Peer-Reviewed Publication
Nat Med2026;32(5):1917-1926.May 1, 2026Journal Article
Genomic epidemiology of the 2025 mpox epidemic in Sierra Leone.
Allan K O Campbell1,2,3, John Demby Sandi4,5,6, Ifeanyi F Omah7,8, Martin Faye9, Edyth Parker10, Taylor Brock-Fisher11, Crystal M Gigante12, Vidalyn Folorunso13, Mohamed Saio Kamara14, Anu Jegede Williams13, Mouhamed Kane9, Tiangay Mariama Patience Sallay Kallon14, Julian Campbell13,15, Kadiatu Salmata Sesay14, Sia Mani13, Choe Miller13, Naomi Daniel Sesay13, Francis Baimba14, Mignane Ndiaye9, Roberta Lansana13, Ibrahim Umaru Fofanah14, Simon Ruhweza16, Zein Souma13, Amanda Kargbo13, Komba Koninga13, Alie Tia17, Jone Ngobeh17, Foday Thoronka17, Alusine Fofanah16,18, Al Ozonoff11, Colby Wilkason11, Danny Park11, Christopher Tomkins-Tinch11, Marietou F Paye11, Christopher Shin11, Ian Baudi11, Brendan Blumenstiel11, Patrick Varilly11, Ivan Specht11,19, Ben Fry20, Karlie Zhao20, Paul Cronan20, Ellory Laning20, Oludayo Oluwaseyi Ope-Ewe10, Ayotunde Elijah Sijuwola10, Femi Saibu10, Harouna Soumare10, Ebenezer Kehinde Ogundana10,21, Ruth Oluwaseun Obaado10, Jolly Amoche Adole10, Imonikhe Kennedy Kio10, Folefac Agnes Njeandoh10, Alexandra Tuttle12, Walter O Oguta22, Jonathan Greene23, Aminata Koroma16, Joseph Kanu16, Mamadou Aliou Barry9, Aboubacry Gaye9, Andy Mahine Diouf9, Christine Hughes12, Joshua I Levy24, Alhaji N'jai25,26,27, Moussa Moise Diagne9, Dolo Nosamiefan10, George Ameh23, John Klena12, Monique A Foster12, Abebaw Kebede28, Collins Tanui28, Boubacar Diallo9, Anise Happi10, Sofonias Tessema28, Abdourahmane Sow9, Yenew Kebede28, Isatta Wurie15, James Squire16, Doris Harding16, Zikan Koroma16, Mohamed Boie Jalloh16,29, Amadou Alpha Sall9, Kristian G Andersen24, Andrew Rambaut7, Mohamed Alex Vandi16, Ibrahima Socé Fall9, Pardis Sabeti11,30, Christian Happi10,21,30, Foday Sahr16, Donald S Grant31,32,33
1National Public Health Agency, Freetown, Sierra Leone. oakcampbell25@gmail.com.
2Central Public Health Reference Laboratory, Freetown, Sierra Leone. oakcampbell25@gmail.com.
3Faculty of Medical Laboratory Sciences and Diagnostics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. oakcampbell25@gmail.com.
4Faculty of Medical Laboratory Sciences and Diagnostics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. johnatsandi@gmail.com.
5Kenema Government Hospital, Kenema, Sierra Leone. johnatsandi@gmail.com.
6School of Community Health Sciences, College of Medical Sciences, Njala University, Bo, Sierra Leone. johnatsandi@gmail.com.
7Institute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.
8Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria.
9Institut Pasteur de Dakar, Dakar, Senegal.
10Institute of Genomics and Global Health, Redeemer's University, Ede, Nigeria.
11The Broad Institute of MIT and Harvard, Cambridge, MA, USA.
12Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
13Central Public Health Reference Laboratory, Freetown, Sierra Leone.
14Kenema Government Hospital, Kenema, Sierra Leone.
15Faculty of Medical Laboratory Sciences and Diagnostics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
16National Public Health Agency, Freetown, Sierra Leone.
17Sierra Leone-China P3 Friendship Laboratory, Freetown, Sierra Leone.
18School of Public Health, Njala University, Bo, Sierra Leone.
19Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
20Fathom Information Design, Boston, MA, USA.
21Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria.
22World Health Organization Regional Office for Africa (WHO AFRO), Dakar, Senegal.
23World Health Organization (WHO), Freetown, Sierra Leone.
24Department of Translational Medicine, The Scripps Research Institute, La Jolla, CA, USA.
25Department of Biological Sciences, Fourah Bay College, University of Sierra Leone, Freetown, Sierra Leone.
26Department of Microbiology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
27Department of Medical Education, California University of Science and Medicine, Colton, CA, USA.
28Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
29College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
30Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
31National Public Health Agency, Freetown, Sierra Leone. donkumfel@yahoo.co.uk.
32College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. donkumfel@yahoo.co.uk.
33Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. donkumfel@yahoo.co.uk.
Abstract
Mpox is a re-emerging zoonotic disease caused by MPXV, which has led to outbreaks across multiple countries in recent years. Sierra Leone reported its first mpox case in 8 years in January 2025, rapidly becoming the epicenter of a continental outbreak with more than 5,000 confirmed cases by August, a surge with unknown origins, timings and drivers. Phylodynamic analyses using 338 genomes generated…
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