ArticleNature medicine2023
Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal.
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Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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36citing papers in PubMed, 1 pooled it
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dynamics of global mpox epidemics, 1970-2025: a systematic review and meta-analysis of evolving transmissibility and intervention effects.BMJ global health · 2026Pooled it
- Nextstrain automates real-time phylogenetic analysis of open data for endemic and emerging pathogens.Bioinformatics (Oxford, England) · 2026Article
- Genomic, virologic, and epidemiologic surveillance to track intrafamilial Mpox, Brazil.Microbiology spectrum · 2026Article
- Undetected circulation of monkeypox virus in Portugal: Evidence for a 50-day gap before first detection.Global epidemiology · 2026Article
- Spatiotemporal Transmission Characteristics of Global Monkeypox - Worldwide, January 2022-September 2025.China CDC weekly · 2026Article
- Viral introductions and return to baseline sexual behaviors maintain low-level mpox incidence in Los Angeles.Nature communications · 2026Article
- Article
- Genome Sequencing in Infectious Disease Outbreaks.Advances in experimental medicine and biology · 2026Review
- Acute Respiratory Infections (ARIs): Current Etiological Perspectives and Advances in Viral Metagenomics-A Review.Viruses · 2025Review
- Phylodynamic inference suggests introductions as main driver of Mpox Clade II outbreak in 2022 in Slovenia.Epidemiology and infection · 2025Article
- Relationship dynamics and behavioral adaptations in the control of the 2022 mpox epidemic.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Mpox Surveillance and Laboratory Response in Portugal: Lessons Learned from Three Outbreak Waves (2022-2025).Infectious disease reports · 2025Article
- Viral introductions and return to baseline sexual behaviors maintain low-level mpox incidence in Los Angeles County, USA, 2023-2024.medRxiv : the preprint server for health sciences · 2025Article
- Poisson random measure noise-induced coherence in epidemiological priors informed deep neural networks to identify the intensity of virus dynamics.Scientific reports · 2025Article
- Transmission dynamics of the 2022 mpox epidemic in New York City.Nature medicine · 2025Article
- Health Behaviors and Experiences of LGBTQ + Individuals during 2022 Mpox Outbreak: Findings from the QVax Study.Journal of community health · 2025Article
- Behavior changes influence mpox transmission in the United States, 2022-2023: Insights from homogeneous and heterogeneous models.PNAS nexus · 2025Article
- Mpox Virus as a Global Public Health Emergency: A Scoping Review.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025Review
- An Overview of Monkeypox Virus Detection in Different Clinical Samples and Analysis of Temporal Viral Load Dynamics.Journal of medical virology · 2024Article
- A retrospective genomic characterisation of the 2022 mpox outbreak in Belgium, and in vitro assessment of three antiviral compounds.EBioMedicine · 2024Article
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Authors and funding
72 authors.
Vítor Borges *Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Mariana Perez Duque *Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal.ORCID http://orcid.org/0000-0001-9999-8402
João Vieira MartinsEpidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal.
Paula VasconcelosPublic Health Emergency Centre, Directorate-General of Health, Lisbon, Portugal.
Rita FerreiraGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Daniel SobralGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0003-3955-0117
Ana PeleritoEmergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Isabel Lopes de CarvalhoEmergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Maria Sofia NúncioEmergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0001-5182-6150
Maria José BorregoNational Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Cornelius RoemerBiozentrum, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-6138-6539
Richard A NeherBiozentrum, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-2525-1407
Megan O'DriscollPathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, United Kingdom.ORCID http://orcid.org/0000-0002-7972-5703
Raquel RochaNational Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Sílvia LopoNational Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Raquel NevesNational Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Paula PalminhaNational Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Luís CoelhoGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Alexandra NunesGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0001-6449-8053
Joana IsidroGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Miguel PintoGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
João Dourado SantosGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Verónica MixãoGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0001-6669-0161
Daniela SantosTechnology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0002-3648-8410
Silvia DuarteTechnology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Luís VieiraTechnology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0002-7703-1409
Fátima MartinsTechnical Board, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Jorge MachadoDepartment Coordination, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
Vítor Cabral VeríssimoEpidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal.
Berta GrauEpidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal.ORCID http://orcid.org/0000-0002-7320-0965
André Peralta-SantosDirectorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal.
José NevesServiço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Margarida CaldeiraServiço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Mafalda PestanaServiço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Cândida FernandesServiço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
João CariaServiço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Raquel PintoServiço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Diana PóvoasServiço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Fernando MaltezServiço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Ana Isabel SáUnidade de Doenças Sexualmente Transmissíveis da Lapa, Lisbon, Portugal.
Mafalda Brito SalvadorUnidade de Doenças Sexualmente Transmissíveis da Lapa, Lisbon, Portugal.
Eugénio TeófiloGAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal.
Miguel RochaGAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal.ORCID http://orcid.org/0000-0003-1057-2419
Virginia MonetiGAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal.
Luis Miguel DuqueGAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal.
Francisco Ferreira E SilvaGAT - Grupo de Ativistas em Tratamentos, Intendente, Lisbon, Portugal.
Teresa BaptistaGAT - Grupo de Ativistas em Tratamentos, Intendente, Lisbon, Portugal.
Joana VasconcelosServiço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
Sara CasanovaServiço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
Kamal MansinhoServiço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
João Vaz AlvesServiço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
João AlvesServiço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal.
António SilvaServiço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal.ORCID http://orcid.org/0000-0002-0433-0352
Miguel AlpalhãoDermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.
Cláudia BrazãoDermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.
Diogo SousaDermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.
Paulo FilipeDermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.
Patrícia PachecoServiço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Francesca PeruzzuServiço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Rita Patrocínio de JesusServiço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.ORCID http://orcid.org/0000-0001-5181-9305
Luís FerreiraServiço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal.
Josefina MendezServiço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal.
Sofia JordãoServiço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal.
Frederico DuarteServiço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal.
Maria João GonçalvesServiço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal.
Eduarda PenaServiço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal.
Claúdio Nunes SilvaServiço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal.
André Rodrigues GuimarãesServiço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal.
Margarida TavaresServiço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal.
Graça FreitasNational Health Authority, Directorate-General of Health, Lisbon, Portugal.
Rita CordeiroEmergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.ORCID http://orcid.org/0000-0001-5321-3657
João Paulo GomesGenomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal. j.paulo.gomes@insa.min-saude.pt.ORCID http://orcid.org/0000-0002-2697-2399
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.
Indexed as
Mpox, MonkeypoxSexual and Gender MinoritiesCluster AnalysisDisease OutbreaksHomosexuality, MaleHumansMalePortugal
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