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

Affiliations

• Institut 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
• Graduate School of Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
• Biosurv International, Salisbury SP4 0DQ, England
• Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
• Rodolphe Merieux INRB-Goma Laboratory, Goma, Democratic Republic of the Congo
• Institute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK
• Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
• PNLFHMPX, Hemorrhagic Fever and Mpox Program, Ministry of Health, Kinshasa, Democratic Republic of the Congo
• Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
• Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
• World Health Organization, Geneva, Switzerland
• Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
• Africa Centers for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
• ANRS Emerging Infectious Diseases (ANRS MIE), INSERM, 75015 Paris, France
• US Department of Agriculture, Manhattan, KS 66502, USA

PMID:  #  DOI: 10.1016/j.cell.2024.10.017

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.

近期报告引发了对刚果民主共和国（DRC）mpox（猴痘）流行病学变化的担忧。我们为来自14个省的337名患者生成了高质量的基因组，以记录病例增加是由于动物溢出事件还是病毒进化，并发现与人类适应相关的APOBEC3突变的富集。我们的研究突出了两种传播模式，帮助解释人类病例的来源。来自东南基伍省的所有新序列（n = 17；占4.8%）对应于最近描述的Ib进化分支，与性接触和持续的人际传播相关。相反，其他所有基因组属于Ia进化分支，展现出高遗传多样性，但与Ib进化分支相比APOBEC3突变数量较少，这表明存在多次动物溢出引入。在城市地区发现多种Ia进化分支变异突显了需要协调国际应对措施以及对mpox传播和宿主的更多研究。

关键词：猴痘，猴痘病毒，mpox，Monkeypox，Clade Ia, Clade Ib, Clade 1a, Clade 1b，佰乐博，佰乐博生物