PARIS, July 28 (EDITIONS) –
Science is advancing and research is providing more and more data on monkeypox, an infection that is currently the subject of debate as to whether or not it is a sexually transmitted disease.
A new study conducted by the Barcelona Institute of Global Health (ISGlobal), a center supported by the “la Caixa” Foundation, and the Hospital Clínic de Barcelona, published in the journal “Eurosurveillance”, shows precisely that Monkeypox virus is frequently detected in saliva, semen, and in other clinical specimens from infected persons.
This scientific work contributes to a better understanding of the mode of transmission of this emerging disease, according to Mikel Martínez, researcher at the Barcelona Institute of Global Health (ISGlobal) and microbiologist at the Clínic Hospital in Barcelona, in an interview with Infosalus .
« There was very little data or information on this virus regarding its biodistribution or its presence in other biological fluids.. It was known to be present in the skin lesions, and these are infectious,” he says.
He specifically mentions that there is very little data from a study in England of cases imported from Africa, where it was seen that it might be detected in nasopharyngeal samples, in blood, in urine; and also from another small Italian study where it was detected in semen in three cases, and one in saliva; “so more information on this subject was necessary”, remarks this expert.
The team led by Mikel Martínez, researcher at ISGlobal, and José Luis Blanco, from Hospital Clínic in Barcelona, verified the presence of genetic material of the virus in different biological samples (more than 140 different), taken at different times, in 12 patients with confirmed monkeypox virus infection.
All patients had high viral loads at diagnosis, as well as DNA in the saliva of all patients, some of whom had high viral loads. “Only one previous study had tested saliva, in a single patient. Viral DNA was also detected in rectal (11 of 12 patients), nasopharyngeal (10/12 patients), semen (7/9 patients), urine (9/12 patients), and fecal (8/12 patients) samples. 12 patients).
« These data report more solid information regarding the presence of the virus. and in some cases with a high viral load, that is to say not only the presence of the virus, but in large quantities, ”he specifies.
As to whether it is common to find traces of the virus in human biological samples, Mr. Martínez specifies that everything depends on the microorganism, which is why he explains that for each virus studied, it is important to determine where it is. is distributed, and that having an idea of the infectivity of the samples provides information on possible transmission mechanisms.
The ISGlobal researcher specifies however that, in his study, the infectivity of the samples was not determined, and recalls that to determine it, the virus must be cultured. However, he points out: “Having detected this product so frequently in these cases, and in some cases in large quantities, I would be surprised if it did not play a role in transmission and in the current epidemic, especially through sexual contact. There is some debate whether it is a sexually transmitted disease or not, but it is clear that close physical contact is contagious, and if you have the contagious skin lesions, and the virus in the samples biological, our opinion is that this widespread presence of the virus contributes to the transmission of this epidemic”.
On this point, the coordinator of the monkey pox working group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), states that, from a clinical point of view, it’s one thing if a positive test is found in the semen, and another if the virus is transmitted. In fact, it is reminiscent of the case of people who are PCR positive for COVID-19 but do not transmit it.
« Whether monkeypox is a sexually transmitted disease is not conclusively proven. He seems to beand we all think so, but the virus would have to be cultured in semen to prove that it is transmissible. This has not been done so far, and in Spain we do not have the means to do it, because we need a biosafety level 4 laboratory, which has not yet been built, although there is a promise that it will be at the National Center for Microbiology,” he adds.
Ensuite, asks to differentiate a sexually transmitted disease, those that are transmitted through sexual fluidsthe fact that the disease is transmitted by sexual contact: “What we know is that the disease is transmitted in almost all cases by direct contact, by skin-to-skin contact between an infected person and an uninfected person, through blisters on the skin that are full of viruses.”
Right from the start, he says that you see patients who have blisters on the pubis, on the penis or in the anal region, and that they infect these people during sexual intercourse; therefore, he insists that the transmission mechanism takes place during sexual intercourse, but it is unclear whether it is through bodily fluids or direct contact at this time.
He also points out that we should not speak of a disease that would be exclusive to homosexual men.The same contagion mechanism also occurs in a heterosexual relationship. Recall that in Madrid, a few days ago, a seven-month-old baby tested positive for monkeypox, which had been infected by his parents.
WHY THIS DISEASE IS BEGINNING TO BE WORRYING
Faced with this high number of cases, Mikel Martínez, researcher at the Barcelona Institute of Global Health (ISGlobal) and microbiologist at the Clínic Hospital in Barcelona, regrets that “the disease is far from being under control”.
“It started at the beginning of May. We are in July and we already have 18,000 reported cases, and this figure is constantly increasing, and it is already localized in more than 60-70 countries, when it was an African endemic disease. Worldwide distributionand in Spain there are more than 3,000 cases. So it’s worrying because cases are increasing and transmission is not controlled,” stress.
VACCINATION ?
He believes that the WHO’s declaration of an “emergency” for the disease will help keep it at bay, putting more focus on the disease and spurring countries to act. He remembers that vaccination campaigns are launched in some places because the smallpox vaccine is known to provide some degree of protection once morest smallpox.
Precisely, Madrid and Catalonia are the two autonomous communities with the highest number of detected cases. Since this week, they have started administering the pre-exposure vaccine to people aged 18 to 45 with risky sexual practices and meeting established clinical criteria.
HOW TO PREVENT IT
The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) monkeypox task force coordinator, Dr Francisco Javier Membrillo de Novales, warns that using condoms alone is not enough to prevent infection.
“Whether or not it is transmitted through semen, or through vaginal fluids, as is the case here. another mechanism that we know is contagious, namely skin lesions.Condoms do not protect once morest infection during sex. So this infection, even if it behaves like a sexually transmitted disease, since we know with certainty that it is transmitted by these lesions, the condom in this case will not protect once morest infection. monkeypox,” he says.
For his part, Mr. Martínez, of ISGlobal, points out that the most important thing to prevent the disease is not to be in contact with a case of monkeypox, due to transmission through close physical contact.
As for the symptoms, he reminds us that in many cases there is a non-specific flu picture (fever, malaise, muscle pain) which sometimes precedes the appearance of skin lesions. “These are kind of vesicles, which turn into papules, with a central depression, then turn into scabs. It is quite characteristic of the disease,” he notes.
He specifies here that these lesions are considered contagious until they disappear, and that they last regarding two or three weeks, until the last scabs fall off. It also warns once morest contact with surfaces that have touched these lesions, or with contaminated clothing, through which the disease can also be transmitted.
