New Delhi: The Union Health Ministry has issued an alert across India after a study conducted by the Indian Council of Medical Research (ICMR) and NIV Pune detected an emerging variant with a higher possibility of transmission of Monkeypox virus (MPXV).
Although 11 Monkeypox cases have been detected in India as of now, the outbreak of MPXV among non-endemic countries has raised concerns and the government has emphasized preparing for diagnosis to understand its linkage. "The preparedness to deal with the emerging situation of monkeypox, a high alert and intensive risk communication have been directed at identified sites in healthcare facilities," a government official said.
The ICMR study said that India identified the first two cases of Monkeypox among UAE returnees in July 2022. "The genomic analysis revealed the infection of these cases with lineage A.2 of subclade IIb. The lineage has 80 nucleotide changes compared to the B.1 lineage which has been the predominant lineage of 2022 suggesting that an independent virus strain has emerged," read the ICMR study.
The 2022 Monkeypox outbreak demonstrates the accelerated microevolution of MPVX leading to the divergence in the viral phylogeny. The genomic and phylogenetic analysis data of 10 Monkeypox cases in India have been examined in the study. "All the MPXV genome sequences retrieved from these cases belonged to lineage A.2 which further diverged into three sub-clusters," the study revealed.
It said that the A.2 lineage MPXV sequences from India showed a divergence from the MPXV sequence reported from Germany, Italy Portugal, Switzerland, and France (lineage B.1) and earlier outbreak sequences from Nigeria, Israel and Singapore 2017/18 (lineage A.1). Although it is helpful to know what is driving the mutational changes, it is equally crucial to understand how genetic alterations are facilitating human to human transmission, the ICMR said in its study.
"Our data revealed an additional 13 APOBEC3 mutation and 16 SNPs in all the available sequences from the current MPXV outbreak 2022 which might contribute as lineage defining changes in the A.2 lineage," the study said. It said that genomic evolutions of the orthopoxviruses such as MPXV might increase the possibility of higher transmission and host range which can affect the larger populations.
Talking over the ICMR findings, Dr Tamorish Kole, president of the Asian Society of Emergency Medicine told ETV Bharat that the study is actually an alarm bell for clinicians and the community. "According to the study, genomic evolutions of MPXV might increase the possibility of higher transmission and host range which can affect larger population," said Dr Kole.
Asserting that the 2022 Monkeypox outbreak demonstrates the accelerated microevolution of the Monkeypox virus leading to wider global spread, Dr Kole said, "Our strategies should include high alertness and intensive risk communication at identified sites in healthcare facilities like skin, pediatric, immunization clinic, etc."
Learning from Covid-19 experience, India has already started preparing its virus research diagnostic and laboratory network for augmenting diagnosis capacity for MPXV, he said.
