Genomic diversity of mpox virus in Paris area (France) during the 2022 outbreak

In May 2022, several countries reported mpox cases from patients without history of traveling to endemic areas. France was one of the most affected European countries by this outbreak. In this study, the clinical characteristics of mpox cases in France were described, and the genetic diversity of the virus was studied. Patients diagnosed with mpox infection (quantitative polymerase chain reaction c(t) < 28) between May 21, and July 4, 2022 and between 16th August and 10th September 2022 were included to this study. Twelve amplicons corresponding to the most polymorphic regions of the mpox genome and covering similar to 30 000 nucleotides were generated and sequenced using the S5 XL Ion Torrent technology to evaluate the genetic diversity of mpox sequences. One hundred and forty-eight patients were diagnosed with mpox-infection. 95% were men, 5% transgender (M-to-F), 50% were taking human immunodeficiency virus (HIV) pre-exposure prophylaxis, and 25% were HIV seropositive. One hundred and sixty-two samples (some patients had two samples) were sequenced and compared to GenBank sequences. Overall, low genetic diversity of mpox sequences was found compared with pre-epidemic Western-African sequences, with 32 distinct mutational patterns. This study provides a first glance at the mutational landscape of early mpox 2022 circulating strains in Paris (France).

Automated summary

In May 2022, mpox cases were reported in several countries without a travel history to endemic areas. France experienced a significant outbreak, and this study analyzed the clinical characteristics and genetic diversity of mpox cases in the country. The study included mpox-infected patients diagnosed between May 21 and July 4, 2022, and between August 16 and September 10, 2022. Genetic diversity analysis revealed low variability compared to pre-epidemic Western-African sequences, with 32 distinct mutational patterns. This study provides valuable insights into the early 2022 circulating strains of mpox in Paris, France.