Highly efficient anogenital transmission of clade Ia monkeypox virus associated with increased shedding

The transmission pattern of mpox has shifted from sporadic zoonotic outbreaks to sustained human-to-human spread. Epidemiological data indicate sexual contact as a crucial driver for efficient transmission and the associated devastating mpox outbreaks in recent years. However, our understanding of exact driving factors and transmission determinants is still limited. Here, we investigate MPXV clade Ia virus pathogenesis, shedding kinetics, and transmission potential in a prairie dog model (Cynomys ludovicianus). Mucosal inoculation via all routes (penile/preputial, vaginal, rectal, intranasal) results in a productive, systemic infection. Inoculation via urogenital routes generate the highest virus shedding and most severe clinical disease. Simulated sexual contact transmission results in 100% transmission efficiency with high virus shedding in sentinels on day 1, even before the onset of visible clinical signs. Our findings provide experimental support for the importance of anogenital mucosal infection and transmission and establish a model for studying these in vivo. These results advocate for a stronger focus on mucosal infection when evaluating countermeasures.

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Publication Details

Journal
Nature Communications
Published
2026-06-25
DOI
https://doi.org/10.1038/s41467-026-74578-9
Primary Topic
Poxvirus research and outbreaks
Type
article
Field-Weighted Citation Impact
0.00

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article

Highly efficient anogenital transmission of clade Ia monkeypox virus associated with increased shedding

Claude Kwe Yinda, Lara Myers, Franziska Kaiser, Kyle Rosenke et al.
Nature Communications
Poxvirus research and outbreaks
article

Highly efficient anogenital transmission of clade Ia monkeypox virus associated with increased shedding

Claude Kwe Yinda, Lara Myers, Franziska Kaiser, Kyle Rosenke, Vincent J. Munster, Missiani Ochwoto, Greg Saturday, Atsushi Okumura, Sarah van Tol, Brian J. Smith, Reshma K. Mukesh, Jessica Prado-Smith, Shane Gallogly, Natalie McCarthy, Aaron Carmody, Jonathan Schulz, Carl Shaia, Julia R. Port
article en

Abstract

The transmission pattern of mpox has shifted from sporadic zoonotic outbreaks to sustained human-to-human spread. Epidemiological data indicate sexual contact as a crucial driver for efficient transmission and the associated devastating mpox outbreaks in recent years. However, our understanding of exact driving factors and transmission determinants is still limited. Here, we investigate MPXV clade Ia virus pathogenesis, shedding kinetics, and transmission potential in a prairie dog model (Cynomys ludovicianus). Mucosal inoculation via all routes (penile/preputial, vaginal, rectal, intranasal) results in a productive, systemic infection. Inoculation via urogenital routes generate the highest virus shedding and most severe clinical disease. Simulated sexual contact transmission results in 100% transmission efficiency with high virus shedding in sentinels on day 1, even before the onset of visible clinical signs. Our findings provide experimental support for the importance of anogenital mucosal infection and transmission and establish a model for studying these in vivo. These results advocate for a stronger focus on mucosal infection when evaluating countermeasures.

Nature Communications
Rocky Mountain Institute (US), Helmholtz Centre for Infection Research (DE), National Institute of Allergy and Infectious Diseases (US), Rocky Mountain Research (United States) (US)
U.S. Department of Health and Human Services, National Institutes of Health, Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases
Good health and well-being
Openalex Percentile: Top 8%
Poxvirus research and outbreaks
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