Fig. 1: VACV-binding and MPXV-neutralizing antibodies in sera from potentially exposed (high-risk) and unexposed (pre-outbreak) individuals in DRC.

a VACV-binding antibodies in sera obtained from bars in 2023 (n = 120), bars in 2024 (n = 48), households (n = 108) (all potentially exposed, orange), controls (unexposed, teal), and validation sera (gray and red). Fraction of seropositive sera is indicated per group. b MPXV-neutralizing antibodies in sera shown in (a). c Correlation between VACV-binding binding and MPXV-neutralizing antibodies in potentially exposed individuals (orange), controls (teal), and validation sera from vaccinated individuals (red). Colored bubbles indicate manually defined clusters. d Percentage of bars with seropositive professional sex workers (PSW). e Serostatus from all individuals in bars; index cases were not sampled. Every row represents a bar, every square a serum. Sera are categorized as mpox-seropositive (red; positive for VACV-binding and MPXV-neutralizing antibodies) or mpox-seronegative (gray; negative for VACV-binding and MPXV-neutralizing antibodies). Sera testing positive for either VACV-binding or MPXV-neutralizing antibodies are shown as orange. f Percentage of households with seropositive members. g Serostatus from all individuals in households; index cases were not sampled. Every row represents a bar, every symbol a serum from an adult (square; ≥18 years old) or a minor (circle; <18 years old). Color-coding is identical to panel (e). DRC Democratic Republic of the Congo, VACV vaccinia virus, MPXV mpox virus, ELISA enzyme-linked immunosorbent assay, PRNT plaque reduction neutralization test.