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Clade I mpox virus genomic diversity in the Democratic Republic of the Congo, 2018-2024: Predominance of zoonotic transmission

Affiliations
  • 1Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo; TransVIHMI, Université de Montpellier, INSERM, IRD, 34394 Montpellier, France. Electronic address: eddylusamaki@gmail.com.
  • 2Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the Congo.
  • 3TransVIHMI, Université de Montpellier, INSERM, IRD, 34394 Montpellier, France.
  • 4Biosurv International, Salisbury SP4 0DQ, England.
  • 5Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA.
  • 6Rodolphe Merieux INRB-Goma Laboratory, Goma, Democratic Republic of the Congo.
  • 7Institute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.
  • 8Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • 9PNLFHMPX, Hemorrhagic Fever and Mpox Program, Ministry of Health, Kinshasa, Democratic Republic of the Congo.
  • 10Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium.
  • 11Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
  • 12World Health Organization, Geneva, Switzerland.
  • 13Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
  • 14Africa Centers for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
  • 15ANRS Emerging Infectious Diseases (ANRS MIE), INSERM, 75015 Paris, France.
  • 16US Department of Agriculture, Manhattan, KS 66502, USA.
  • 17TransVIHMI, Université de Montpellier, INSERM, IRD, 34394 Montpellier, France. Electronic address: martine.peeters@ird.fr.

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October 25, 2024

Abstract

Recent reports raise concerns on the changing epidemiology of mpox in the Democratic Republic of the Congo (DRC). High-quality genomes were generated for 337 patients from 14/26 provinces to document whether the increase in number of cases is due to zoonotic spillover events or viral evolution, with enrichment of APOBEC3 mutations linked to human adaptation. Our study highlights two patterns of transmission contributing to the source of human cases. All new sequences from the eastern South Kivu province (n = 17; 4.8%) corresponded to the recently described clade Ib, associated with sexual contact and sustained human-to-human transmission. By contrast, all other genomes are clade Ia, which exhibits high genetic diversity with low numbers of APOBEC3 mutations compared with clade Ib, suggesting multiple zoonotic introductions. The presence of multiple clade I variants in urban areas highlights the need for coordinated international response efforts and more studies on the transmission and the reservoir of mpox.

Keywords:

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