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. 2023 Oct 12;229(Suppl 2):S144–S155. doi: 10.1093/infdis/jiad452

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© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 1. — Phylogenetic tree of Monkeypox virus (MPXV) outbreak, including case-patient derived isolates. Phylogenetic tree of the outbreak human MPXV lineage B.1. MPXV detections by microbial cell-free DNA in the respective case-patients are shown within their phylogenetic context (A). The tree was constructed and visualized using the Nextstrain toolkit [32]. The MPXV detected in case-patients 1, 2, 5, 9, 11, and 12, respectively, were observed to descend directly from the ancestral B.1 strain. For case-patients 2, 5, and 12, this is likely related to insufficient coverage for exhaustive genotyping. The MPXV from case-patients 3, 4, 7, and 8, respectively, were genotyped to be derived from lineage B.1.2 (B). Two main clades within the sublineage are observed. All 4 isolates were imputed to originate from the predominantly North American subclade. The MPXV detected in case-patients 6 and 10, respectively, were found to be from sublineage B.1.11, which likely arose in late May 2022 and has been detected only within the United States (USA) and Colombia (C).

Figure 1. — Phylogenetic tree of Monkeypox virus (MPXV) outbreak, including case-patient derived isolates. Phylogenetic tree of the outbreak human MPXV lineage B.1. MPXV detections by microbial cell-free DNA in the respective case-patients are shown within their phylogenetic context (A). The tree was constructed and visualized using the Nextstrain toolkit [32]. The MPXV detected in case-patients 1, 2, 5, 9, 11, and 12, respectively, were observed to descend directly from the ancestral B.1 strain. For case-patients 2, 5, and 12, this is likely related to insufficient coverage for exhaustive genotyping. The MPXV from case-patients 3, 4, 7, and 8, respectively, were genotyped to be derived from lineage B.1.2 (B). Two main clades within the sublineage are observed. All 4 isolates were imputed to originate from the predominantly North American subclade. The MPXV detected in case-patients 6 and 10, respectively, were found to be from sublineage B.1.11, which likely arose in late May 2022 and has been detected only within the United States (USA) and Colombia (C).