First case of mpox due to monkeypox virus clade Ia infection detected outside Africa
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In February 2025, the first confirmed case of monkeypox virus (MPXV) clade Ia infection outside Africa was identified in a traveller returning to Ireland from the Democratic Republic of the Congo (DRC). We report the clinical, laboratory, and epidemiologic features of this case, including the stable disease course and absence of secondary transmission. We also present phylogenetic analysis and APOBEC3-associated mutation profiling that placed the virus obtained from this patient in an evolving cluster of MPXV clade Ia infections in Kinshasa, DRC, likely driven by sustained human-to-human transmission. This case highlights the evolving epidemiology of MPXV clade Ia and its potential for further international spread, reinforcing the need for vigilance and coordinated global surveillance.
