Monkeypox virus may have been in India for years, say experts

MUMBAI: Monkeypox cases detected in Kerala may not be connected to the super-spreader event in Spain that triggered a worldwide outbreak, according to the country's scientists. Genomic sequencing of the samples of India's first two monkeypox cases has revealed the A.2 strain of the virus, while the European outbreak has been caused by the B.1 lineage.
In an analytical commentary, scientists from CSIR-Institute of Genomics and Integrative Biology, Delhi, have called this the "curious case" of Indian monkeypox genomes. The IGIB's Dr Vinod Scaria and his team have also made another observation: monkeypox has possibly been around for longer, possibly years.
'Kerala monkeypox strain is usually seen in US, Thailand'
Even as India has four confirmed cases of monkeypox-three patients in Kerala and one in New Delhi- experts now say that "we might be looking at a distinct cluster of human-human transmission and possibly unrecognised for years."
In a Twitter thread, IGIB's Dr Vinod Scaria has explained that the A.2 strain found in the Kerala patients is usually seen in the US (Florida, Texas & Virginia) and Thailand. "The earliest sample in the cluster from the US is indeed from 2021, suggesting the virus has been in circulation for quite some time, and earlier than the European events," he said.
Meanwhile, concurring with Dr Scaria's analysis, other national experts said monkeypox has possibly been undetected in India for years.
"Monkeypox has so far not been a severe condition, and while cases have possibly occurred in India as well, they haven't been prominent,'' Dr Jacob John of CMC, Vellore, said. He added that the virus, which belongs to the same variola family of viruses that causes the smallpox, has not been highly transmissible so far.
Dr Nerges Mistry, director of the Foundation for Medical Research in Mumbai, said it's not strange to consider that monkeypox cases may have occurred in India. "The same virus could have different strains in different locations with different transmissibility,'' she said. On whether B.1 or A.2 is more transmissible or capable of causing severe disease, she said it's still early days to comment. Another doctor said surveillance in India is so poor that it's possible monkeypox cases were written off as chicken pox or other similar disease.