Explore the vast range of titles available.

During 1979-2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.

Mpox was first identified against the backdrop of the smallpox eradication campaign. Monkeypox virus (MPXV), the causative agent of mpox, has been maintained in animal reservoirs in the forested regions of West and Central Africa as 2 distinct clades; clade I has historically caused more severe infection in Central Africa than clade II, historically found in West Africa. However, rapid reemergence and spread of both MPXV clades through novel routes of transmission have challenged the known characteristics of mpox. We summarize mpox demographic distribution, clinical severity, and case-fatality rates attributed to genetically distinct MPXV subclades and focus on MPXV clade Ib, the more recently identified subclade. Broad worldwide assistance will be necessary to halt the spread of both MPXV clades within mpox endemic and nonendemic regions to prevent future outbreaks.

Abstract Mpox in humans is a rash illness resulting from infection with monkeypox virus (MPXV). In 2022, a public health emergency of international concern (PHEIC) was declared with 115 countries reporting cases of Mpox. Most of these countries had not previously reported cases. This global outbreak was sustained primarily by human-to-human transmission within complex sexual networks. Whilst these cases were similar to previous clade II West African MPXV isolates, they were sufficiently genomically distinct to result in WHO recognizing two subclades within clade II: clade IIa and clade IIb. In 2024, a second PHEIC was declared, resulting from a marked increase in cases of clade I MPXV. In this scoping review, we compare the major clinical, epidemiological, and genomic features of the major mpox lineages and the implications for vaccination, transmission, infection control and treatment.. A scoping review, comparing the major clinical, epidemiological, and genomic features of clades I, IIa, and IIb MPXV.

Background Monkeypox (Mpox), a zoonotic disease caused by the monkeypox virus, has gained global attention due to rising incidence and the emergence of new clades. Understanding the epidemiology, transmission dynamics, and diagnostic challenges associated with the two major clades, Clades I and II, is crucial for outbreak preparedness and control. Methods This review analyzes Mpox clades, highlighting their geographic distribution, virulence, transmissibility, and diagnostic approaches. It also presents recent outbreaks, diagnostic advancements, vaccination strategies, and critical research gaps in Mpox surveillance and response. Results Clade I, primarily in Central Africa, exhibits the highest virulence with a 5–10% case fatality rate. Clade II, which includes subclades IIa, IIb, and the newly identified Clade Ib, demonstrates lower virulence but higher transmissibility beyond endemic regions. Recent outbreaks (2022–2024), driven by Clade IIb, present atypical clinical presentations and emphasize intimate human-to-human contact as a key transmission route. Polymerase chain reaction, next-generation sequencing, and emerging CRISPR-based diagnostics have improved detection, while modified vaccinia Ankara-based vaccines have shown effectiveness despite challenges in equitable distribution. Conclusions Addressing critical research gaps, such as clade-specific virulence mechanisms, zoonotic reservoirs, and evolutionary patterns, is essential for improving Mpox surveillance and control. Strengthening genomic surveillance, expanding access to affordable diagnostics, and fostering international collaboration will enhance preparedness for future outbreaks and mitigate the impact of this emerging infectious disease. Highlights • Comparison of Mpox virus (MPXV) clades, in geography, virulence, transmission, and clinical outcomes between Clade I, Clade II, and emerging subclades IIb and Ib. • The epidemiology of Mpox focuses on the 2022–2024 global outbreaks of Clade IIb, marked by unusual clinical presentations and fast human-to-human spread in non-endemic areas. • Key advancements in diagnostic technologies like PCR, NGS, and CRISPR assays, improving MPXV detection and clade differentiation. • The effectiveness of MVA-based vaccines against various MPXV clades is presented while highlighting challenges in equitable distribution and region-specific vaccination strategies. • Emerging Mpox research priorities include genomic surveillance, clade-specific virulence, affordable diagnostics, and overcoming socioeconomic barriers to outbreak management. Graphical Abstract

IntroductionSoil nitrous oxide (N2O) emissions are a major contributor to global warming and climate change. Microbial N2O reduction via the nosZ gene—classified into clade I and clade II—is the only known biological sink for N2O.MethodsIn this study, we isolated two N2O-reducing bacterial strains: an Enterobacter sp. harboring nosZ clade I ( nosZ I) and a Pseudomonas sp. harboring nosZ clade II ( nosZ II). We evaluated their performance under different environmental conditions and their effects on N2O emissions from agricultural soils subjected to varying fertilization strategies.ResultsPure culture experiments revealed that growth and N2O-reducing activity in both strains were significantly influenced by pH, oxygen concentration, nitrate levels, and carbon source. Notably, the nosZ II strain demonstrated broader environmental adaptability and higher N2O-reduction efficiency across a range of conditions. In soil microcosm experiments, N2O emissions were strongly affected by fertilization type, with mixed organic-inorganic treatments producing the highest emissions. Inoculation with the nosZ II strain significantly reduced N2O emissions in soils receiving inorganic or combined fertilizers. In contrast, the nosZ I strain tended to increase emissions, except under the mixed fertilization regime.DiscussionThese findings highlight the importance of selecting N2O-reducing microbial strains based on their functional capacity and environmental tolerance. This work advances the development of targeted microbial strategies for mitigating N2O emissions, supporting more sustainable and climate-resilient agricultural practices.

Since the elimination of smallpox, mpox (monkeypox) is the most medically significant orthopoxvirus infection. As a result of numerous regional, national and global outbreaks of MPXV (mpox virus), there is an abundance of new data available on the effects of the different viral clades on clinical obstetrical and perinatal outcomes when infection occurs in pregnancy. In addition, there have been additional placentas from cases of congenital MPXV infection available for study. These recent data indicate that there are prominent differences between viral strains and their effects on the fetus, with MPXV Clade I strains (Ia, Ib) having the greatest risk for an adverse outcome in pregnancy, and Clade II strains (IIa, IIb) having far less risk. In particular, the ongoing outbreak of MPXV Clade Ib in the DRC indicates that there is a significant risk for adverse perinatal outcomes associated with infection in pregnancy, especially during the first trimester. These outcomes include spontaneous abortion, stillbirth, neonatal death and congenital mpox. The placenta in cases of congenital infection demonstrates abundant virus in the chorionic villi, with prominent involvement of Hofbauer cells. Similar to smallpox, transplacental transmission and adverse pregnancy outcomes are an important feature of certain strains of this orthopoxvirus infection when occurring in pregnant women.

Clade I mpox virus (MPXV) is endemic in the Democratic Republic of the Congo (DRC). Recent studies have described the changing epidemiology of mpox in the country, which has been mainly characterized by the emergence of new MPXV lineages, Clade Ib/sh2023 and Ia/sh2024, associated with sustained human-to-human transmission. Both Clade Ib/sh2023 and Ia/sh2024 are co-circulating in Kinshasa, the capital city of the DRC. Here, we report the first two cases of Clade IIb/sh2017 identified in Kinshasa, DRC, imported from West Africa and locally transmitted. Clinical specimens were collected and tested by PCR. We performed whole genome sequencing using a tiled-amplicon sequencing approach with Clade IIb MPXV-specific primers. The phylogenetic tree shows that Kinshasa Clade IIb MPXV is assigned to Clade IIb/sh2017 within the newly designated lineage G.1, as identified in January 2025 in Sierra-Leone.

Background: Monkeypox (MPX), caused by the Monkeypox virus (MPOX) of the Orthopoxvirus genus, has re-emerged as a significant global health threat. Once confined to Central and West Africa, the 2022–2025 multi-country outbreaks, predominantly caused by Clade IIb, demonstrated sustained human-to-human transmission and global spread. Objective: This review summarizes current knowledge on MPX virology, epidemiology, clinical presentation, and diagnostic technologies, with a focus on innovations supporting rapid and field-deployable detection in resource-limited settings. Methods: The recent literature (2019–2025), including peer-reviewed studies, WHO and Africa CDC reports, and clinical guidelines, was critically reviewed. Data were synthesized to outline key developments in diagnostic methodologies and surveillance approaches. Results: MPX comprises two genetic clades: Clade I (Congo Basin) and Clade II (West African), which differ in virulence and transmission. Clade IIb is associated with sexual and close-contact transmission during recent outbreaks. Clinical manifestations have shifted from classic disseminated rash to localized anogenital lesions and atypical or subclinical infections. RT-PCR remains the diagnostic gold standard, while emerging assays such as loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR/Cas-based platforms show promise for rapid point-of-care (POC) testing. Complementary serological tools, including ELISA and lateral flow assays, enhance surveillance and immune profiling. Conclusions: The resurgence of MPX highlights the urgent need for accessible, sensitive, and specific diagnostic platforms to strengthen surveillance and outbreak control, especially in endemic and resource-constrained regions.

The ongoing epidemic of monkeypox virus (MPXV) infection has already reached more than 50,000 persons worldwide until the end of August 2022. We report the first case detected in Venezuela. The patient reported traveling from Spain and contact with friends tested positive for MPXV after his return. Partial complete genome phylogenetic analysis allowed to group the isolate within the clade II of MPXV, the major one circulating worldwide. No other case of MPXV has been detected until the end of August 2022 in the country, although the presence of undiagnosed cases due to the fear of stigmatization cannot be ruled out.

Monkeypox virus (MPXV) hosts are of multiple species, with a risk of cross-species transmission. This phenomenon poses a threat to unreported affected domestic animals and increases the risk to human public health. Clinical diagnostics continue to face challenges regarding specificity among poxviruses. The need for a rapid and precise assay to differentiate between MPXV clades I and II, as well as goatpox virus (GTPV) is essential for enhancing our capacity for disease prevention, control, and epidemiological investigation. To address this need, we have successfully developed a multiplex real-time PCR assay targeting MPXV D14L gene for clade I, MPXV D18L gene for clade II, and GTPV RPO30 gene, which can simultaneously detect MPXV clades I and II as well as GTPV. The developed assay demonstrated high sensitivity, with limits of detection at 207.83 copies/reaction for MPXV clade I, 252.07 copies/reaction for MPXV clade II, and 208.72 copies/reaction for GTPV. Importantly, there was no cross-reactivity with other non-pox viruses which infect goats. The assay exhibited excellent repeatability, with coefficients of variation (CV%) for intra-assay and inter-assay ranging from 0.17% to 0.89% and 0.58% to 1.09%, respectively. This assay can serve as a vital resource to safeguard against the MPXV epidemic posing a threat to the life safety of goats, to mitigate potential risks to the sheep farming industry, and to prevent the transmission of MPXV to humans through sheep, which could act as a potential transmission vector for infection.