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when is the first monkey flower Cases were identified in early May, stunned European health officials. The virus was not known to spread easily among humans, let alone infecting dozens and soon hundreds of young men.

The origins of the epidemic are now becoming clearer. Genetic analysis shows that despite the rapid spread of monkeypox virus in the open, it has been circulating quietly in humans for years.

Health officials have identified two varieties of monkeypox, suggesting at least two separate chains of transmission among American patients. Researchers in several countries found cases with no known source of infection. undetected community spread. And a research team argued last month that monkeypox had already emerged. crossed a threshold sustainable human-to-human transmission.

genetic information ever available stated Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle, said at some point in the last few years the virus got better at spreading between people.

Dr. “Genomic patterns may suggest that this happened around 2018,” Bedford said.

If the virus has adapted to include humans as hosts, epidemics of monkeypox may become more frequent and more difficult to control. This risks transmission of monkeypox from infected humans to animals – most likely rodents – in countries outside of Africa, which have struggled with this problem for decades. The virus can persist in infected animals and sporadically trigger new infections in humans.

“We can also transmit this to animals that spread the disease in the wild, and back to humans,” said Sagan Friant, an anthropologist at Pennsylvania State University who has been working on human-animal interactions for nearly 15 years.

Dr. The longer it takes to contain the virus, the more likely it is to find a new permanent home in humans or animals, Friant said.

On Wednesday, the United States had identified 156 cases in 23 states and the District of Columbia. The global toll has exceeded 3,400 confirmed cases, and 3,500 more cases are under consideration, tripling the numbers from two weeks ago.

eight countries in africa had reported More than 1,500 suspected cases and 72 deaths, mostly in the Democratic Republic of the Congo, as of 10 June.

Monkeypox is a large double-stranded DNA virus, about seven times larger than the coronavirus. DNA-based viruses can correct their own mistakes when copying their genetic material. They can only collect one or two mutations per year, compared to 20 to 30 mutations for an RNA virus like the coronavirus.

But the monkeypox virus appears to have accumulated an unexpectedly high number of mutations—about 50, according to a version published in 2018. preliminary analyzes.

Of the 47 mutations identified in one analysis, 42 carry the distinctive signature of an enzyme called Apobec3. First discovered by researchers working on HIV, this enzyme is a so-called host defense factor, an immune system weapon that animals and humans use to neutralize viruses such as monkeypox.

The enzyme essentially forces viruses to make mistakes when they try to replicate, causing them to self-destruct. Mice carry only one version of this enzyme, while humans have seven. Dr. Bedford said the rapid accumulation of mutations characteristic of the enzyme since 2018 suggests that monkeypox may have been home to humans at the time.

It is unclear how the mutations might alter the virus. of 48 mutations defined in the UKAccording to the UK Health Safety Agency21, it can affect how the disease spreads, its severity and how well it responds to a treatment called tecovirimat.

However, Michael Malim, a virologist at King’s College London who discovered Apobec3 in 2002, said that their amount alone is not of concern, as the mutations introduced by the Apobec3 enzyme are intended to damage the virus. “said. Comparing the current version of the virus with samples from the past few years may help to understand how it evolved, but this information is scarce. Nigeria did not have the ability to sequence genetic material until 2017.

Director of the Nigeria Center for Disease Control, Dr. Since then, scientists have been analyzing sequences of about 50 cases of monkeypox, according to Ifedayoadetifa. But without the specialized equipment or expertise required for rapid analysis, the scientists have yet to complete their work, he said.

While the researchers made several requests for data from outside of Nigeria, Dr. Adetifa said they will wait to publish their work to prevent teams with more resources from outpacing them and gaining credit.

“I’m in favor of open data sharing and all that,” he said. “The question is, who benefits?”

There are some experts warned for years Elimination of smallpox in 1980 left the world defenseless joined the larger poxvirus family, increasing the likelihood that monkeypox could evolve. a successful human pathogen.

Incidence of monkeypox in West Africa at least increased twenty times since 1986. In African countries in general, Dr. “We suspect some under-reporting, as there is relatively low awareness and perhaps a low perceived risk of monkeypox,” saidadetifa. Nigeria is increasing its surveillance of monkeypox and added that the number of cases could rise as more people become aware of the virus.

Although monkeypox has a prominent rash on the palms of the hands and soles of the feet, it is often mixed with chickenpox. Many men in the current epidemic have lesions on their genitals, but these can be mistaken for sexually transmitted infections such as syphilis. gonorrhea and chlamydia.

researchers in Italy and Germany reported that they found monkey pox DNA in spermhowever, it is unclear whether the virus spreads this way or is found only in semen and vaginal secretions.

Dissemination among young men with genital ulcers has been observed at least once before. In 2017, Nigeria recorded 228 suspected cases of monkeypox and confirmed 60. The virus has spread primarily among young men who had genital ulcers.

Britain’s experience shows how tracking contacts can be complicated Presence of a sexually transmitted virus, especially when infected persons have more than one anonymous partner. Officials said in the first analysis of a subset of cases, less than a third of the 78 reported sexual contacts were able to obtain their names.

It was observed that many cases in Africa were contacted. wild animals or the use of animal products medical or cultural practices.

As deforestation and urbanization bring humans and animals closer together, more viruses can spread to human hosts. Monkeypox is more likely to jump from rodents to humans. There are about 2,000 rodent species worldwide, accounting for 40 percent of all mammal species. The African rope squirrel is a prime candidate as the primary reservoir for monkeypox, but there are other contenders, including striped mice and yurts, giant opossums, rusty-nosed rats, and brush-tailed hedgehogs.

In a 2003 outbreak in the United States, a shipment of Gambian opossums imported from Africa infected prairie dogs with monkeypox, which later infected 71 Americans. But officials were unable to find signs of the virus in animals in the United States after the cases ended.

There is no guarantee that luck will hold this time. Dr. “These spreads from other species and what that means and what the trend is — it’s very unpredictable,” Malim said. “And it’s happening more and more.”