Kerala's Mpox cases connected to UAE travel, genetic research shows

Most cases from Kerala's 2024 Mpox outbreak were linked to international travel from the United Arab Emirates (UAE), according to a genetic analysis of the virus. The findings suggested that overseas travel played a key role in introducing the infection into the state.

Researchers, including scientists from the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, analysed 10 laboratory-confirmed cases of the Mpox virus (MPXV) Clade Ib strain reported in Kerala between September 2024 and March 2025.

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The study, published in the journal Virology, found that seven of the 10 infected individuals had a recent travel history to the UAE, while one had travelled from Oman and another was identified as a contact case, pointing to limited local transmission.

Clade Ib strain spread

The MPXV Clade Ib strain was first identified in the Democratic Republic of Congo in September 2023. Since then, it has spread to several African countries, including Uganda, Rwanda, Kenya, and Burundi.

On August 14, 2024, the World Health Organization declared the Mpox outbreak a public health emergency of international concern, citing the rapid spread and increased severity associated with the Clade Ib strain.

Outside Africa, Clade Ib infections were first detected in Sweden, followed by cases in the United Kingdom, India, the United States, and China.

Originated in Congo

As of early 2025, more than 22,000 confirmed or suspected Clade Ib Mpox cases have been reported worldwide, with over 60 deaths-most of them in the Democratic Republic of Congo-according to the researchers. The study noted that the fatality rate of Clade Ib is around three per cent higher than that of Clade Ilb, which was responsible for the 2022 global outbreak.

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Clade Ilb, particularly its A.2 sub-lineage, was associated with efficient human-to-human transmission through both sexual and non-sexual contact, according to the study. The sub-lineage also lead to over 102,000 cases globally and prompting the WHO to declare a public health emergency in July 2022.

All about Mpox

Mpox, earlier known as monkeypox, is a viral disease caused by the monkeypox virus. It typically presents with a skin rash or lesions on the skin or mucous membranes that can last two to four weeks. Other common symptoms include fever, headache, muscle and back pain, fatigue, and swollen lymph nodes.

(With agency inputs)