Health
Researchers identify second drug-resistant mpox cluster in the US
Genetic sequencing has identified a second cluster of Tecobilimat-resistant mpox infections in the United States. This is the first cluster with interstate transmission. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) and partners in five affected states reported their findings yesterday. Morbidity and Mortality Weekly Report.
The first Tpoxx resistance cluster was identified in California in late 2022 or early 2023 in people who had not previously been treated with the drug. A new report describes a new, unrelated cluster of 18 people in multiple states with no prior medical history.
Sequencing identified a unique combination of resistance mutations in 20 samples collected from 18 patients between October 2023 and February 2024. The patients were from five states: Illinois (8 patients), California (5 patients), Louisiana (2 patients), and Texas (2 patients). New York (1).
Of the 16 previously treated patients, 1 was receiving medication prior to sample collection. Of the 17 patients with available clinical data, the illness was mild and similar to a standard clade 2 infection, but 2 were hospitalized for pain management.
Findings may underestimate the prevalence of resistance mutations
In vitro testing of seven samples showed resistance to Tpoxx. Whole-genome sequencing showed that the resistance mutations originate from a common ancestor but are distinct from the initial California cluster.
Researchers note that this finding likely underestimates the prevalence of newly identified drug-resistant variants because not all viruses in mpox cases have been sequenced. said. They added that additional monitoring is needed, as well as adherence to CDC Tpoxx usage protocols. The findings also highlight the need for additional treatments against mpox, as well as preparedness for the smallpox biothreat, the researchers wrote.
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