Scientists estimate a precurser to the 2022 strain first emerged in Nigeria in August 2014 and spread to 11 Nigerian states before human infections were detected in 2017.
The test the US Centers for Disease Control and Prevention uses to identify clade I mpox cases is 'most likely not reliable' for detection of the substrain identified in the study, the authors say.
Another mpox study today showed that dose-sparing vaccine administration of the Jynneos vaccine appeared to have worked.
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Population density and tourism are among factors driving infections in Sierra Leone, which made up 53% of mpox illnesses in Africa last week.
HHS received a list of 100 ways it could better prepare for and respond to public health emergencies such as pandemics.
Togo's outbreak brings Africa's number of affected countries to 25, amid exponential spread in Sierra Leone.
On viral culture, 4 of 21 environmental samples (19%) contained infectious virus.
Responding to the surge is a major focus, partly to prevent the spread to other West African countries.
Sierra Leone is averaging 100 new cases a day, fueled by the clade 2b virus.
Healthcare workers remain the most trusted sources of information (73%), while trust in the federal government to provide factual information rose to 58%.
Some of the key steps have included deployment of more community health workers and decentralized lab testing.
The cases in Malawi bring the number of African countries affected by mpox to 23.
Cases are declining in some hot spot countries, as officials warns that nations outside Africa are still reporting imported cases.
