Genomic recombination causing rapid evolution of Mpox clade 1b, diverging into four lineages and 14 subgroups!

Medical News: In the midst of ongoing global health concerns, scientists have uncovered alarming new developments surrounding the Mpox (Monkeypox) virus, specifically Clade 1b. A recent study, conducted by researchers from various international institutions, reveals that this particular strain of the virus is evolving at a rapid rate due to an unusually high frequency of genomic recombination. The virus has not only diverged into four distinct lineages but has also formed 14 subgroups based on tandem repeat (TR) polymorphisms. This rapid evolution raises concerns about the potential emergence of more lethal variants if action is not taken swiftly.


Genomic recombination causing rapid evolution of Mpox clade 1b, diverging
into four lineages and 14 subgroups!

The researchers involved in this study are from several prestigious institutions, including Auxergen Inc., Rita Rossi Colwell Center in Baltimore, USA; Auxergen S.r.l., Tecnopolis PST, University of Bari in Italy; and Kaohsiung Municipal United Hospital in Taiwan. Their collaborative work has highlighted the significance of these findings in understanding the 2024 outbreak of Mpox and addressing the growing threat it poses to global public health.
 
This Medical News report delves deeper into the findings of this crucial research, shedding light on how genomic recombination is accelerating the evolution of Mpox Clade 1b and what this means for public health efforts worldwide.
 
Mpox Virus Clade 1b: A Public Health Emergency
On August 14, 2024, the World Health Organization (WHO) declared the Mpox virus Clade 1b outbreak a public health emergency of international concern. At that time, 18,737 cases and 541 deaths across 14 countries had been reported, with a fatality rate of approximately 3%. According to the European Centre for Disease Prevention and Control (ECDC), the actual number of cases is likely higher due to underreporting and under-ascertainment in certain regions.
 
Mpox Clade 1b is diverging at a much faster rate than Clade 2b, the strain that was primarily responsible for the 2022 outbreak. The accelerated divergence is attributed to a significant increase in genomic recombination, which is when segments of the virus’s genetic material are exchanged between different viral strains, leading to new variants.
 
The study revealed that the rate of recombination in Mpox Clade 1b is nearly twice that of Clade 2b, which had 11 subgroups. The findings show that this particular strain has already evolved into four separate lineages and 14 subgroups. This suggests that the virus is undergoing more frequent mutations and recombinations, making it more difficult to predict its future behavior and the potential impact on the affected populations.
 
Genomic Recombination: Fueling the Evolution of Mpox
One of the key factors contributing to the rapid evolution of Mpox Clade 1b is genomic recombination, a process where genetic material is exchanged between two or more viral strains. This exchange results in the creatio n of new viral variants, which can sometimes exhibit different characteristics, such as increased transmissibility, resistance to treatments, or heightened virulence.
 
Researchers used genomic sequences from 32 Mpox Clade 1b samples collected between October 2023 and August 2024 to conduct their analysis. They found that the tandem repeats in the genome of Clade 1b are mutating at a significantly higher frequency compared to Clade 2b, which dominated the 2022 outbreak. These tandem repeats play a crucial role in the structural integrity of the virus’s genome and its ability to replicate within host cells.
 
Through their phylogenetic analysis, the team identified four distinct lineages within Mpox Clade 1b. Each lineage has evolved into various subgroups, forming a total of 14 subgroups based on nine tandem repeat polymorphisms. The presence of these subgroups indicates that the virus is continuously evolving, with new variants emerging over time.
 
The study also highlighted that linkage disequilibrium (LD) analysis uncovered 10 independent recombination clusters among all four lineages. Recombination rates in Clade 1b were found to be substantially higher than in Clade 2b, with incidences of superinfection - where a single host is infected with multiple strains of the virus - playing a key role in the ongoing recombination of the virus.
 
Potential Public Health Implications
The findings from this study raise significant concerns about the potential for more lethal Mpox strains to emerge. The accelerated recombination and mutation rates seen in Clade 1b make it difficult to predict how the virus will evolve in the future. Without timely intervention, there is a risk that new variants may arise with greater pathogenicity, leading to higher morbidity and mortality rates.
 
In regions where laboratory capacity is limited, particularly in parts of Africa, the ability to detect and track new Mpox cases is hindered. This lack of surveillance means that the true extent of the virus’s evolution may be underestimated. The researchers emphasize the need for increased genomic surveillance and more transparent sharing of viral sequences in order to better understand the scope of the outbreak and take appropriate measures to contain it.
 
It has also been shown that poxvirus recombinants can emerge from virus-by-virus crosses within the same genus. This suggests that further recombination events could lead to the development of new strains with altered characteristics, potentially exacerbating the global outbreak.
 
Study Findings and Conclusion
The study’s findings underscore the urgency of addressing the rapid evolution of Mpox Clade 1b. The emergence of four lineages and 14 subgroups is a clear indication that the virus is evolving at a rate faster than previously observed in the 2022 outbreak of Clade 2b. With recombination rates doubling and superinfections contributing to the ongoing evolution of the virus, public health officials must act quickly to prevent the spread of more dangerous variants.
 
The study concluded that genomic surveillance and transparent sharing of Mpox sequences across affected regions are critical to understanding the virus’s evolution. By monitoring the virus more closely, scientists can provide better insights into the outbreak and develop strategies to mitigate its impact on global health. The continued evolution of the virus poses a significant threat, and the development of new recombinant variants could result in increased transmissibility or higher mortality rates. Prompt action is essential to avoid the emergence of more virulent strains.
 
The study findings were published on a preprint server and are currently being peer reviewed,
https://www.medrxiv.org/content/10.1101/2024.09.18.24313912v1
 
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https://www.thailandmedical.news/articles/monkeypox