Phylogenetic reconstruction
The 162 mpox sequences of this study were compared with representative sequences of clades. Phylogenetic reconstruction was realized using maximum Likelihood method and, Tamura-Nei 93 + G model, 1,000 replicates; (Supplementary Method S1) . All patterns from this study, were closely related to other 2022 epidemic strains (ON745225_Spain_2022, ON637938_Germany_2022; Figure 1 ). However, for one patient returning from Asia, pattern #32 was identified, closely related to clade 3 pre-epidemic and USA-2022_FL001 (ON674051) strains. This suggests a possible low-level circulation of non-epidemic mpox virus in Western countries, probably underdiagnosed and detected here due to attention generated by the current outbreak.