Breakthrough Mpox outbreak investigation, the delicate balance between host immune response and viral immune escape

Marco Moretti, Annelies Maurits Y Meuwissen, Antonio Mauro Rezende, Sabine Zange, Els Van Nedervelde, Tessa De Block, Koen O A Vercauteren, Thomas Demuyser, Sabine Allard

Onderzoeksoutput: Articlepeer review

Samenvatting

Background
Limited data is available on Mpox breakthrough infections.

Purpose
Investigate a Mpox breakthrough outbreak in three vaccinated individuals.

Methods
Study participants provided informed consent. Serology testing was performed in one involved individual (ID-1) using an in-house assay detecting anti-orthopoxvirus IgG. Whole genome sequencing (WGS) was carried out and compared to the reference sequence ON563414.3 (https://www.ncbi.nlm.nih.gov/nuccore/ON563414.3/).

Results
Three individuals vaccinated with modified vaccinia Ankara–Bavaria Nordic contracted Mpox following one sexual intercourse event. One of them (ID-1) had received only one vaccine dose, while the other two were fully vaccinated. ID-1 presented to the sexual health clinic of the Universitair Ziekenhuis Brussel with proctitis related to Mpox. Despite one vaccination, serology testing Three months post vaccine showed absence of Mpox virus (MPXV) specific antibodies in ID-1. In contrast, two weeks following the sexual intercourse, seroconversion occurred. WGS of the isolated MPXV showed, compared to the reference sequence, a total of seven single nucleotide variants with four of them indicating protein amino-acid changes.

Conclusion
Incomplete MPXV vaccination as well as MPXV variants might result in breakthrough infections. Preventive measures, such as MPVX vaccination, could maintain immunity in individuals with higher risk of MPXV infection, and might lower disease severity.
Originele taal-2English
Pagina's (van-tot)499-503
Aantal pagina's5
TijdschriftSexually Transmitted Diseases
Volume51
Nummer van het tijdschrift7
Vroegere onlinedatum19 apr 2024
DOI's
StatusE-pub ahead of print - 19 apr 2024

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