Mpox, earlier known as Monkeypox, has been circulating in humans since 2016, before sparking a global health emergency in 2022, according to research.

Mpox virus is transmitted primarily through close physical contact and causes a disease with symptoms similar to smallpox, although less severe. In May 2022, the virus saw a major outbreak, spreading to more than 100 countries and causing over 86,900 infections across the world.

The study, published in the journal Science, showed that mpox virus (MPXV) mutated to better spread between humans.

For the study, the international team of researchers including from the UK, Switzerland, Nigeria and Portugal, sequenced the genome of the mpox virus.

Their findings revealed that the clade IIb had spread around the world, and it appeared different from other strains that had been seen before in Africa.

Importantly, they found that infections in humans led to the production of an enzyme called APOBEC3, which was found to cause further mutations that alter genome base pairs. Tracing the evolutionary history of the virus the team found such mutations go back to approximately 2016, strongly suggesting that the virus has been transmittable between humans since that year.

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“These observations of sustained MPXV transmission present a fundamental shift to the perceived paradigm of MPXV epidemiology as a zoonosis and highlight the need for revising public health messaging around MPXV as well as outbreak management and control,” said the corresponding author Aine O’Toole, from the Institute of Ecology and Evolution, University of Edinburgh in the paper.

O’Toole added that “any new or nascent outbreak may have potential to go global” if it is able to silently infect and evolve in humans.

“We need to focus on detecting outbreaks even when case numbers are low, and find a way of stamping it out before it establishes in the human population,” she was quoted as saying to the Guardian Mpox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions.

It was first identified in monkeys in research laboratories in the 1950s, and it was not until 1970 that the first human case was discovered.