The name “hMPXV A.1” may not slip off the tongue, but a leading international group of researchers argues that something similar should replace the current naming system of monkeypox and its so-called West African and West African strains. Congo basin.
“In the context of the current global epidemic, the ongoing references and nomenclature of this African virus are not only inaccurate, they are also discriminatory and stigmatizing,” 29 co-authors from 11 countries write today in a preprint published on virological.org today. They also note that the strain now circulating in people outside Africa is likely distinct from the virus in animals and “urge a quick decision and the adoption of a new name.”
The call echoes earlier debates over the names of other diseases and pathogens, including a recent one that led to the current nomenclature for SARS-CoV-2 variants, with Greek letters replacing geographic names such as the Wuhan or South African strain. Likewise, the authors of the preprint want a “practical and neutral nomenclature system” used for monkeypox.
“Very, very happy to see this,” tweeted Neil Stone, an infectious disease specialist at University College London Hospitals, in response to the preprint.
The current monkeypox epidemic, the first ever to occur on multiple continents outside of Africa, has spread to more than 1,500 people in 47 countries. Years ago, researchers divided monkeypox viruses into “clades” or branches of West Africa and the Congo Basin, which have unique genomic signatures and cause disease of varying severity. Viruses sequenced in the current outbreak largely match those in the typically milder West African clade.
But some researchers argue that the human strains now seen around the world actually form a third clade, and those viruses may also have different transmission characteristics. “It is quite clear that this virus is related in a very different way” to the previously sequenced strains, says Tulio de Oliveira, an evolutionary biologist at the University of KwaZulu-Natal, who was the last author of the preprint.
Typically, monkeypox outbreaks occur in Africa when the virus spreads from animal species, most commonly rodents, not monkeys, which regularly infect each other and act as reservoirs for the pathogen. But no animal links have been found in the cases of the current outbreak, and the first patients have emerged in Europe, where mounting evidence suggests the virus may have been passed between humans undetected for many months. “There has been a great adaptation to the human host. The real source of this outbreak is mainly Europe and then it was introduced anywhere else in the world, “says Oliveira.
Oliveira and colleagues on the prepress suggest human monkeypox (hMPXV) as a placeholder name with numbers representing the clades: 1 for the Congo Basin as it was the first to be detected, 2 for West Africa and 3 for the strain current, which might inappropriately be called the “Euro” clade. Lineages within a clade could use the alphabet, such as SARS-CoV-2 with Omicron BA.5. The group has already discussed its ideas with the World Health Organization (WHO) and the International Committee on Taxonomy of Viruses (ICTV).
The geographical naming of viruses and diseases has had negative consequences. A SARS-CoV-2 variant that Oliveira and her colleagues were the first to describe has been dubbed the South African strain, which has led to travel bans; WHO later dubbed it Beta. Locations that fear negative reactions if they have a pathogen named after them “may contain information when they discover a new virus,” he adds.
Although WHO had already recommended against geography-based names in 2015, many viruses on the ICTV’s main species list still have them: Ebola, named after a river in the Democratic Republic of the Congo, is typically divided into stocks from Sudan and Zaire and Oliveira says it’s time to rethink them all. “Most of these were named by people who were researching colonialism with parachutes, going to one place, ‘Oh, I find it, I’ll call the virus whatever I want,'” he says. “So that’s how people did in the past. Is this the right way to do it? I do not believe”.