{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T08:43:14Z","timestamp":1794040994755,"version":"4.8.0"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"8074","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nature"],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Five years before the 2022 multi-country mpox outbreak, Nigeria and Cameroon reported their first cases in more than three decades\n                    <jats:sup>1,2<\/jats:sup>\n                    . Whereas the outbreak in Nigeria is recognized as an ongoing human epidemic, the drivers of the resurgence in Cameroon remain unclear\n                    <jats:sup>3,4<\/jats:sup>\n                    . The rate of zoonoses remains uncertain in both countries, and gaps in genomic data obscure the timing and zoonotic and geographic origin of monkeypox virus (MPXV) emergence in humans. Here, to address these uncertainties, we sequenced 118 MPXV genomes isolated from cases in Nigeria and Cameroon between 2018 and 2023. We show that in contrast to cases in Nigeria, cases in Cameroon are the result of repeated zoonoses, with two distinct zoonotic lineages circulating across the Nigeria\u2013Cameroon border. Our findings suggest that shared animal populations in the cross-border forest ecosystems drive the emergence and spread of the virus. Accordingly, we identify the closest zoonotic outgroup to the Nigerian human epidemic lineage (hMPXV-1) in a southern Nigerian border state. We estimate that the shared ancestor of the zoonotic outgroup and hMPXV-1 circulated in animals in southern Nigeria in late 2013. We find that hMPXV-1 emerged in humans in August 2014 in the southern Rivers State and circulated undetected for three years. Rivers State was the main source of viral spread during the human epidemic. Our study sheds light on the recent establishment of MPXV in the human population and highlights the risk of persistent zoonotic emergence of MPXV in the complex border regions of Cameroon and Nigeria.\n                  <\/jats:p>","DOI":"10.1038\/s41586-025-09128-2","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T11:01:50Z","timestamp":1747652510000},"page":"1343-1351","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Genomics reveals zoonotic and sustained human mpox spread in West Africa"],"prefix":"10.1038","volume":"643","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-1446","authenticated-orcid":false,"given":"Edyth","family":"Parker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9044-3096","authenticated-orcid":false,"given":"Ifeanyi F.","family":"Omah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7818-6245","authenticated-orcid":false,"given":"Delia Doreen","family":"Djuicy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Magee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-6421","authenticated-orcid":false,"given":"Christopher H.","family":"Tomkins-Tinch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Richard","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Varilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akeemat Opeyemi","family":"Ayinla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-9727","authenticated-orcid":false,"given":"Ayotunde E.","family":"Sijuwola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad I.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oludayo O.","family":"Ope-Ewe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-0338","authenticated-orcid":false,"given":"Olusola Akinola","family":"Ogunsanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9940-1004","authenticated-orcid":false,"given":"Alhaji","family":"Olono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femi Mudasiru","family":"Saibu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philomena","family":"Eromon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-2884","authenticated-orcid":false,"given":"Mo\u00efse Henri","family":"Moumbeket Yifomnjou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3702-3110","authenticated-orcid":false,"given":"Loique Landry","family":"Messanga Essengue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martial Gides Wansi","family":"Yonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gael Dieudonn\u00e9","family":"Essima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3896-6684","authenticated-orcid":false,"given":"Ibrahim Pascal","family":"Touoyem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Landry Jules Mouliem","family":"Mounchili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Irene","family":"Eyangoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain Georges Mballa","family":"Etoundi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Esso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e8s Mandah Emah","family":"Nguidjol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve Franck","family":"Metomb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius","family":"Chebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Mbah","family":"Agwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Makembe","family":"Mossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanceline Ndongo","family":"Bilounga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1107-035X","authenticated-orcid":false,"given":"Olusola","family":"Akanbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abiodun","family":"Egwuenu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odianosen","family":"Ehiakhamen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2411-0290","authenticated-orcid":false,"given":"Chimaobi","family":"Chukwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabiru","family":"Suleiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afolabi","family":"Akinpelu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadijah Isa","family":"Imam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Ojedele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Oripenaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Ikeata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophiyah","family":"Adelakun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babatunde","family":"Olajumoke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-474X","authenticated-orcid":false,"given":"\u00c1ine","family":"O\u2019Toole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Zeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5027-3440","authenticated-orcid":false,"given":"Karthik","family":"Gangavarapu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7226-7781","authenticated-orcid":false,"given":"Daniel J.","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8445-9414","authenticated-orcid":false,"given":"Gerald","family":"Mboowa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofonias Kifle","family":"Tessema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenew Kebede","family":"Tebeje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7283-2920","authenticated-orcid":false,"given":"Onikepe","family":"Folarin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anise","family":"Happi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2826-5353","authenticated-orcid":false,"given":"Philippe","family":"Lemey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9818-479X","authenticated-orcid":false,"given":"Marc A.","family":"Suchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-5982","authenticated-orcid":false,"given":"Kristian G.","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9843-1890","authenticated-orcid":false,"given":"Pardis","family":"Sabeti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-3707","authenticated-orcid":false,"given":"Andrew","family":"Rambaut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikwe","family":"Ihekweazu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idris","family":"Jide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-9407","authenticated-orcid":false,"given":"Ifedayo","family":"Adetifa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Njouom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3056-6705","authenticated-orcid":false,"given":"Christian T.","family":"Happi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"9128_CR1","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.3201\/eid2406.180017","volume":"24","author":"A Yinka-Ogunleye","year":"2018","unstructured":"Yinka-Ogunleye, A. et al. Reemergence of human monkeypox in Nigeria, 2017. Emerg. Infect. Dis. 24, 1149\u20131151 (2018).","journal-title":"Emerg. Infect. Dis."},{"key":"9128_CR2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.meegid.2019.01.006","volume":"69","author":"SA Sadeuh-Mba","year":"2019","unstructured":"Sadeuh-Mba, S. A. et al. Monkeypox virus phylogenetic similarities between a human case detected in Cameroon in 2018 and the 2017\u20132018 outbreak in Nigeria. Infect. Genet. Evol. 69, 8\u201311 (2019).","journal-title":"Infect. Genet. Evol."},{"key":"9128_CR3","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1126\/science.adg8116","volume":"382","author":"\u00c1 O\u2019Toole","year":"2023","unstructured":"O\u2019Toole, \u00c1. et al. APOBEC3 deaminase editing in mpox virus as evidence for sustained human transmission since at least 2016. Science 382, 595\u2013600 (2023).","journal-title":"Science"},{"key":"9128_CR4","doi-asserted-by":"publisher","first-page":"432","DOI":"10.3201\/eid3003.230861","volume":"30","author":"DD Djuicy","year":"2024","unstructured":"Djuicy, D. D. et al. Concurrent clade I and clade II monkeypox virus circulation, Cameroon, 1979\u20132022. Emerg. Infect. Dis. 30, 432\u2013443 (2024).","journal-title":"Emerg. Infect. Dis."},{"key":"9128_CR5","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3390\/v9100283","volume":"9","author":"JB Doty","year":"2017","unstructured":"Doty, J. B. et al. Assessing monkeypox virus prevalence in small mammals at the human\u2013animal interface in the Democratic Republic of the Congo. Viruses 9, 283 (2017).","journal-title":"Viruses"},{"key":"9128_CR6","doi-asserted-by":"publisher","first-page":"2168","DOI":"10.3390\/v7042168","volume":"7","author":"Y Nakazawa","year":"2015","unstructured":"Nakazawa, Y. et al. A phylogeographic investigation of African monkeypox. Viruses 7, 2168\u20132184 (2015).","journal-title":"Viruses"},{"key":"9128_CR7","first-page":"165","volume":"58","author":"JG Breman","year":"1980","unstructured":"Breman, J. G. et al. Human monkeypox, 1970\u201379. Bull. World Health Organ. 58, 165\u2013182 (1980).","journal-title":"Bull. World Health Organ."},{"key":"9128_CR8","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/cid\/cit703","volume":"58","author":"AM McCollum","year":"2014","unstructured":"McCollum, A. M. & Damon, I. K. Human monkeypox. Clin. Infect. Dis. 58, 260\u2013267 (2014).","journal-title":"Clin. Infect. Dis."},{"key":"9128_CR9","first-page":"125","volume":"93","author":"KN Durski","year":"2018","unstructured":"Durski, K. N. et al. Emergence of monkeypox in West Africa and Central Africa, 1970\u20132017. Wkly Epidemiol. Rec. 93, 125\u2013133 (2018).","journal-title":"Wkly Epidemiol. Rec."},{"key":"9128_CR10","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/S1473-3099(19)30294-4","volume":"19","author":"A Yinka-Ogunleye","year":"2019","unstructured":"Yinka-Ogunleye, A. et al. Outbreak of human monkeypox in Nigeria in 2017\u201318: a clinical and epidemiological report. Lancet Infect. Dis. 19, 872\u2013879 (2019).","journal-title":"Lancet Infect. Dis."},{"key":"9128_CR11","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.1038\/s41591-023-02542-x","volume":"29","author":"V Borges","year":"2023","unstructured":"Borges, V. et al. Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal. Nat. Med. 29, 2509\u20132517 (2023).","journal-title":"Nat. Med."},{"key":"9128_CR12","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.1093\/molbev\/msq088","volume":"27","author":"C Firth","year":"2010","unstructured":"Firth, C. et al. Using time-structured data to estimate evolutionary rates of double-stranded DNA viruses. Mol. Biol. Evol. 27, 2038\u20132051 (2010).","journal-title":"Mol. Biol. Evol."},{"key":"9128_CR13","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1093\/infdis\/jiad165","volume":"228","author":"R Susp\u00e8ne","year":"2023","unstructured":"Susp\u00e8ne, R. et al. APOBEC3F is a mutational driver of the human monkeypox virus identified in the 2022 outbreak. J. Infect. Dis. 228, 1421\u20131429 (2023).","journal-title":"J. Infect. Dis."},{"key":"9128_CR14","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1038\/s41591-023-02456-8","volume":"29","author":"N Ndodo","year":"2023","unstructured":"Ndodo, N. et al. Distinct monkeypox virus lineages co-circulating in humans before 2022. Nat. Med. 29, 2317\u20132324 (2023).","journal-title":"Nat. Med."},{"key":"9128_CR15","unstructured":"Molua, E. L. & Lambi, C. M. in Environmental Issues: Problems and Prospects 45\u201366 (Unique Printers, 2001)."},{"key":"9128_CR16","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/14787210.2019.1567330","volume":"17","author":"MG Reynolds","year":"2019","unstructured":"Reynolds, M. G., Doty, J. B., McCollum, A. M., Olson, V. A. & Nakazawa, Y. Monkeypox re-emergence in Africa: a call to expand the concept and practice of One Health. Expert Rev. Anti. Infect. Ther. 17, 129\u2013139 (2019).","journal-title":"Expert Rev. Anti. Infect. Ther."},{"key":"9128_CR17","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1038\/s41564-020-0770-5","volume":"5","author":"A Rambaut","year":"2020","unstructured":"Rambaut, A. et al. A dynamic nomenclature proposal for SARS-CoV-2 lineages to assist genomic epidemiology. Nat. Microbiol. 5, 1403\u20131407 (2020).","journal-title":"Nat. Microbiol."},{"key":"9128_CR18","doi-asserted-by":"publisher","first-page":"e3001769","DOI":"10.1371\/journal.pbio.3001769","volume":"20","author":"C Happi","year":"2022","unstructured":"Happi, C. et al. Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus. PLoS Biol. 20, e3001769 (2022).","journal-title":"PLoS Biol."},{"key":"9128_CR19","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.biocon.2011.12.018","volume":"147","author":"DW Macdonald","year":"2012","unstructured":"Macdonald, D. W. et al. Bushmeat trade in the Cross\u2013Sanaga rivers region: evidence for the importance of protected areas. Biol. Conserv. 147, 107\u2013114 (2012).","journal-title":"Biol. Conserv."},{"key":"9128_CR20","doi-asserted-by":"publisher","first-page":"e0003792","DOI":"10.1371\/journal.pntd.0003792","volume":"9","author":"S Friant","year":"2015","unstructured":"Friant, S., Paige, S. B. & Goldberg, T. L. Drivers of bushmeat hunting and perceptions of zoonoses in Nigerian hunting communities. PLoS Negl. Trop. Dis. 9, e0003792 (2015).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"9128_CR21","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.biocon.2005.11.031","volume":"129","author":"JE Fa","year":"2006","unstructured":"Fa, J. E. et al. Getting to grips with the magnitude of exploitation: bushmeat in the Cross\u2013Sanaga rivers region, Nigeria and Cameroon. Biol. Conserv. 129, 497\u2013510 (2006).","journal-title":"Biol. Conserv."},{"key":"9128_CR22","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/S0140-6736(86)90748-8","volume":"1","author":"L Khodakevich","year":"1986","unstructured":"Khodakevich, L., Jezek, Z. & Kinzanzka, K. Isolation of monkeypox virus from wild squirrel infected in nature. Lancet 1, 98\u201399 (1986).","journal-title":"Lancet"},{"key":"9128_CR23","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.3201\/eid2006.131329","volume":"20","author":"A Radoni\u0107","year":"2014","unstructured":"Radoni\u0107, A. et al. Fatal monkeypox in wild-living sooty mangabey, C\u00f4te d\u2019Ivoire, 2012. Emerg. Infect. Dis. 20, 1009\u20131011 (2014).","journal-title":"Emerg. Infect. Dis."},{"key":"9128_CR24","doi-asserted-by":"publisher","first-page":"727","DOI":"10.3390\/v15030727","volume":"15","author":"M Curaudeau","year":"2023","unstructured":"Curaudeau, M. et al. Identifying the most probable mammal reservoir hosts for monkeypox virus based on ecological niche comparisons. Viruses 15, 727 (2023).","journal-title":"Viruses"},{"key":"9128_CR25","first-page":"747","volume":"66","author":"L Khodakevich","year":"1988","unstructured":"Khodakevich, L., Jezek, Z. & Messinger, D. Monkeypox virus: ecology and public health significance. Bull. World Health Organ. 66, 747\u2013752 (1988).","journal-title":"Bull. World Health Organ."},{"key":"9128_CR26","doi-asserted-by":"publisher","first-page":"410","DOI":"10.4269\/ajtmh.15-0168","volume":"93","author":"LD Nolen","year":"2015","unstructured":"Nolen, L. D. et al. Introduction of monkeypox into a community and household: risk factors and zoonotic reservoirs in the Democratic Republic of the Congo. Am. J. Trop. Med. Hyg. 93, 410\u2013415 (2015).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"9128_CR27","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1126\/science.1125237","volume":"312","author":"C Viboud","year":"2006","unstructured":"Viboud, C. et al. Synchrony, waves, and spatial hierarchies in the spread of influenza. Science 312, 447\u2013451 (2006).","journal-title":"Science"},{"key":"9128_CR28","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1038\/nature22040","volume":"544","author":"G Dudas","year":"2017","unstructured":"Dudas, G. et al. Virus genomes reveal factors that spread and sustained the Ebola epidemic. Nature 544, 309\u2013315 (2017).","journal-title":"Nature"},{"key":"9128_CR29","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.1038\/s41591-024-03130-3","volume":"30","author":"EH Vakaniaki","year":"2024","unstructured":"Vakaniaki, E. H. et al. Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo. Nat. Med. 30, 2791\u20132795 (2024).","journal-title":"Nat. Med."},{"key":"9128_CR30","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1038\/d41586-022-01587-1","volume":"606","author":"M Kozlov","year":"2022","unstructured":"Kozlov, M. Monkeypox vaccination begins\u2014can the global outbreaks be contained? Nature 606, 444\u2013445 (2022).","journal-title":"Nature"},{"key":"9128_CR31","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/S0140-6736(22)02075-X","volume":"401","author":"O Mitj\u00e0","year":"2023","unstructured":"Mitj\u00e0, O. et al. Monkeypox. Lancet 401, 60\u201374 (2023).","journal-title":"Lancet"},{"key":"9128_CR32","unstructured":"Nigeria Centre for Disease Control. National Monkeypox Public Health Response Guidelines (Federal Ministry of Health, 2019)."},{"key":"9128_CR33","doi-asserted-by":"publisher","unstructured":"Park, D. et al. broadinstitute\/viral-Ngs: v1.19.2. Zenodo https:\/\/doi.org\/10.5281\/zenodo.1167849 (2018).","DOI":"10.5281\/zenodo.1167849"},{"key":"9128_CR34","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1093\/bioinformatics\/btp324","volume":"25","author":"H Li","year":"2009","unstructured":"Li, H. & Durbin, R. Fast and accurate short read alignment with Burrows\u2013Wheeler transform. Bioinformatics 25, 1754\u20131760 (2009).","journal-title":"Bioinformatics"},{"key":"9128_CR35","doi-asserted-by":"publisher","first-page":"2078","DOI":"10.1093\/bioinformatics\/btp352","volume":"25","author":"H Li","year":"2009","unstructured":"Li, H. et al. The Sequence Alignment\/Map format and SAMtools. Bioinformatics 25, 2078\u20132079 (2009).","journal-title":"Bioinformatics"},{"key":"9128_CR36","doi-asserted-by":"publisher","DOI":"10.1186\/s13059-018-1618-7","volume":"20","author":"ND Grubaugh","year":"2019","unstructured":"Grubaugh, N. D. et al. An amplicon-based sequencing framework for accurately measuring intrahost virus diversity using PrimalSeq and iVar. Genome Biol. 20, 8 (2019).","journal-title":"Genome Biol."},{"key":"9128_CR37","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1093\/molbev\/msaa015","volume":"37","author":"BQ Minh","year":"2020","unstructured":"Minh, B. Q. et al. IQ-TREE 2: new models and efficient methods for phylogenetic inference in the genomic era. Mol. Biol. Evol. 37, 1530\u20131534 (2020).","journal-title":"Mol. Biol. Evol."},{"key":"9128_CR38","doi-asserted-by":"publisher","first-page":"3773","DOI":"10.21105\/joss.03773","volume":"6","author":"I Aksamentov","year":"2021","unstructured":"Aksamentov, I., Roemer, C., Hodcroft, E. & Neher, R. Nextclade: clade assignment, mutation calling and quality control for viral genomes. J. Open Source Softw. 6, 3773 (2021).","journal-title":"J. Open Source Softw."},{"key":"9128_CR39","doi-asserted-by":"publisher","first-page":"vey016","DOI":"10.1093\/ve\/vey016","volume":"4","author":"MA Suchard","year":"2018","unstructured":"Suchard, M. A. et al. Bayesian phylogenetic and phylodynamic data integration using BEAST 1.10. Virus Evol. 4, vey016 (2018).","journal-title":"Virus Evol."},{"key":"9128_CR40","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1093\/sysbio\/syz020","volume":"68","author":"DL Ayres","year":"2019","unstructured":"Ayres, D. L. et al. BEAGLE 3: improved performance, scaling, and usability for a high-performance computing library for statistical phylogenetics. Syst. Biol. 68, 1052\u20131061 (2019).","journal-title":"Syst. Biol."},{"key":"9128_CR41","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1093\/sysbio\/syy032","volume":"67","author":"A Rambaut","year":"2018","unstructured":"Rambaut, A., Drummond, A. J., Xie, D., Baele, G. & Suchard, M. A. Posterior summarization in Bayesian phylogenetics using Tracer 1.7. Syst. Biol. 67, 901\u2013904 (2018).","journal-title":"Syst. Biol."},{"key":"9128_CR42","doi-asserted-by":"publisher","first-page":"e1000520","DOI":"10.1371\/journal.pcbi.1000520","volume":"5","author":"P Lemey","year":"2009","unstructured":"Lemey, P., Rambaut, A., Drummond, A. J. & Suchard, M. A. Bayesian phylogeography finds its roots. PLoS Comput. Biol. 5, e1000520 (2009).","journal-title":"PLoS Comput. Biol."},{"key":"9128_CR43","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1093\/molbev\/mss265","volume":"30","author":"MS Gill","year":"2013","unstructured":"Gill, M. S. et al. Improving Bayesian population dynamics inference: a coalescent-based model for multiple loci. Mol. Biol. Evol. 30, 713\u2013724 (2013).","journal-title":"Mol. Biol. Evol."},{"key":"9128_CR44","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s00285-007-0120-8","volume":"56","author":"VN Minin","year":"2008","unstructured":"Minin, V. N. & Suchard, M. A. Counting labeled transitions in continuous-time Markov models of evolution. J. Math. Biol. 56, 391\u2013412 (2008).","journal-title":"J. Math. Biol."},{"key":"9128_CR45","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1038\/s41586-021-03754-2","volume":"595","author":"P Lemey","year":"2021","unstructured":"Lemey, P. et al. Untangling introductions and persistence in COVID-19 resurgence in Europe. Nature 595, 713\u2013717 (2021).","journal-title":"Nature"},{"key":"9128_CR46","unstructured":"Demographic Statistics Bulletin 2020. NBS https:\/\/nigerianstat.gov.ng\/elibrary\/read\/1241121 (2020)."},{"key":"9128_CR47","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1093\/molbev\/msq067","volume":"27","author":"P Lemey","year":"2010","unstructured":"Lemey, P., Rambaut, A., Welch, J. J. & Suchard, M. A. Phylogeography takes a relaxed random walk in continuous space and time. Mol. Biol. Evol. 27, 1877\u20131885 (2010).","journal-title":"Mol. Biol. Evol."},{"key":"9128_CR48","doi-asserted-by":"publisher","first-page":"e1003932","DOI":"10.1371\/journal.ppat.1003932","volume":"10","author":"P Lemey","year":"2014","unstructured":"Lemey, P. et al. Unifying viral genetics and human transportation data to predict the global transmission dynamics of human influenza H3N2. PLoS Pathog. 10, e1003932 (2014).","journal-title":"PLoS Pathog."},{"key":"9128_CR49","unstructured":"Okeowo, G. & Fatoba, I. (eds) State of States 2022 (BudgIT, 2022)."},{"key":"9128_CR50","unstructured":"PEPFAR 2019 Country Operational Plan Guidance for all PEPFAR Countries (PEPFAR, 2019)."},{"key":"9128_CR51","unstructured":"Drug Use in Nigeria (National Bureau of Statistics, 2018)."}],"container-title":["Nature"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41586-025-09128-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41586-025-09128-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41586-025-09128-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T16:13:24Z","timestamp":1757175204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41586-025-09128-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":51,"journal-issue":{"issue":"8074","published-print":{"date-parts":[[2025,7,31]]}},"alternative-id":["9128"],"URL":"https:\/\/doi.org\/10.1038\/s41586-025-09128-2","relation":{},"ISSN":["0028-0836","1476-4687"],"issn-type":[{"value":"0028-0836","type":"print"},{"value":"1476-4687","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]},"assertion":[{"value":"18 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.A.S. receives grants and contracts from the US Food and Drug Administration, the US Department of Veterans Affairs and Johnson & Johnson, all outside the scope of this work. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}