Genomic Epidemiology and Clinical Characteristics of Mpox Lineage C.1 Outbreak in Thailand, 2023-2024.

Kamol Suwannakarn; Chutikarn Chaimayo; Atsadang Boonmee; Charussri Leeyaphan; Pattriya Jirawattanadon; Pravarit Athiprayoon; Natsada Saengdao; Piyarat Taiphakphaibun; Chutima Deetippasert; Warinya Nuwong; Niracha Athipanyasilp; Archiraya Pattama; Navin Horthongkham

doi:10.1002/jmv.71142

PubMed · 42708527

Genomic Epidemiology and Clinical Characteristics of Mpox Lineage C.1 Outbreak in Thailand, 2023-2024.

Kamol Suwannakarn·Chutikarn Chaimayo·Atsadang Boonmee·Charussri Leeyaphan·Pattriya Jirawattanadon·Pravarit Athiprayoon·Natsada Saengdao·Piyarat Taiphakphaibun·Chutima Deetippasert·Warinya Nuwong·Niracha Athipanyasilp·Archiraya Pattama·Navin Horthongkham

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Abstract

Since 2022, human monkeypox virus (hMPXV) has emerged in non-endemic regions, including Thailand. However, the genomic dynamics and clinical correlates of local transmission remain incompletely defined. Whole-genome sequencing was performed on hMPXV from 16 patients in Thailand (2023-2024) using targeted amplicon NGS. Phylogenetic analyses integrated global reference sequences. Mutational profiles, specifically non-synonymous substitutions and APOBEC3-associated signatures, were analyzed in relation to clinical data. Phylogenetic reconstruction identified three temporal phases. Early 2022 cases (clade IIb lineages A and B) were interspersed with global sequences, consistent with multiple introductions. In contrast, 2023-2024 cases were dominated by lineage C.1. All 16 genomes belonged to C.1 (one C.1.1), and formed a distinct mid-2023 cluster, designated C.1/Thai/Cluster, supporting sustained local transmission. APOBEC3-associated mutations were pervasive across the C.1 lineage overall, including within C.1/Thai/Cluster, without evidence of significant enrichment specific to this cluster. The cohort comprised exclusively male patients (81% HIV-positive, MSM), with predominantly genital painful lesions and a median recovery time of 23 days. No significant associations were detected between viral genetic variation and clinical outcomes. Mpox transmission in Thailand evolved from multiple introductions to sustained C.1-dominated local spread, underscoring the importance of continued genomic surveillance.

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Humans Thailand Phylogeny Male Disease Outbreaks Genome, Viral Mpox, Monkeypox Whole Genome Sequencing Female Molecular Epidemiology Mutation Adult Mpox genomic epidemiology human monkeypox virus lineage C.1 local transmission whole‐genome sequencing Journal Article

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Kamol Suwannakarn, Chutikarn Chaimayo, Atsadang Boonmee, Charussri Leeyaphan, Pattriya Jirawattanadon, Pravarit Athiprayoon, Natsada Saengdao, Piyarat Taiphakphaibun, Chutima Deetippasert, Warinya Nuwong, Niracha Athipanyasilp, Archiraya Pattama, Navin Horthongkham. 2026. Genomic Epidemiology and Clinical Characteristics of Mpox Lineage C.1 Outbreak in Thailand, 2023-2024.. https://doi.org/10.1002/jmv.71142

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