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.

中文翻译：

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2018-2024 年刚果民主共和国 I 猴痘病毒基因组多样性：人畜共患传播的优势


最近的报告引起了人们对刚果民主共和国 （DRC） 猴痘流行病学变化的担忧。为来自 14/26 个省份的 337 名患者生成了高质量的基因组，以记录病例数的增加是由于人畜共患溢出事件还是病毒进化，以及与人类适应相关的 APOBEC3 突变的富集。我们的研究强调了导致人类病例来源的两种传播模式。来自南基伍省东部的所有新序列 （n = 17; 4.8%） 对应于最近描述的分支 Ib，与性接触和持续的人际传播有关。相比之下，所有其他基因组都是 Ia 分支，与分支 Ib 相比，它表现出高度的遗传多样性和 APOBEC3 突变的数量，表明存在多个人畜共患疾病的引入。城市地区存在多个分支 I 变体，这凸显了协调国际应对工作和对 mpox 传播和储存库进行更多研究的必要性。