The first two imported cases of monkey pox into India are of the A.2 lineage, different from the strain predominantly reported from the rest of the world, especially Europe, according to a study by the Indian Council of Medical Research’s National Institute of Virology (Pune).

The first two cases were reported from travellers coming into the country from the United Arab Emirates, who presented with symptoms, including fever and lesions, said the study, whose preprint appeared in Research Square. The study is still to be peer-reviewed.

While the genome sequences of all nine cases in the country are being analysed, the genome for monkey pox being big would take time to analyse, said Pragya Yadav, lead author of the study and scientist with ICMR-NIV. Responding to whether this strain was of less concern, compared to the B.1 strain seen in Europe, Yadav told BusinessLine it was too early to comment and that more data was required to infer. Its impact would need to be assessed over time, she added.

Giving details, the study said the clinical specimens of both cases were tested with real-time PCR for Orthopoxvirus, Monkeypox virus (MPXV), West African clade-specific MPXV. “Phylogenetic analysis revealed that the two cases were infected with Monkeypox virus strain A.2, which belong to hMPXV-1A lineage of clade 3,” said the study.

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The monkeypox virus (MPXV), belongs to Orthopoxvirus genus and Poxviridae family, endemic in Central and West Africa since 1970, and now being reported from various non-endemic countries in 2022, the study noted. Late last month, the World Health Organization declared monkeypox a global public health concern.

“The current monkeypox outbreak in the US represents the circulation of MPXV lineage A.2 from 2021, which has evolved from lineage A that caused the Nigeria outbreak in 2017–2018. The MPXV genome retrieved from confirmed Monkeypox cases with travel history from UAE to India also demonstrated the circulation of A.2 lineage in UAE. Unfortunately, no epidemiological data is available for the introduction of MPXV to the UAE,” said the study.

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