Epidemiological and virological characterization of mpox cases in Venezuela during the multinational 2022-2023 outbreak.

Mpox (formerly known as monkeypox) is an infectious disease caused by MPXV, a member of the family Poxviridae. On July 23, 2022, the WHO declared the first Public Health Emergency of International Concern of Mpox due to an escalating global outbreak with low intensity. Two clades of MPXV and sev-eral lineages within each of these clades have been described. Clade I, also known as the Central African clade, causes a more severe and lethal disease than clade II, which circulates in West Africa. MPXV clade IIb caused the first international outbreak (2022), while clade Ib caused a more recent one (2023-2024). Venezue-la reported 12 cases during the 2022-2023 outbreak. This study aims to describe the epidemiological and virological characteristics of these cases. The first three cases were from men infected outside Venezuela, while most of the subsequent ones were from men who acquired the disease in the country. All the cases were from men who have sex with men, and frequently also people living with HIV-1/AIDS. No critical outcome was observed in any of the patients. Sequence analysis showed that most of the MPXV belonged to clade IIb lineage B.1. The recurrent emergence of mpox epidemics warrants the further implementation of molecular epidemiology surveillance and vaccination programs.