Dados do Trabalho

Título

Epidemiological and genomic surveillance of Monkeypox Virus, Rio Grande do Sul, Brazil

Introdução

Mpox is a zoonotic disease caused by monkeypox virus (MPXV). On 23 July 2022, the World Health Organization declared the multi-country outbreak of MPXV as a Public Health Emergency of International Concern, endorsing the need to increase surveillance and public health measures to contain its transmission.

Objetivo (s)

Our aim was to track circulating strains and investigate genomic diversity of MPXV in Rio Grande do Sul (RS), Brazil.

Material e Métodos

We selected 49 human MPXV-positive samples collected from July to October 2022 for whole-genome sequencing using an amplicon-based approach on Illumina platform. Consensus sequences were retrieved to perform phylogenetic and phylodynamic inferences along with a clinical-epidemiological analysis.

Resultados e Conclusão

Brazil accounted for 48,648 Mpox suspected cases in 2022 with 10,039 (20.6%) laboratory-confirmed cases. In RS, 327 (12.9%) Mpox confirmed cases were registered from 2,529 suspected cases investigated. Men were the most affected (n = 290; 88.7%), and the median age was 34 years (range = 0-73 years). Sexual transmission was the most frequent spread form (n = 118; 36.1%), followed by human-to-human (n = 37; 11.3%). Among confirmed cases, 15 (4.6%) required hospitalization for isolation or clinical reasons. All patients have favorable outcomes. All the 49 MPXV genomes sequenced were assigned to clade IIb and most of them to Lineage B.1.9 (25/49) followed by B.1.1 (16/49), B.1 (7/49) and B.1.13 (1/49) lineages. We identified multiple MPXV introductions events from the United States, Portugal, Germany, and Belgium, followed by MPXV community transmission in the RS territory. We identified a genomic cluster, including two sequences from Porto Alegre residents' individuals, with the onset of symptoms one day apart and the same sample collection date, even though no epidemiological link was found among them. We also found a genomic cluster including samples from an infected patient and a healthcare worker from a possible occupational infection transmitted through fomite exposure with surfaces in the patient’s home. Genomic surveillance of emerging and re-emerging diseases plays a key role in disease control. Our results put in evidence important aspects of MPXV transmission routes and their importance in infection control.

Palavras-chave

Monkeypox virus; genomic surveillance; public health.

Agradecimentos

Equipe: Tatiana S. Gregianini, Fernanda M.Rocha, Renata P. Mondini, Karine M. Amaral, Fernanda C. L. Delela, Sabrina Vizeu
Financiamento: Ministério da Saúde, SES/RS, FAPERGS.