{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:47:31Z","timestamp":1760147251056,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad de Cartagena under the program \u201cPlan de Fortalecimiento de Doctorado de la Universidad de Cartagena\u201d","award":["UDC-2022"],"award-info":[{"award-number":["UDC-2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Since early May 2022, numerous cases of Monkeypox (Mpox) have been reported globally in non-endemic areas. However, despite numerous reports worldwide, the epidemiological and genomic information related to the 2022 multi-country outbreak remains scarce in South America. By late June 2022, the first Mpox cases were detected in Colombia. Cartagena is a Colombian Caribbean city with high domestic and international connectivity, and, therefore, is vulnerable to the introduction of the Monkeypox virus (MPXV). This report provides an in-depth description of the epidemiological, clinical, and virological characteristics of the first four cases detected in Cartagena including three cases with no history of recent travel and one imported case. Using various laboratory tools based on PCR, next-generation sequencing, and viral isolation and quantification methods, the MPXV clade IIB was detected and isolated. Importantly, infectious viral particles were identified in lesion swabs collected from all cases and in oropharyngeal swabs collected from two cases. Blood samples tested negative using PCR and isolation. In summary, our work contributes complete genomic, clinical, and epidemiological information that will be useful for a number of studies going forward, and it also documents local information that contributes to our understanding of Mpox at the local level.<\/jats:p>","DOI":"10.3390\/pathogens12020159","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T02:04:35Z","timestamp":1674093875000},"page":"159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiological, Clinical, and Virological Investigation of the First Four Cases of Monkeypox in Cartagena during the 2022 Outbreak"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-2423","authenticated-orcid":false,"given":"Steev","family":"Loyola","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"},{"name":"Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4399-2719","authenticated-orcid":false,"given":"Mashiel","family":"Fern\u00e1ndez-Ruiz","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"},{"name":"Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"G\u00f3mez-Camargo","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"},{"name":"Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"ref_1","first-page":"165","article-title":"Human monkeypox, 1970\u20131979","volume":"58","author":"Breman","year":"1980","journal-title":"Bull. World Health Organ."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bunge, E.M., Hoet, B., Chen, L., Lienert, F., Weidenthaler, H., Baer, L.R., and Steffen, R. (2022). The changing epidemiology of human monkeypox\u2014A potential threat? A systematic review. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010141"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101923","DOI":"10.1016\/j.cimid.2022.101923","article-title":"How can imported monkeypox break the borders? A rapid systematic review","volume":"92","author":"Ghazy","year":"2022","journal-title":"Comp. Immunol. Microbiol. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102398","DOI":"10.1016\/j.tmaid.2022.102398","article-title":"Recently spreading human monkeypox virus infection and its transmission during COVID-19 pandemic period: A travelers\u2019 prospective","volume":"49","author":"Bhattacharya","year":"2022","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_5","unstructured":"World Health Organization (2022, September 07). Multi-Country Monkeypox Outbreak: Situation Update\u201417 June 2022. Available online: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2022-DON393."},{"key":"ref_6","unstructured":"World Health Organization (2022, September 07). WHO Director-General Declares the Ongoing Monkeypox Outbreak a Public Health Emergency of International Concern. Available online: https:\/\/www.who.int\/europe\/news\/item\/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern."},{"key":"ref_7","unstructured":"Centers for Disease Control and Prevention (2022, December 01). 2022 Monkeypox Outbreak Global Map, Available online: https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/response\/2022\/world-map.html."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1056\/NEJMoa2207323","article-title":"Monkeypox Virus Infection in Humans across 16 Countries\u2014April\u2013June 2022","volume":"387","author":"Thornhill","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","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":"Alemany","year":"2022","journal-title":"Lancet"},{"key":"ref_10","unstructured":"Ministerio de Salud y Protecci\u00f3n Social de Colombia (2022, September 07). Minsalud e INS Confirman Tres Casos de Viruela S\u00edmica en Colombia, Available online: https:\/\/www.minsalud.gov.co\/Paginas\/Minsalud-e-INS-confirman-tres-casos-de-viruela-simica-en-Colombia.aspx."},{"key":"ref_11","unstructured":"Instituto Nacional de Salud de Colombia (2022, December 19). Enfermedades Emergentes\u2014Viruela S\u00edmica, Available online: https:\/\/www.ins.gov.co\/Noticias\/Paginas\/Enfermedades-emergentes.aspx#hepatitis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jviromet.2010.07.012","article-title":"Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA","volume":"169","author":"Li","year":"2010","journal-title":"J. Virol. Methods"},{"key":"ref_13","unstructured":"Matthijs, W., Jonges, M., and van den Ouden, A. (2022, September 07). Monkeypox Virus Whole Genome Sequencing Using Combination of NextGenPCR and Oxford Nanopore. Available online: https:\/\/www.protocols.io\/view\/monkeypox-virus-whole-genome-sequencing-using-comb-n2bvj6155lk5\/v1."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"541","DOI":"10.7705\/biomedica.6647","article-title":"Monkeypox virus genome sequence from an imported human case in Colombia","volume":"42","author":"Prada","year":"2022","journal-title":"Biomedica"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S1473-3099(22)00513-8","article-title":"Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding","volume":"22","author":"Lapa","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.24171\/j.phrp.2022.0232","article-title":"Isolation and identification of monkeypox virus MPXV-ROK-P1-2022 from the first case in the Republic of Korea","volume":"13","author":"Kim","year":"2022","journal-title":"Osong Public Health Res. Perspect."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Noe, S., Zange, S., Seilmaier, M., Antwerpen, M.H., Fenzl, T., Schneider, J., Spinner, C.D., Bugert, J.J., Wendtner, C.-M., and W\u00f6lfel, R. (2022). Clinical and virological features of first human monkeypox cases in Germany. Infection, 1\u20136.","DOI":"10.21203\/rs.3.rs-1725831\/v1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jviromet.2012.09.026","article-title":"Assessment of plaque assay methods for alphaviruses","volume":"187","author":"Juarez","year":"2013","journal-title":"J. Virol. Methods"},{"key":"ref_19","unstructured":"Ministerio de Salud y Protecci\u00f3n Social\u2014Instituto Nacional de Salud de Colombia (2022, December 19). Viruela S\u00edmica (Monkepox), Available online: https:\/\/app.powerbi.com\/view?r=eyJrIjoiNjQzZGQ0ZjAtODRhMi00MzFhLWFmODctOWMxNGVkNGFjMDhkIiwidCI6ImE2MmQ2YzdiLTlmNTktNDQ2OS05MzU5LTM1MzcxNDc1OTRiYiIsImMiOjR9."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"N\u00fa\u00f1ez, I., Garc\u00eda-Grimshaw, M., Ceballos-Liceaga, S.E., Toledo-Salinas, C., Carbajal-Sandoval, G., Sosa-Laso, L., Garc\u00eda-Rodr\u00edguez, G., Cort\u00e9s-Alcal\u00e1, R., de la Torre, A., and Fragoso-Saavedra, S. (2022). Epidemiological and clinical characteristics of patients with human monkeypox infection in Mexico: A nationwide observational study. Lancet Reg. Health Am., 100392.","DOI":"10.2139\/ssrn.4211417"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2200448","DOI":"10.2807\/1560-7917.ES.2022.27.24.2200448","article-title":"Estimated incubation period for monkeypox cases confirmed in the Netherlands, May 2022","volume":"27","author":"Miura","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Brites, C., Deminco, F., S\u00e1, M.S., Brito, J.T., Luz, E., and Stocker, A. (2022). The First Two Cases of Monkeypox Infection in MSM in Bahia, Brazil, and Viral Sequencing. Viruses, 14.","DOI":"10.3390\/v14091841"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2200636","DOI":"10.2807\/1560-7917.ES.2022.27.35.2200636","article-title":"Monkeypox DNA levels correlate with virus infectivity in clinical samples, Israel, 2022","volume":"27","author":"Paran","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Su\u00f1er, C., Ubals, M., Tar\u00edn-Vicente, E.J., Mendoza, A., Alemany, A., Hern\u00e1ndez-Rodr\u00edguez, \u00c1., Casa\u00f1, C., Descalzo, V., Ouchi, D., and Marc, A. (2022). Viral dynamics in patients with monkeypox infection: A prospective cohort study in Spain. Lancet Infect. Dis.","DOI":"10.2139\/ssrn.4248017"},{"key":"ref_25","unstructured":"(2022, December 20). Global Initiative on Sharing Avian Influenza Data (GISAID)\u2014Submission Tracker Global hMpxV. Available online: https:\/\/gisaid.org\/submission-tracker-global-hmpxv\/."},{"key":"ref_26","unstructured":"(2022, December 19). Global Initiative on Sharing Avian Influenza Data (GISAID)\u2014hMpxV Phylogeny. Available online: https:\/\/gisaid.org\/hmpxv-phylogeny\/."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Scarpa, F., Sanna, D., Azzena, I., Cossu, P., Locci, C., Angeletti, S., Maruotti, A., Ceccarelli, G., Casu, M., and Fiori, P.L. (2022). Genetic Variability of the Monkeypox Virus Clade IIb B.1. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216388"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/2\/159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:09:16Z","timestamp":1760119756000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/2\/159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["pathogens12020159"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12020159","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2023,1,18]]}}}