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Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus - Virological

Mary Wilson

Well-known member
Clade 3, hMPXV

June 10 2022

Authors: Christian Happi[SUP]1,2*[/SUP], Ifedayo Adetifa[SUP]3[/SUP], Placide Mbala[SUP]4[/SUP], Richard Njouom[SUP]5[/SUP], Emmanuel Nakoune[SUP]6[/SUP], Anise Happi[SUP]1[/SUP], Nnaemeka Ndodo[SUP]3[/SUP], Oyeronke Ayansola[SUP]3[/SUP], Gerald Mboowa[SUP]7[/SUP], Trevor Bedford[SUP]8,9[/SUP], Richard A. Neher[SUP]10,11[/SUP], Cornelius Roemer[SUP]10,11[/SUP], Emma Hodcroft[SUP]11,12,13[/SUP], Houriiyah Tegally[SUP]14,15[/SUP], Áine O’Toole[SUP]16[/SUP], Andrew Rambaut[SUP]16[/SUP], Oliver Pybus[SUP]17,18,19[/SUP], Moritz U.G. Kraemer[SUP]17,18[/SUP], Eduan Wilkinson[SUP]14[/SUP], Joana Isidro[SUP]20[/SUP], Vítor Borges[SUP]20[/SUP], Miguel Pinto[SUP]20[/SUP], João Paulo Gomes[SUP]20[/SUP], Cheryl Baxter[SUP]15,21[/SUP], Richard Lessells[SUP]14,21[/SUP], Ahmed E. Ogwell[SUP]7[/SUP], Yenew Kebede[SUP]7[/SUP], Sofonias K. Tessema[SUP]7[/SUP], Tulio de Oliveira[SUP]14,15,21,22*[/SUP]

[SUP]...[/SUP]Current classification

In the current classification of MPXV genetic diversity only two clades of MPXV are recognized – referred to as the “West African” clade and the “Central African” or “Congo Basin” clade[10]. However, these historic MPXV clade names are counter to the best practice of avoiding geographic locations in the nomenclature of diseases and disease groups [11,12]. The recent and prompt example implemented for SARS-CoV-2 should be the norm [11]. Given the increasingly rapid communication of, and attention to, the international human MPXV outbreak, it is important to consider an appropriate, non-discriminatory, and non-stigmatizing nomenclature and classification of MPXV clades. In recent publications[12] and symposia, including the WHO Research and Development (R&D) symposium, it was highlighted that the current global outbreak was caused by MPXV of the West African clade. Some genome sequences on the NCBI Genbank database use “West African” for the field “strain” or “genotype” (including the NCBI reference genome: NC_063383 1). Like many previous geographic labels of infectious diseases based on locations of first detection, it is misleading and inaccurate because very limited surveillance and limited diagnostic capacity means that the full range of the pathogen is not known. This is crucially demonstrated by the discovery in May 2022 that MPXV has been circulating in over 44 countries without detection and is likely to be present in many more.

Proposed Classification

Here, we propose a novel classification of MPXV that is non-discriminatory and non-stigmatizing and aligned with best practices in naming of infectious diseases [11] in a way that minimizes unnecessary negative impacts on nations, geographic regions, economies and people and that considers the evolution and spread of the virus.

We propose the classification of three main clades; MPXV clades 1, 2 and 3, named in order of detection. These include viral genomes from Western African, Central African and localized spillover events in global north countries and from both human and non-human hosts (Figure 1A). Here, clade 1 corresponds to the prior “Congo Basin clade”, while clades 2 and 3 corresponds to the prior “West African clade”. These three clades represent deep MPXV diversity, accumulated over many years of evolution in the animal reservoir. Further sequencing of MPXV from the animal reservoir may potentially uncover further clades 4, 5, 6, and so forth.

We also suggest naming a new clade, containing genomes sampled between 2017–2019 from the UK, Israel, Nigeria, USA, and Singapore and genomes from 2022 global outbreaks (Figure 1B). Since viruses in this clade have been transmitting from person to person in dozens of countries and potentially over multiple years, we propose that this represents transmission route distinct from that of previous MPXV cases in humans and should be afforded a distinct name so that it can be referred to specifically in both scientific discourse and the general media. Whilst the formal naming of virus species is the purview of the International Committee of Taxonomy of Viruses (ICTV), we believe this is an opportunity for a break with the name monkeypox and the historical associations attached to that name. However, we believe that a distinct and convenient name for the virus causing this epidemic would facilitate communication without further negative connotations. Here we use the placeholder label ‘hMPXV’ to denote where we believe this now human virus becomes distinct from MPXV13 (Figure 1B), and urge a speedy decision and adoption of a new name. ...

https://virological.org/t/urgent-nee...rus/853#post_1
 
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