • Simulated sexual contact was used to assess transmission efficiency.

Main Results:

  • Mucosal inoculation led to productive, systemic mpox infections.
  • Urogenital route inoculation resulted in the highest virus shedding and disease severity.
  • Simulated sexual contact achieved 100% transmission efficiency, with shedding before clinical signs.

Conclusions:

  • Anogenital mucosal surfaces are critical for mpox virus transmission.
  • The prairie dog model effectively replicates key aspects of MPXV pathogenesis and spread.
  • Countermeasures should prioritize strategies targeting mucosal infection and transmission routes.

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