{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:56:56Z","timestamp":1790128616975,"version":"4.0.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Monkeypox virus (MPXV) is an emerging zoonotic pathogen with increasing human-to-human transmission. Since the first case in Shandong Province in June 2023, 61 cases were reported by the end of 2024, predominantly among young men who have sex with men. Genomic and phenotypic characterization of circulating strains is crucial for assessing transmission dynamics and public health risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Genomic sequencing was performed on the clinical samples to determine viral lineages and identify single nucleotide polymorphisms (SNPs). In vitro experiments were conducted to assess phenotypic differences among MPXV strains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sequencing revealed clustering into three main MPXV lineages C.1, C.1.1, and the emerging E.3, which became dominant in 2024. Molecular analyses identified 157 SNPs, most of which were APOBEC3-like mutations, suggesting host-driven viral editing. A higher number of SNPs and APOBEC3-related mutations in 2024 compared to 2023 indicates ongoing viral evolution. Phenotypic variability was observed among Clade IIb sub-lineages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings underscore the rapid diversification and adaptation of MPXV under sustained human-to-human transmission. They highlight the urgent need for integrated genomic and phenotypic surveillance to evaluate public health risks posed by emerging variants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1677051","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T18:28:07Z","timestamp":1762540087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Evolutionary epidemiology of the monkeypox virus in Shandong Province during the post-global outbreak era"],"prefix":"10.3389","volume":"16","author":[{"given":"Chengyunxiao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dali","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ti","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renpeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengqiang","family":"Kou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhong","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.3390\/v12111257","article-title":"Monkeypox virus in Nigeria: infection biology, epidemiology, and evolution","volume":"12","author":"Alakunle","year":"2020","journal-title":"Viruses"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001725","article-title":"Insights into the challenging multi-country outbreak of Mpox: a comprehensive review","volume":"72","author":"Bhat","year":"2023","journal-title":"J. Med. Microbiol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0010141","DOI":"10.1371\/journal.pntd.0010141","article-title":"The changing epidemiology of human monkeypox-A potential threat? A systematic review","volume":"16","author":"Bunge","year":"2022","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.15585\/mmwr.mm7136a1","article-title":"HIV and sexually transmitted infections among persons with Monkeypox - eight U.S. jurisdictions, may 17-July 22, 2022","volume":"71","author":"Curran","year":"2022","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"432","DOI":"10.3201\/eid3003.230861","article-title":"Concurrent clade I and clade II Monkeypox virus circulation, Cameroon, 1979-2022","volume":"30","author":"Djuicy","year":"2024","journal-title":"Emerg. Infect. Dis."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e29320","DOI":"10.1002\/jmv.29320","article-title":"The prevalence of mpox and its association with sexual behavior among Chinese men who have sex with men in early august 2023","volume":"95","author":"Du","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e0006223","DOI":"10.1128\/msphere.00062-23","article-title":"An APOBEC3 mutational signature in the genomes of human-infecting Orthopoxviruses","volume":"8","author":"Forni","year":"2023","journal-title":"mSphere."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1056\/NEJMra2208860","article-title":"Monkeypox","volume":"387","author":"Gessain","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e3001769","DOI":"10.1371\/journal.pbio.3001769","article-title":"Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus","volume":"20","author":"Happi","year":"2022","journal-title":"PLoS Biol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1111\/hiv.13378","article-title":"Clinical characteristics of monkeypox virus infections among men with and without HIV: A large outbreak cohort in Germany","volume":"24","author":"Hoffmann","year":"2023","journal-title":"HIV Med."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ijid.2023.03.047","article-title":"Prior viral infection determines the mode and severity of monkeypox virus","volume":"131","author":"Hussain","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1038\/s41591-022-01907-y","article-title":"Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus","volume":"28","author":"Isidro","year":"2022","journal-title":"Nat. Med."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.jiph.2023.02.003","article-title":"Monkeypox (mpox) virus: classification, origin, transmission, genome organization, antiviral drugs, and molecular diagnosis","volume":"16","author":"Karagoz","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"101223","DOI":"10.1016\/j.lanmic.2025.101223","article-title":"Partial deletion of the OPG164 (A36R) transmembrane phosphoprotein in monkeypox virus clade Ib\/sh2023 disrupts the active region involving Tyr140","author":"Kumar","year":"2025","journal-title":"Lancet Microbe."},{"key":"ref15","first-page":"593","article-title":"A human infection caused by monkeypox virus in Basankusu territory, Democratic Republic of the Congo","volume":"46","author":"Ladnyj","year":"1972","journal-title":"Bull. World Health Organ."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e1012","DOI":"10.1016\/S2214-109X(23)00198-5","article-title":"Description of the first global outbreak of mpox: an analysis of global surveillance data","volume":"11","author":"Laurenson-Schafer","year":"2023","journal-title":"Lancet Glob. Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"107227","DOI":"10.1016\/j.ijid.2024.107227","article-title":"The WHO mpox public health emergency of international concern declaration: need for reprioritisation of global public health responses to combat the MPXV clade I epidemic","volume":"147","author":"Lee","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ve\/vead058","article-title":"The role of APOBEC3-induced mutations in the differential evolution of monkeypox virus","volume":"9","author":"Li","year":"2023","journal-title":"Virus Evol."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s41256-025-00418-w","article-title":"Mpox-related stigma and healthcare-seeking behavior among men who have sex with men","volume":"10","author":"Liu","year":"2025","journal-title":"Glob Health Res Policy."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.46234\/ccdcw2024.245","article-title":"Phylogeny of seven genomes of Monkeypox virus - Anhui Province, China, 2023","volume":"6","author":"Lu","year":"2024","journal-title":"China CDC Wkly."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"102551","DOI":"10.1016\/j.tmaid.2023.102551","article-title":"Monkeypox virus (MPXV) genomics: A mutational and phylogenomic analyses of B.1 lineages","volume":"52","author":"Luna","year":"2023","journal-title":"Travel Med. Infect. Dis."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"102402","DOI":"10.1016\/j.tmaid.2022.102402","article-title":"Phylogenomic analysis of the monkeypox virus (MPXV) 2022 outbreak: emergence of a novel viral lineage?","volume":"49","author":"Luna","year":"2022","journal-title":"Travel Med. Infect. Dis."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"11779322221141164","DOI":"10.1177\/11779322221141164","article-title":"Drug and anti-viral peptide design to inhibit the monkeypox virus by restricting A36R protein","volume":"16","author":"Miah","year":"2022","journal-title":"Bioinform. Biol. Insights"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e70464","DOI":"10.1002\/hsr2.70464","article-title":"Mpox and viral co-infections: A narrative review","volume":"8","author":"Nakhaie","year":"2025","journal-title":"Health Sci Rep."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1038\/s41591-023-02456-8","article-title":"Distinct monkeypox virus lineages co-circulating in humans before 2022","volume":"29","author":"Ndodo","year":"2023","journal-title":"Nat. Med."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1038\/s41591-024-03370-3","article-title":"Global genomic surveillance of monkeypox virus","volume":"31","author":"Otieno","year":"2025","journal-title":"Nat. Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1126\/science.adg8116","article-title":"Apobec3 deaminase editing in mpox virus as evidence for sustained human transmission since at least 2016","volume":"382","author":"O'Toole","year":"2023","journal-title":"Science"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"619","DOI":"10.46234\/ccdcw2024.118","article-title":"The epidemiological characteristics of Mpox cases - China, 2023","volume":"6","author":"Ren","year":"2024","journal-title":"China CDC Wkly."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.3390\/v13071366","article-title":"Human APOBEC3 variations and viral infection","volume":"13","author":"Sadeghpour","year":"2021","journal-title":"Viruses"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"7","DOI":"10.7554\/eLife.35453","article-title":"Long read sequencing reveals poxvirus evolution through rapid homogenization of gene arrays","volume":"7","author":"Sasani","year":"2018","journal-title":"eLife"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1093\/infdis\/jiad165","article-title":"APOBEC3F is a mutational driver of the human Monkeypox virus identified in the 2022 outbreak","volume":"228","author":"Suspene","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/S0140-6736(22)01436-2","article-title":"Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study","volume":"400","author":"Tarin-Vicente","year":"2022","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.1007\/s11010-022-04657-0","article-title":"Human monkeypox: epidemiology, transmission, pathogenesis, immunology, diagnosis and therapeutics","volume":"478","author":"Thakur","year":"2023","journal-title":"Mol. Cell. Biochem."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/S1473-3099(23)00055-5","article-title":"New nomenclature for mpox (monkeypox) and monkeypox virus clades","volume":"23","author":"Ulaeto","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.1038\/s41591-024-03130-3","article-title":"Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo","volume":"30","author":"Vakaniaki","year":"2024","journal-title":"Nat. Med."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1016\/j.cmi.2023.08.008","article-title":"Emergence of mpox in the post-smallpox era-a narrative review on mpox epidemiology","volume":"29","author":"Van Dijck","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1126\/science.1153201","article-title":"Evidence for editing of human papillomavirus DNA by APOBEC3 in benign and precancerous lesions","volume":"320","author":"Vartanian","year":"2008","journal-title":"Science"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.1128\/JVI.78.5.2486-2493.2004","article-title":"Vaccinia virus A36R membrane protein provides a direct link between intracellular enveloped virions and the microtubule motor kinesin","volume":"78","author":"Ward","year":"2004","journal-title":"J. Virol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.1016\/S0140-6736(22)01437-4","article-title":"Monkeypox as a PHEIC: implications for global health governance","volume":"400","author":"Wenham","year":"2022","journal-title":"Lancet"},{"key":"ref40","first-page":"284","volume-title":"Monkeypox: experts give virus variants new namesNeurosciences (Riyadh)","year":"2022"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1093\/infdis\/jiad414","article-title":"The fading of the Mpox outbreak among men who have sex with men: A mathematical modelling study","volume":"230","author":"Xiridou","year":"2024","journal-title":"J. Infect. Dis."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1618022","DOI":"10.3389\/fpubh.2025.1618022","article-title":"Genomic and phenotypic insights into the first imported monkeypox virus clade Ia isolate in China, 2025","volume":"13","author":"Yin","year":"2025","journal-title":"Front. Public Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"8241","DOI":"10.1038\/s41467-023-44092-3","article-title":"Phylogeny and molecular evolution of the first local monkeypox virus cluster in Guangdong Province, China","volume":"14","author":"Yu","year":"2023","journal-title":"Nat. Commun."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"918","DOI":"10.46234\/ccdcw2023.173","article-title":"Genetic features of 84 genomes of Monkeypox virus in recent circulation - Beijing municipality, China, 2023","volume":"5","author":"Zhang","year":"2023","journal-title":"China CDC Wkly."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"7452","DOI":"10.1038\/s41467-024-51737-4","article-title":"Evolutionary trajectory and characteristics of Mpox virus in 2023 based on a large-scale genomic surveillance in Shenzhen, China","volume":"15","author":"Zhang","year":"2024","journal-title":"Nat. Commun."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"853","DOI":"10.46234\/ccdcw2022.175","article-title":"The first imported case of Monkeypox in the mainland of China - Chongqing municipality, China, September 16, 2022","volume":"4","author":"Zhao","year":"2022","journal-title":"China CDC Wkly."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1677051\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T18:28:09Z","timestamp":1762540089000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1677051\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":46,"alternative-id":["10.3389\/fmicb.2025.1677051"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2025.1677051","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]},"article-number":"1677051"}}