Genomic surveillance of an imported recombinant Clade Ib and IIb monkeypox virus case in India.

Double-stranded DNA viruses can recombine, such as the monkeypox virus (MPXV), but only one recombinant MPXV has been reported previously in the UK. Here we characterize a recombinant Clade Ib and IIb MPXV isolated from a travel-associated mpox case in India. The mosaic genome contains clade-defining mutations from both Ib and IIb and clusters with the UK recombinant. Both recombinant viruses show 34 recombinant tracts and 21 recombinant lineage-associated mutations. This has implications for genomic surveillance and diagnostics.