Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding.
Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding.
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DOI：
10.1016/s1473-3099(22)00513-8
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发表时间：
2022-09
影响因子：
56.3
通讯作者：
Maggi, Fabrizio
中科院分区：
文献类型：
--
作者：
Lapa, Daniele;Carletti, Fabrizio;Mazzotta, Valentina;Matusali, Giulia;Pinnetti, Carmela;Meschi, Silvia;Gagliardini, Roberta;Colavita, Francesca;Mondi, Annalisa;Minosse, Claudia;Scorzolini, Laura;Cicalini, Stefania;Maffongelli, Gaetano;Specchiarello, Eliana;Camici, Marta;Bettini, Aurora;Baldini, Francesco;Francalancia, Massimo;Mizzoni, Klizia;Garbuglia, Anna Rosa;Nicastri, Emanuele;Girardi, Enrico;Antinori, Andrea;Vaia, Francesco;Maggi, Fabrizio
自2022年5月开始，非流行国家的人类猴痘病例意外增加，引发了人们对新型全球传染病威胁的担忧。自1970年在刚果民主共和国发现首例人间病例以来，该病毒已在非洲中部和西部的几个国家流行。1非洲以外地区（英国、美国、新加坡和以色列）零星报告了输入性病例，大多数病例与从流行国家返回的旅行者有关，或由于医院接触或接触受感染的输入啮齿动物。截至2022年7月22日，全球75个国家报告了16016例实验室确诊猴痘病例，世卫组织总干事已宣布不断升级的全球猴痘疫情为国际关注的突发公共卫生事件。4绝大多数病例报告在欧洲和其他非流行国家，大多数诊断为年轻男性，自我认同为男男性行为者（MSM）。猴痘病毒的传播可能通过粘膜或不完整的皮肤与感染性物质的密切接触，或长时间面对面接触时的大呼吸道飞沫发生。5猴痘病毒是否可以通过生殖器液进行性传播仍在调查中。在英国，有两名没有到流行国家旅行史的男子在性交过程中传播猴痘病毒，其症状与性接触的时间相关性以及与性接触相匹配的原发性病变部位的位置证明了这一点。6据报道，在意大利的三个病例和随后在德国的两名猴痘患者中，精液样本中检测到病毒DNA。此外，在2022年全球爆发的一个大型病例系列中，32名猴痘患者中有29人（91%）的精液中检测到猴痘DNA。9然而，迄今为止，没有证据表明精液中的猴痘病毒具有传染性。因此，我们研究了从国家传染病研究所“Lazzaro Spallanzani”（罗马，意大利;附录p 1）诊断的1例猴痘病毒确诊病例症状发作后5-19天采集的纵向精液样本中的病毒脱落。患者是一名39岁的男性，于2022年5月的前两周在奥地利旅行。他自认为是一名男男性接触者和性工作者，并报告在上个月与几名男性伴侣发生了无套性交。患者为HIV感染者，接受度鲁特韦和拉米夫定治疗，病毒抑制和免疫恢复，并报告性传播感染史。他在症状发作后5天入院。他的症状包括发烧，随后在肛门区域出现成簇的瘙痒性丘疹病变，
The unexpected increase in human monkeypox cases in non-endemic countries that began in May, 2022, is raising concerns of a novel global infectious threat. Since the first human case in 1970 in the Democratic Republic of the Congo, the virus has become endemic in several countries in central and western Africa. 1 Imported cases have been sporadically reported outside Africa (in England, the USA, Singapore, and Israel), with the majority of cases associated with travellers returning from endemic countries, or due to nosocomial contact or contact with infected imported rodents. 2, 3 As of July 22, 2022, 16 016 laboratory-confirmed 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 fluids 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 fluid of 29 (91%) of 32 people affected 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 confirmed monkeypox virus case diagnosed at the National Institute for Infectious Diseases ‘Lazzaro Spallanzani’(Rome, Italy; appendix p 1). The patient was a 39-year-old man, who travelled in Austria during the first 2 weeks of May, 2022. He selfidentified as an MSM and sex worker and reported condomless sexual intercourse with several male partners during the previous month. The patient was HIV-infected, treated with dolutegravir and lamivudine, with viral suppression and immune recovery, and reported a history of sexually transmitted infections. He was admitted to the hospital 5 days after symptom onset. His symptoms included fever, followed by the appearance of clustered itchy papular lesions in the anal region and