Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh,

Grounds assessments

activeAt least one additional EU/G7 country beyond Spain will report a documented Clade Ib mpox sustained transmission cluster (≥5 epidemiologically linked cases over ≥3 weeks) by September 30 2026, driven by the WHO DON587-confirmed multi-mode global Clade Ib spread and cross-border network linkage with Spain's ongoing outbreak.50%activeA locally-acquired Clade I mpox transmission chain (≥2 epidemiologically linked cases without African travel history) will be confirmed in North America within 90 days of the San Francisco Clade I detection (Apr 19 2026).40%activePakistan (Khairpur/Sindh) mpox cases will be genomically confirmed as Clade Ib by WHO DON or Pakistan MoH by June 2026, representing the third non-African Clade Ib community transmission geography after Spain (Dec 2025) and Singapore (Apr 2026), based on infant mortality in Khairpur district (7 infants dead/positive, Apr 2026) and demographic severity patterns consistent with Clade Ib rather than Clade IIb.40%activeAt least one confirmed mpox Clade Ib case with travel linkage to Singapore will be detected in Japan, South Korea, or Australia by October 2026, given Singapore's confirmed local Clade Ib transmission (2 cases, CDA Apr 4 2026) and Singapore's role as the primary aviation hub for East Asia–Pacific travel.50%resolvedAt least one confirmed mpox Clade IIb case linked to Singapore will be detected in Japan, South Korea, or Australia by October 2026, given Singapore's confirmation of local Clade IIb transmission (Apr 14 2026) and its role as the primary aviation hub for East Asia–Pacific travel.50%resolvedMpox clade Ib will be confirmed in at least 2 East African countries outside the DRC by April 2026.90%activeAt least one confirmed mpox Clade Ib case imported to the US will be significantly delayed in diagnosis (>7 days from symptom onset to laboratory confirmation) or go initially undetected due to CDC diagnostic capacity gaps, by October 2026, given that CDC paused mpox and rabies diagnostic testing capability (Apr 1–2 2026) during an active global PHEIC with confirmed Clade Ib community transmission outside Africa.50%activeAt least one confirmed mpox case (clade unspecified) will be detected in India within 90 days of the Pakistan Khairpur Sindh infant deaths cluster (by July 14 2026), given Pakistan-India cross-border movement in the Punjab/Rajasthan/Gujarat corridor and the unprecedented pediatric severity profile suggesting Clade Ib circulation in an adjacent geography.40%resolvedMpox Clade Ib will establish at least one additional documented sustained community transmission chain outside the African continent by July 2026.70%activeA novel recombinant mpox lineage arising from tri-clade co-circulation (Clade Ia, Ib, and Clade IIb) in the Republic of the Congo will be genomically documented by April 2027, based on the first reported co-circulation of all three major mpox clades in a single geography.30%activeMpox Clade IIb C.1 will establish sustained community transmission in at least one additional Southeast Asian country beyond Cambodia by October 2026, based on the documented Phnom Penh outbreak and regional mobility patterns.50%activeMpox Clade IIb C.1 community transmission in Phnom Penh will be documented to involve a heterosexual or mixed-route transmission cluster by July 2026, based on phylogenomic confirmation of community spread and newly published MPXV replication efficiency in vaginal and ectocervical epithelial tissue.50%activeAt least one imported Clade IIb C.1 case linked to Cambodia will be confirmed in Thailand or Vietnam by July 31 2026, based on phylogenomic documentation of sustained community transmission in Phnom Penh and high-frequency air travel routes connecting Cambodia to these countries.60%

Evidence content

Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, — research event update (updated 2026-04-14T12:08)

Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh,

Field	Value
date	2026-04-14
event_type	pubmed
headline	Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh,
research_domain	generic
scope	mpox
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source_url	https://pubmed.ncbi.nlm.nih.gov/41575511/
summary	Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, Cambodia (2023-2024). A large-scale outbreak linked to Clade IIb emerged in 2022 and rapidly spread to more than 100 countries worldwide.

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Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, — research event update (updated 2026-04-14T12:08)

Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh,

Field	Value
date	2026-04-14
event_type	pubmed
headline	Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh,
research_domain	generic
scope	mpox
source_meta	{"source":{"sourceId":"pubmed","name":"PubMed","tier":"T2","url":"https://pubmed.ncbi.nlm.nih.gov","documentUrl":"https://pubmed.ncbi.nlm.nih.gov/41575511/","documentTitle":"Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, Cambodia (2023-2024)."},"hypothesisLinks":[{"hypothesisId":"hyp:mpox:2026-07-31:2026-04-14","direction":"supports","weight":0.349},{"hypothesisId":"hyp:mpox:2026-04-30:2026-04-12","direction":"supports","weight":0.332},{"hypothesisId":"hyp:mpox:2026-10-31:2026-04-13","direction":"supports","weight":0.243},{"hypothesisId":"hyp:mpox:2026-07-31:2026-04-13","direction":"supports","weight":0.22},{"hypothesisId":"hyp:mpox:2026-10-31:2026-04-14","direction":"supports","weight":0.203}],"flags":["potentially_coordinated"],"direction":"supports","relevanceScore":0.349,"publishedAt":"2026-03-11T00:00:00.000Z","metadata":{"pmid":"41575511","journal":"Emerging microbes & infections","extractionMethod":"eutils","query":"(mpox OR monkeypox OR orthopox OR "clade Ib") AND (outbreak OR transmission OR cases OR surveillance OR resistance OR mutation)","queries":["(mpox OR monkeypox OR orthopox OR "clade Ib") AND (outbreak OR transmission OR cases OR surveillance OR resistance OR mutation)"],"scopeHints":["mpox"],"language":"en","extractedTitle":"Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, Cambodia (2023-2024).","claimLevel":true,"literatureSource":"pubmed","claimOrdinal":0,"claimFingerprint":"58bb2d6b9c6a7942323659d004e4b64916dcf49ba3dac73c3d6a5b82e87ee59b","signalClass":"mutation","pathogens":["mpox"],"hosts":[],"places":["Cambodia"],"country":"Cambodia","location":"Cambodia","canonicalPlaceIds":["cambodia"],"lineages":[],"mutations":[],"resistanceGenes":[],"counts":{"cases":0,"deaths":0,"samples":0},"studyType":null,"certainty":null,"classification":{"strategy":"keyword-v1","scopeId":"mpox","hypothesisMatches":5,"scopeRelevance":0.20930232558139536,"matchedIndicators":["mpox"]}}}
source_url	https://pubmed.ncbi.nlm.nih.gov/41575511/
summary	Epidemiology and phylogenomic characterization of the Clade IIb C.1 Mpox outbreak in Phnom Penh, Cambodia (2023-2024). A large-scale outbreak linked to Clade IIb emerged in 2022 and rapidly spread to more than 100 countries worldwide.