ArticleNature medicine2026
Genomic epidemiology of the 2025 mpox epidemic in Sierra Leone.
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Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9citing papers in PubMed
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Who cites it
9 citing papers in PubMed.
- Completion of early response actions accounted for most elapsed time across the 7-1-7 pathway in Sierra Leone, 2023-2025.Public health in practice (Oxford, England) · 2026Article
- Mpox in Sierra Leone and the Mano River Union: an epidemic unfolding in real time.BMJ global health · 2026Review
- 2026 Bundibugyo virus outbreak: the role of genomics inMicrobial genomics · 2026Article
- Characterization of the first complete genome sequence of yellow fever virus (YFV) in Sierra Leone: Implications for public health.PLoS neglected tropical diseases · 2026Article
- Genomic Characterization of the Index Case of Human Monkeypox Virus Infection in Mali, 2025.Viruses · 2026Article
- Article
- Mpox Clade IIb Virus Introduction into Kinshasa, Democratic Republic of the Congo, July 2025.Viruses · 2026Article
- Serological evidence uncovers undocumented mpox exposure in febrile patients in Nigeria.Frontiers in public health · 2026Article
- Suffering in silence: Stigma, healthcare barriers, and resilience during Sierra Leone's 2025 clade IIb mpox outbreak-A multi-perspective qualitative study.PLOS global public health · 2026Article
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Authors and funding
89 authors.
Allan K O Campbell *National Public Health Agency, Freetown, Sierra Leone. oakcampbell25@gmail.com.ORCID http://orcid.org/0000-0002-9178-1556
John Demby Sandi *Faculty of Medical Laboratory Sciences and Diagnostics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. johnatsandi@gmail.com.
Ifeanyi F OmahInstitute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.
Martin FayeInstitut Pasteur de Dakar, Dakar, Senegal.ORCID http://orcid.org/0000-0003-3207-6344
Edyth ParkerInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Taylor Brock-FisherThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.ORCID http://orcid.org/0009-0000-5388-9315
Crystal M GiganteCenters for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Vidalyn FolorunsoCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Mohamed Saio KamaraKenema Government Hospital, Kenema, Sierra Leone.
Anu Jegede WilliamsCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Mouhamed KaneInstitut Pasteur de Dakar, Dakar, Senegal.ORCID http://orcid.org/0009-0009-6489-7244
Tiangay Mariama Patience Sallay KallonKenema Government Hospital, Kenema, Sierra Leone.
Julian CampbellCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Kadiatu Salmata SesayKenema Government Hospital, Kenema, Sierra Leone.
Sia ManiCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Choe MillerCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Naomi Daniel SesayCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Francis BaimbaKenema Government Hospital, Kenema, Sierra Leone.
Mignane NdiayeInstitut Pasteur de Dakar, Dakar, Senegal.
Roberta LansanaCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Ibrahim Umaru FofanahKenema Government Hospital, Kenema, Sierra Leone.
Simon RuhwezaNational Public Health Agency, Freetown, Sierra Leone.ORCID http://orcid.org/0009-0008-9798-7134
Zein SoumaCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Amanda KargboCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Komba KoningaCentral Public Health Reference Laboratory, Freetown, Sierra Leone.
Alie TiaSierra Leone-China P3 Friendship Laboratory, Freetown, Sierra Leone.
Jone NgobehSierra Leone-China P3 Friendship Laboratory, Freetown, Sierra Leone.
Foday ThoronkaSierra Leone-China P3 Friendship Laboratory, Freetown, Sierra Leone.
Alusine FofanahNational Public Health Agency, Freetown, Sierra Leone.
Al OzonoffThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.ORCID http://orcid.org/0000-0003-4233-5899
Colby WilkasonThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Danny ParkThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.ORCID http://orcid.org/0000-0001-7226-7781
Christopher Tomkins-TinchThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Marietou F PayeThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Christopher ShinThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.ORCID http://orcid.org/0009-0001-7234-318X
Ian BaudiThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Brendan BlumenstielThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Patrick VarillyThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Ivan SpechtThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Ben FryFathom Information Design, Boston, MA, USA.ORCID http://orcid.org/0000-0002-6414-5570
Karlie ZhaoFathom Information Design, Boston, MA, USA.
Paul CronanFathom Information Design, Boston, MA, USA.
Ellory LaningFathom Information Design, Boston, MA, USA.
Oludayo Oluwaseyi Ope-EweInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Ayotunde Elijah SijuwolaInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.ORCID http://orcid.org/0000-0002-4539-9727
Femi SaibuInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Harouna SoumareInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Ebenezer Kehinde OgundanaInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Ruth Oluwaseun ObaadoInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Jolly Amoche AdoleInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.ORCID http://orcid.org/0000-0001-9231-3474
Imonikhe Kennedy KioInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Folefac Agnes NjeandohInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
Alexandra TuttleCenters for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Walter O OgutaWorld Health Organization Regional Office for Africa (WHO AFRO), Dakar, Senegal.ORCID http://orcid.org/0000-0002-4374-4777
Jonathan GreeneWorld Health Organization (WHO), Freetown, Sierra Leone.
Aminata KoromaNational Public Health Agency, Freetown, Sierra Leone.
Joseph KanuNational Public Health Agency, Freetown, Sierra Leone.
Mamadou Aliou BarryInstitut Pasteur de Dakar, Dakar, Senegal.
Aboubacry GayeInstitut Pasteur de Dakar, Dakar, Senegal.
Andy Mahine DioufInstitut Pasteur de Dakar, Dakar, Senegal.
Christine HughesCenters for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Joshua I LevyDepartment of Translational Medicine, The Scripps Research Institute, La Jolla, CA, USA.
Alhaji N'jaiDepartment of Biological Sciences, Fourah Bay College, University of Sierra Leone, Freetown, Sierra Leone.
Moussa Moise DiagneInstitut Pasteur de Dakar, Dakar, Senegal.
Dolo NosamiefanInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.ORCID http://orcid.org/0009-0005-9157-3609
George AmehWorld Health Organization (WHO), Freetown, Sierra Leone.
John KlenaCenters for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Monique A FosterCenters for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Abebaw KebedeAfrica Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.ORCID http://orcid.org/0000-0002-6154-7275
Collins TanuiAfrica Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
Boubacar DialloInstitut Pasteur de Dakar, Dakar, Senegal.
Anise HappiInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.ORCID http://orcid.org/0000-0001-8959-5175
Sofonias TessemaAfrica Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.ORCID http://orcid.org/0000-0003-1057-5310
Abdourahmane SowInstitut Pasteur de Dakar, Dakar, Senegal.
Yenew KebedeAfrica Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.ORCID http://orcid.org/0000-0001-7224-8628
Isatta WurieFaculty of Medical Laboratory Sciences and Diagnostics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
James SquireNational Public Health Agency, Freetown, Sierra Leone.
Doris HardingNational Public Health Agency, Freetown, Sierra Leone.
Zikan KoromaNational Public Health Agency, Freetown, Sierra Leone.ORCID http://orcid.org/0000-0002-4512-8038
Mohamed Boie JallohNational Public Health Agency, Freetown, Sierra Leone.
Amadou Alpha SallInstitut Pasteur de Dakar, Dakar, Senegal.
Kristian G AndersenDepartment of Translational Medicine, The Scripps Research Institute, La Jolla, CA, USA.ORCID http://orcid.org/0000-0001-6431-5982
Andrew RambautInstitute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-4337-3707
Mohamed Alex VandiNational Public Health Agency, Freetown, Sierra Leone.
Ibrahima Socé FallInstitut Pasteur de Dakar, Dakar, Senegal.
Pardis SabetiThe Broad Institute of MIT and Harvard, Cambridge, MA, USA.ORCID http://orcid.org/0000-0002-9843-1890
Christian HappiInstitute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.ORCID http://orcid.org/0000-0002-3056-6705
Foday SahrNational Public Health Agency, Freetown, Sierra Leone.
Donald S GrantNational Public Health Agency, Freetown, Sierra Leone. donkumfel@yahoo.co.uk.ORCID http://orcid.org/0000-0002-4329-0795
Funding
Wellcome Trust (Wellcome) 218471/Z/19/Z
Abstract
Mpox is a re-emerging zoonotic disease caused by MPXV, which has led to outbreaks across multiple countries in recent years. Sierra Leone reported its first mpox case in 8 years in January 2025, rapidly becoming the epicenter of a continental outbreak with more than 5,000 confirmed cases by August, a surge with unknown origins, timings and drivers. Phylodynamic analyses using 338 genomes generated from 14 districts suggests that the outbreak was caused by lineage G.1 (A.2.2.1) which descended from lineages circulating in Nigeria. Here we observed a strong APOBEC3 mutational enrichment, consistent with sustained human transmission that circulated undetected for ~3 months before the first confirmed case in January 2025. The Western Area Urban district served as the primary hub for nationwide spread and persistence, as well as multiple international export events. We further estimated that the true epidemic size was nearly double official case counts, highlighting substantial surveillance gaps. These findings underscore the urgent need for strengthened genomic and diagnostic surveillance systems across West Africa to pre-empt epidemics.
Indexed as
Mpox, MonkeypoxDisease OutbreaksEpidemicsGenome, ViralGenomicsHumansMolecular EpidemiologyMutationPhylogenySierra Leone
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