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<p>In regions where both monkeypox virus (MPXV) and varicella zoster virus (VZV) are co-circulating, overlapping clinical manifestations can complicate clinical diagnosis. During the MPXV outbreak declared in Uganda in July, 2024, symptomatic suspected cases tested PCR negative for Mpox. To determine the cause of symptoms, we employed metagenomic sequencing with a targeted Viral Surveillance panel in 284 MPXV negative samples. VZV was identified as the predominant pathogen in 86% of MPXV-negative cases, suggesting a concurrent chickenpox surge. Using the VaricellaGen pipeline for variant calling, clade typing, and phylogeny, 118 (49%) samples that achieved ≥ 70% genome coverage were of clade 5 based on the single-nucleotide polymorphism (SNP) dataset. This data confirms co-circulation of VZV during the MPXV outbreak in Uganda. Our results underscore the need for laboratory confirmation of MPXV and the inclusion of VZV in the testing algorithm during the Mpox outbreak.</p>

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Targeted metagenomics reveals hidden chickenpox epidemic amid Mpox surveillance in Uganda

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月6日

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  • Stephen Kanyerezi,
  • Alisen Ayitewala,
  • Jupiter Marina Kabahita,
  • Hellen Rosette Oundo,
  • Julius Sseruyange,
  • Wilson Tenywa,
  • Godwin Tusabe,
  • Stacy Were,
  • Moses Murungi,
  • Martha Nabukyu,
  • Valeria Nakintu,
  • Caroline Makoha,
  • Ivan Sserwadda,
  • Harris Onywera,
  • Collins Tanui,
  • Ibrahim Mugerwa,
  • Atek Kagirita,
  • Benard Lubwama,
  • Eilu Roggers Michael,
  • David Patrick Kateete,
  • Morgan Otita,
  • Samuel Giduddu,
  • Daudi Jjingo,
  • Andrew Nsawotebba,
  • Gerald Mboowa,
  • Aloysious Ssemaganda,
  • Susan Nabadda,
  • Sofonias K. Tessema,
  • Isaac Ssewanyana

摘要

In regions where both monkeypox virus (MPXV) and varicella zoster virus (VZV) are co-circulating, overlapping clinical manifestations can complicate clinical diagnosis. During the MPXV outbreak declared in Uganda in July, 2024, symptomatic suspected cases tested PCR negative for Mpox. To determine the cause of symptoms, we employed metagenomic sequencing with a targeted Viral Surveillance panel in 284 MPXV negative samples. VZV was identified as the predominant pathogen in 86% of MPXV-negative cases, suggesting a concurrent chickenpox surge. Using the VaricellaGen pipeline for variant calling, clade typing, and phylogeny, 118 (49%) samples that achieved ≥ 70% genome coverage were of clade 5 based on the single-nucleotide polymorphism (SNP) dataset. This data confirms co-circulation of VZV during the MPXV outbreak in Uganda. Our results underscore the need for laboratory confirmation of MPXV and the inclusion of VZV in the testing algorithm during the Mpox outbreak.