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Comment: Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding -

Mary Wilson

Well-known member
Published:August 02, 2022

DOI: https://doi.org/10.1016/S1473-3099(22)00513-8

Daniele Lapa, Fabrizio Carletti, Valentina Mazzotta, Giulia Matusali, Carmela Pinnetti, Silvia Meschi, et al. Show all authors

... As of July 22, 2022, 16016 laboratory-con rmed monkeypox cases have been reported from 75 countries worldwide, and the WHO Director-General has declared the escalating global monkeypox outbreak to be a public health emergency of international concern.4 The vast majority of cases have been reported in Europe and other non-endemic countries, mostly diagnosed in young men, self-identifying as men who have sex with men (MSM). Monkeypox virus transmission might occur through close contact of mucosa or non-intact skin with infectious material, or large respiratory droplets during prolonged face-to-face contact.5 Whether monkeypox virus can be sexually transmitted via genital uids remains under investigation. Monkeypox virus transmission during sexual intercourse has been documented in the UK in two men with no travel history to endemic countries and evidenced by the temporal association of symptoms with sexual contact and the location of primary lesion sites matching those of sexual contact.6 Viral DNA detection in semen samples has been reported in three cases in Italy and subsequently in two patients with monkeypox in Germany.7,8 Furthermore, monkeypox DNA was detected in the seminal uid of 29 (91%) of 32 people a ected by monkeypox in a large case series on the 2022 global outbreak.9 However, to date, no evidence is available on the infectiousness of monkeypox virus in semen. Therefore, we investigated viral shedding in longitudinal semen samples collected 5–19 days after symptom onset from one con rmed monkeypox virus case diagnosed at the National Institute for Infectious Diseases ‘Lazzaro Spallanzani’ (Rome, Italy; appendix p 1). ...

https://www.thelancet.com/action/sho...2822%2900513-8
 
"The patient was HIV-infected, treated with dolutegravir and lamivudine, with viral suppression and immune recovery, and reported a history of sexually transmitted infections......Further studies on the viral tropism for the genital tract and data on the frequency of virus detection and duration of replicative monkeypox virus shedding in the seminal fluid, also in patients who do not have HIV, are crucial to better understand the viral pathogenesis and the potential role of semen-driven transmission in the spreading of monkeypox infection and disease burden."
 
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