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Genomic epidemiology uncovers the timing and origin of the emergence of mpox in humans

Parker, E.; Omah, I.; Varilly, P.; Magee, A.; Ayinla, A. O.; Sijuwola, A. E.; Ahmed, M. I.; Ope-Ewe, O. O.; Ogunsanya, O. A.; Olono, A.; Eromon, P.; Tomkins-Tinch, C. H.; Otieno, J. R.; Akanbi, O.; Egwuenu, A.; Ehiakhamen, O.; Chukwu, C.; Suleiman, K.; Akinpelu, A.; Ahmad, A.; Imam, K. I.; Ojedele, R.; Oripenaye, V.; Ikeata, K.; Adelakun, S.; Olajumoke, B.; Essengue, L. L. M.; Djuicy, D. D.; Yifomnjou, M. H. M.; Zeller, M.; Gangavarapu, K.; O'Toole, A.; Park, D.; Mbowa, G.; Kiffle Tessema, S.; Tebeje, Y. K.; Folarin, O.; Happi, A.; Lemey, P.; Suchard, M. A.; Andersen, K. G.; Sabeti, P.; Rambau

2024-06-19 epidemiology Community evaluation
10.1101/2024.06.18.24309104 medRxiv
Show abstract

Five years before the 2022-2023 global mpox outbreak Nigeria reported its first cases in nearly 40 years, with the ongoing epidemic since driven by sustained human-to-human transmission. However, limited genomic data has left questions about the timing and origin of the mpox virus (MPXV) emergence. Here we generated 112 MPXV genomes from Nigeria from 2021-2023. We identify the closest zoonotic outgroup to the human epidemic in southern Nigeria, and estimate that the lineage transmitting from human-to-human emerged around July 2014, circulating cryptically until detected in September 2017. The epidemic originated in Southern Nigeria, particularly Rivers State, which also acted as a persistent and dominant source of viral dissemination to other states. We show that APOBEC3 activity increased MPXVs evolutionary rate twenty-fold during human-to-human transmission. We also show how Delphy, a tool for near-real-time Bayesian phylogenetics, can aid rapid outbreak analytics. Our study sheds light on MPXVs establishment in West Africa before the 2022-2023 global outbreak and highlights the need for improved pathogen surveillance and response.

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