Highlights
• The Children’s Hospital of Philadelphia (CHOP) detected a B3 MeV case in 2023 and in 2025.
• Whole-genome amplification of the two CHOP B3 MeV isolates was performed.
• The CHOP genomes were assessed with a global dataset of all 168 National Center for Biotechnology Information B3 MeV near-full length genomes from 2005-2025.
• The CHOP isolates form a clade with 39 other isolates from four countries, 36 of which cluster with a 15 single nucleotide polymorphism cutoff.
• The CHOP clade diverged in 2019, contains the most recently emerged B3 nodes, and shares a private mutation in the phosphoprotein at a codon undergoing positive selection.
Abstract
Background
Children’s Hospital of Philadelphia (CHOP) identified a MeV case in late 2023 and also early 2025, both of which were associated with international travel. Of the 24 MeV genotypes, the B3 and D8 lineages have been the most prevalent globally since 2021. Initial genotyping indicated that the two CHOP isolates belong to the B3 lineage.
Objectives
To inform MeV molecular surveillance, we conducted a genomic epidemiology analysis to situate the CHOP strains within the global genetic landscape of past and present MeV B3 cases.
Study design
We performed whole-genome amplification, genome assembly, and phylogenomics of our two MeV cases. These strains were then analyzed alongside all 168 National Center for Biotechnology Information near-full length MeV B3 genomes using population and evolutionary genetic approaches. This dataset includes strains isolated from 13 countries between 2005 and 2025.
Results
The two CHOP strains form a monophyletic group with 39 other isolates from four countries; 36 clade members form a discrete network connected by a 15 single nucleotide polymorphism (SNP) cutoff. The CHOP clade shares a Q45H phosphoprotein mutation at a codon undergoing diversifying selection, as with a H593R hemagglutinin mutation carried by the 2025 CHOP strain. The CHOP clade likely diverged in 2019 and has a median root-to-tip distance of 0.020 compared to 0.017 for the other B3 strains, consistent with this clade encompassing the most recently divergent nodes.
Conclusions
Our work places the CHOP MeV cases within a diversifying and emergent global clade of the dominating B3 lineage that is a future risk due to ongoing B3 MeV transmission.

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