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.