Molecular Epidemiology to Decipher the Transmission Networks of Mpox in an Outbreak Scenario: Applications in Thailand During the 2023 Global Health Emergency.

BACKGROUND

The 2022 MPXV global health emergency highlighted the necessity for rapid diagnostic measures in response to mpox clade IIb outbreaks. This study investigates the mpox lineages identified in Thailand during this period and explores the transmission dynamics of dominant lineages.

METHODS

Using targeted next-generation sequencing from 162 individuals infected with mpox, we created a transmission network map by linking high-similarity sequences through molecular-temporal distance matrices.

RESULTS

Our findings reveal that the study population aligns with global trends of transmission almost exclusively within the community of men who have sex with men, with a majority of cases resulting from lineage C viruses as well as 8 additional sublineages. Within the observed substitutions, a majority of mutations were either G→A (n = 289, 49.74%) or C→T (n = 221, 38.04%), indicating APOBEC-3-driven deaminase activity. We also present a global transmission network for lineage C mpox genomes, illustrating domestic and international spread.

CONCLUSIONS

This research underscores the significance of whole genome sequencing in diagnostics during outbreaks and the importance of sharing genomic data to enhance our understanding of disease transmission on a global scale.