ArticleNature medicine2023
Distinct monkeypox virus lineages co-circulating in humans before 2022.
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 43 papers.
What it found
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The trial behind it
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Who cites it
43 citing papers in PubMed, 78 citations in OpenAlex.
- APOBEC3-driven attenuation of the 2022 global outbreak monkeypox virus relative to its clade IIb ancestor.Nature communications · 2026Article
- Assessing mpox knowledge and sexual behaviours within high-risk populations in the Democratic Republic of the Congo.BMJ global health · 2026Article
- Genomic epidemiology of the 2025 mpox epidemic in Sierra Leone.Nature medicine · 2026Article
- Article
- Multiplex PCR to Differentiate Monkeypox Virus Clades.Emerging infectious diseases · 2026Article
- Sero-genomic evidence for occult mpox exposure in healthy Nigerian adults.Nature communications · 2026Article
- Serological evidence uncovers undocumented mpox exposure in febrile patients in Nigeria.Frontiers in public health · 2026Article
- Review
- First imported cases of MPXV Clade Ib from Goma, Democratic Republic of the Congo.Communications medicine · 2025Article
- Emerging strategies for monkeypox: antigen and antibody applications in diagnostics, vaccines, and treatments.Military Medical Research · 2025Review
- A systematic nomenclature for mpox viruses causing outbreaks with sustained human-to-human transmission.Nature medicine · 2025Article
- Understanding the evolutionary dynamics of Monkeypox virus through less explored pathways.Scientific reports · 2025Article
- Article
- Mpox: A case study for a one health approach to infectious disease prevention.One health (Amsterdam, Netherlands) · 2025Review
- Mpox poses an ever-increasing epidemic and pandemic risk.Nature medicine · 2025Article
- Transmission dynamics of the 2022 mpox epidemic in New York City.Nature medicine · 2025Article
- Monkeypox Virus: WHO's Second Public Health Emergency of International Concern Within 2 Years.Microbial biotechnology · 2025Review
- Viral infection and antiviral immunity in the oral cavity.Nature reviews. Immunology · 2025Review
- Portable molecular diagnostic platform for rapid point-of-care detection of mpox and other diseases.Nature communications · 2025Article
- Strong and early monkeypox virus-specific immunity associated with mild disease after intradermal clade-IIb-infection in CAST/EiJ-mice.Nature communications · 2025Article
Corrections and comments
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Authors and funding
24 authors at 7 institutions in 2 countries.
Funding
Abstract
The 2022 global mpox outbreak raises questions about how this zoonotic disease established effective human-to-human transmission and its potential for further adaptation. The 2022 outbreak virus is related to an ongoing outbreak in Nigeria originally reported in 2017, but the evolutionary path linking the two remains unclear due to a lack of genomic data between 2018, when virus exportations from Nigeria were first recorded, and 2022, when the global mpox outbreak began. Here, 18 viral genomes obtained from patients across southern Nigeria in 2019-2020 reveal multiple lineages of monkeypox virus (MPXV) co-circulated in humans for several years before 2022, with progressive accumulation of mutations consistent with APOBEC3 activity over time. We identify Nigerian A.2 lineage isolates, confirming the lineage that has been multiply exported to North America independently of the 2022 outbreak originated in Nigeria, and that it has persisted by human-to-human transmission in Nigeria for more than 2 years before its latest exportation. Finally, we identify a lineage-defining APOBEC3-style mutation in all A.2 isolates that disrupts gene A46R, encoding a viral innate immune modulator. Collectively, our data demonstrate MPXV capacity for sustained diversification within humans, including mutations that may be consistent with established mechanisms of poxvirus adaptation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.