Phylogenetic analysis of 64 monkeypox (mpox) virus (MPXV) genome sequences in the National Center for Biotechnology Information (NCBI). The sequences were analyzed using mega software (version 10.16). The bootstrap consensus tree inferred from 1,000 replicates was taken to represent the evolutionary history of the taxa analyzed. The reference sequence of the Democratic Republic of the Congo (DRC) clade (A.1) from human (GenBank accession no. NC_003310.1) was reported from DRC in 1996. Some sequences were obtained from a sporadic outbreak from the USA in 2003 and genetically classified into the Republic of the Congo (ROC) clade (A.2). MT724769.1 from Malacomys longipes was reported from the DRC in 2012 and can be classified genetically into the ROC clade (A.2). The sequences from 2017 to 2022 phylogenetically form a new clade (clade B.1); seven sequences that reported from Nigeria in 2017 and six sequences in 2018 and 2019 from Israel, Singapore, and UK are tightly clustered together. The clinical information from the patients in 2018 and 2019 and their genetic information suggest that they originated in Nigeria. Three sequences (ON676701.1 from Texas in 2021, ON674051.1 from Florida in 2022, and ON675438.01 from Virginia) revealed high similarity with the earlier Nigeria strains and the MPXV sequence of ON676708 (USA_2021_MD) from a case who traveled from Nigeria to the United States in 2021 was phylogenetically placed between the sequences of strains in 2018-2019 and 2022. These findings suggest that mpox cases were already presented in the USA before the global outbreak in 2022. As all sequences in 2022 are identical, the emergence of the 2022 outbreak may be transmitted from one hidden source that potentially emerged from the continuous cryptic circulation of the same virus that caused the 2017-2018 outbreak in Nigeria. Origins and Yr (year) mean “which country” and “when” submits the sequences to the NCBI site. Host means an organism that is infected with the MPXV.

Urogenit Tract Infect 2023;18:35-44 https://doi.org/10.14777/uti.2023.18.2.35

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