Infectious Disease

Genetic data suggest multiple monkeypox outbreaks, CDC says

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McQuiston reports no relevant financial disclosures.

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New genetic sequencing data indicate there are at least two separate monkeypox outbreaks underground outside of Africa, the CDC said Friday.

“As the monkeypox outbreak has continued, our laboratory scientists have been working to better understand how the US cases might be linked to [cases in] Europe or other places,” Jennifer McQuiston, DVM, MS, deputy director of the CDC’s Division of High Consequence Pathogens and Pathology, said during a press briefing. “New analysis resulted in sequencing uploaded publicly today showing that in the US, we have seen at least two genetically distinct variants circulating.”

Source: CDC.gov.

Genetic sequencing data indicate there are at least two separate monkeypox outbreaks underground outside of Africa, the CDC said. Source: CDC.

As of Friday, McQuiston said 21 cases have been confirmed in the US The cases are all of the West African clade of monkeypoxwhich is the less severe of the two clades.

According to McQuiston, most US cases have been linked to the large outbreak that began in Europe. Those cases are also similar to one of the imported US cases reported in 2021 through a traveler from Nigeria, who ended up in Maryland.

“It’s been circulating since that time at least,” she said.

Two other monkeypox cases sequenced were similar to another imported case in 2021 that was reported in Texas. McQuiston explained that these cases were reported in a woman who had traveled to West Africa and a man who traveled to the Middle East and Africa. She added that these cases are all similar to each other but are not linked. In contrast, the ones associated with Europe are “very tightly linked to each other.”

“It’s not clear what all of this means, but it’s likely that within the last couple of years, there have been at least instances where monkeypox virus spilled over to people in Nigeria from the animal that maintains it and that virus likely began to spread [from] person to person through close contact and possibly sexual contact,” she said.

According to the CDC and WHO, cases have primarily been reported among gay and bisexual men who have gone to sexual health clinics with mild symptoms. However, at least one case of monkeypox in the US was confirmed in a woman who reported heterosexual sex.

Monkeypox can infect anyone and is not exclusive to any one population. In an MMWR report published Friday, researchers explained that the current epidemiology suggests person-to-person community spread and that close contact with infected people or shared linens is the most significant risk factor for monkeypox infection.

McQuiston said heath officials are working hard to contain the outbreak.

“I know that there are scientists that are beginning to talk about monkeypox becoming endemic,” she said. “It’s too early to know if monkeypox could become endemic, but it’s important to keep in mind that monkeypox has been endemic in other countries for years.”

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