title: A tale of two clades: monkeypox viruses.
abstract: Human monkeypox was first recognized outside Africa in 2003 during an outbreak in the USA that was traced to imported monkeypox virus (MPXV)-infected West African rodents. Unlike the smallpox-like disease described in the Democratic Republic of the Congo (DRC; a Congo Basin country), disease in the USA appeared milder. Here, analyses compared clinical, laboratory and epidemiological features of confirmed human monkeypox case-patients, using data from outbreaks in the USA and the Congo Basin, and the results suggested that human disease pathogenicity was associated with the viral strain. Genomic sequencing of USA, Western and Central African MPXV isolates confirmed the existence of two MPXV clades. A comparison of open reading frames between MPXV clades permitted prediction of viral proteins that could cause the observed differences in human pathogenicity between these two clades. Understanding the molecular pathogenesis and clinical and epidemiological properties of MPXV can improve monkeypox prevention and control.
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Likos
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Sammons
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Olson
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: A Michael
authors.initials: AM
authors.lastname: Frace
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Olsen-Rasmussen
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Whitni
authors.initials: W
authors.lastname: Davidson
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Galloway
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Marina L
authors.initials: ML
authors.lastname: Khristova
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Darin S
authors.initials: DS
authors.lastname: Carroll
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Curns
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Formenty
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Esposito
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Regnery
authors.affiliation: National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G43, Atlanta, GA 30333, USA.
authors.forename: Inger K
authors.initials: IK
authors.lastname: Damon
mesh_terms: D000818:Animals; D004279:DNA, Viral / Q000235:genetics; D016679:Genome, Viral; D008969:Molecular Sequence Data; D008993:Monkeypox virus / Q000145:classification / Q000235:genetics; D016366:Open Reading Frames; D010802:Phylogeny; D017386:Sequence Homology, Amino Acid; D012689:Sequence Homology, Nucleic Acid; D045908:Mpox, Monkeypox / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D004279:DNA, Viral