The monkeypox (MPXV) virus now spreading in non-endemic countries has mutated at an unprecedented speed. That is according to a study published in Nature Medicine on June 24, 2022.
The monkeypox in the current outbreak is different by 50 mutations compared to the monkeypox virus from the 2018-2019 outbreak. That is roughly 6 to 12 fold more than one would expect. Typically it is only 1-2 substitutions per site per year.
The last time a monkeypox outbreak happened outside Africa was in 2018 – 2019 when an imported animal carried the virus to the United Kingdom, Israel, and Singapore.
The number of mutations this year is enough for the present monkeypox virus to be classified as MPXV clade 3. A clade describes groups of similar viruses based on their genetic sequences.
There are two monkeypox clades. The West African clade with a <1% mortality rate, and the deadlier Central African or Congo Basin clade with a >10% fatality rate.
Monkeypox clade 3 belongs to the West African clade, which explains why there are no reported deaths for the current outbreak.
The image below shows the monkeypox clade 3 (red circle) branching off from the West African clade to cause the 2022 outbreak (purple rectangle)
The mutation mechanism
The mutation that happens is single nucleotide polymorphism (SNP). SNP occurs when a single nucleotide is exchanged for another in a specific genome position.
In their study, the accelerated evolution could be due to APOBEC3. APOBEC3 is a human gene family that produces cytidine deaminase enzymes to fight viral infections by changing their genes to deactivate them.
However, the effect of the mutation may go the other way and increase the survival of the virus by making it more infectious. In the current epidemic, human-to-human transmission and adaptation are facilitated.
Monkeypox circulates among African rodents, but it was first discovered in a monkey which explains the name.
As of writing, there are 4,229 monkeypox cases from 65 countries. Yesterday, it was 3,661.
The cases may increase after the weekend Pride activities in New York City. That’s because monkeypox is associated with men having sex with men. A New York City health clinic tried to roll out monkeypox vaccines, but it closed when it ran out of them due to high demand.
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References:
- Isidro, J., Borges, V., Pinto, M. et al. Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus. Nat Med (2022). https://doi.org/10.1038/s41591-022-01907-y
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