Genomics reveals zoonotic and sustained human mpox spread in West Africa
Edyth Parker, Ifeanyi F. Omah, Délia Doreen Djuicy, Andrew F. Magee, Christopher H. Tomkins-Tinch, James R. Otieno, Patrick Varilly, Akeemat Opeyemi Ayinla, Ayotunde E. Sijuwola, Muhammad I. Ahmed, Oludayo O. Ope-ewe, Olusola Ogunsanya, Alhaji Olono, Femi Saibu, Philomena Eromon, Moïse Henri Moumbeket-Yifomnjou, Loique Landry Messanga Essengue, Martial Yonga, Gael Dieudonné Essima, Ibrahim Pascal Touoyem, Landry Mounchili, Sara Eyangoh, Alain Georges Mballa Etoundi, Linda Esso, Inès Mandah Emah Nguidjol, Steve Franck Metomb, Cornelius Chebo, Samuel Mbah Agwe, Hans Makembe Mossi, Chanceline Ndongo Bilounga, Olusola Anuoluwapo Akanbi, Abiodun Egwuenu, Odianosen Ehiakhamen, Chimaobi Chukwu, Kabiru Suleiman, Afolabi Akinpelu, Adama Ahmad, Khadijah Isa Imam, Richard Ojedele, Victor Oripenaye, Kenneth Ikeata, Sophiyah Adelakun, Babatunde Olajumoke, Áine O’Toole, Mark Zeller, Karthik Gangavarapu, Daniel J. Park, Gerald Mboowa, Sofonías K. Tessema, Yenew Kebede Tebeje, Onikepe Folarin, Anise Happi, Philippe Lemey, Marc A. Suchard, Kristian G. Andersen, Pardis C. Sabeti, Andrew Rambaut, Chikwe Ihekweazu, Jide Idris, Ifedayo Adetifa, Richard Njouom, Christian Happi
Abstract
Abstract Five years before the 2022 multi-country mpox outbreak, Nigeria and Cameroon reported their first cases in more than three decades 1,2 . Whereas the outbreak in Nigeria is recognized as an ongoing human epidemic, the drivers of the resurgence in Cameroon remain unclear 3,4 . The rate of zoonoses remains uncertain in both countries, and gaps in genomic data obscure the timing and zoonotic and geographic origin of monkeypox virus (MPXV) emergence in humans. Here, to address these uncertainties, we sequenced 118 MPXV genomes isolated from cases in Nigeria and Cameroon between 2018 and 2023. We show that in contrast to cases in Nigeria, cases in Cameroon are the result of repeated zoonoses, with two distinct zoonotic lineages circulating across the Nigeria–Cameroon border. Our findings suggest that shared animal populations in the cross-border forest ecosystems drive the emergence and spread of the virus. Accordingly, we identify the closest zoonotic outgroup to the Nigerian human epidemic lineage (hMPXV-1) in a southern Nigerian border state. We estimate that the shared ancestor of the zoonotic outgroup and hMPXV-1 circulated in animals in southern Nigeria in late 2013. We find that hMPXV-1 emerged in humans in August 2014 in the southern Rivers State and circulated undetected for three years. Rivers State was the main source of viral spread during the human epidemic. Our study sheds light on the recent establishment of MPXV in the human population and highlights the risk of persistent zoonotic emergence of MPXV in the complex border regions of Cameroon and Nigeria.