Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018

Nicolas Berthet,Camille Besombes,Benjamin Selekon,Ingrid Labouba,Emmanuel Nakoune,Jean-Claude Manuguerra,Andriniaina Andy Nkili Meyong,Maxence Feher,Stéphane Descorps-Declère,Huguette Dorine Simo Tchetgna,Antoine Gessain,Rita Sem Ouilibona,Arnaud Fontanet,Mirdad Kazanji,Ella Cyrielle Gonofio,Alexandre Hassanin,Manon Curaudeau

doi:10.1038/s41598-021-92315-8

Abstract

Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox. In the two past decades, Central Africa has seen an increase in the frequency of cases, with many monkeypox virus (MPXV) isolates detected in the Democratic Republic of Congo (DRC) and the Central African Republic (CAR). To date, no complete MPXV viral genome has been published from the human cases identified in the CAR. The objective of this study was to sequence the full genome of 10 MPXV isolates collected during the CAR epidemics between 2001 and 2018 in order to determine their phylogenetic relationships among MPXV lineages previously described in Central Africa and West Africa. Our phylogenetic results indicate that the 10 CAR isolates belong to three lineages closely related to those found in DRC. The phylogenetic pattern shows that all of them emerged in the rainforest block of the Congo Basin. Since most human index cases in CAR occurred at the northern edge of western and eastern rainforests, transmissions from wild animals living in the rainforest is the most probable hypothesis. In addition, molecular dating estimates suggest that periods of intense political instability resulting in population movements within the country often associated also with increased poverty may have led to more frequent contact with host wild animals. The CAR socio-economic situation, armed conflicts and ecological disturbances will likely incite populations to interact more and more with wild animals and thus increase the risk of zoonotic spillover.

Highlights

Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox
Three human cases were diagnosed in the United Kingdom (UK), the first of which involved a person traveling through Paris from Nigeria, and the second resulting in a nosocomial transmission to a health worker in the U K15
Many monkeypox virus (MPXV) genomes have been sequenced from previous outbreaks in the Democratic Republic of Congo (DRC) and Nigeria, but no genomic data is currently available for MPXV detected over the past two decades in the Central African Republic (CAR)

Summary

Introduction

Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox. In the two past decades, Central Africa has seen an increase in the frequency of cases, with many monkeypox virus (MPXV) isolates detected in the Democratic Republic of Congo (DRC) and the Central African Republic (CAR). No complete MPXV viral genome has been published from the human cases identified in the CAR. In the past two decades, Congo Basin MPXVs have primarily affected two Central African countries, the DRC and the Central African Republic (CAR), at a growing case rate 3,9–11. Given the close phylogenetic relationship identified between the Cameroonian (for the 2018 strain) and Nigerian isolates, the close geographical proximity of the affected regions and the absence of human cases in Cameroon since 1989, the origin of this isolate is likely an import from Nigeria (West Africa). Obtaining genomic data from viruses isolated between 2001 and 2018 in the CAR can be very interesting to better understand how outbreaks emerged at the ecotone between rainforests and savannahs

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Conclusion