NEW YORK CITY: A genetic analysis of recent monkeypox cases suggests there are two distinct strains in the United States, health officials said on Friday (Saturday in Manila), raising the possibility that the virus has been circulating undetected for some time.

Many of the US cases were caused by the same strain as recent cases in Europe, but a few samples show a different strain, federal health officials said. Each strain had been seen in US cases last year, before the recent international outbreak was identified.

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