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Clade I-Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo

Emile M Kibungu et al. Emerg Infect Dis. 2024 Jan.

Abstract

We report a cluster of clade I monkeypox virus infections linked to sexual contact in the Democratic Republic of the Congo. Case investigations resulted in 5 reverse transcription PCR-confirmed infections; genome sequencing suggest they belonged to the same transmission chain. This finding demonstrates that mpox transmission through sexual contact extends beyond clade IIb.

Keywords: MPXV; monkeypox virus; mpox; sexually transmitted infections; the Democratic Republic of the Congo; viruses.

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Figures

Figure 1
Figure 1
Penile lesions and papules associated with clade I monkeypox virus infection in a man in his late 20s who reported having 2 sexual encounters with a man in Europe 1 week before arriving in Democratic Republic of the Congo.
Figure 2
Figure 2
Phylogenetic analysis of MPXV sequences from a cluster of mpox cases described in Kwango Province, Democratic Republic of the Congo. A) MPXV global phylogeny showing that the Kwango Province outbreak cluster belongs to clade I MPXV. B) Phylogenetic analysis of MPXV genome sequences from the reported cases and clade I MPXV sequences from Central Africa. Posterior support values are shown at branch points. DNA was extracted at Institut National de Recherche Biomédicale using a QIAGEN DNA Mini Kit (https://www.qiagen.com) from blood samples and subsequently screened for MPXV with an orthopoxvirus-specific real-time PCR assay. Whole-genome sequencing was attempted on samples from the index case by next-generation sequencing. The library preparation was performed using Illumina DNA Prep with Enrichment (https://www.illumina.com), and the libraries were enriched for MPXV using biotinylated custom probes synthesized by Twist Biosciences (https://www.twistbioscience.com). Note that 23MPX098 (or 23MPX0245V) and 23MPX099 (or 23MPX0245C) are vesicle and crust samples from case-patient 1. Scale bar indicates number of substitutions per site. DRC, Democratic Republic of the Congo; hMPXV, human MPXV; MPXV, monkeypox virus.
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