Chaix Estelle, Boni Mickaël, Guillier Laurent, Bertagnoli Stéphane, Mailles Alexandra, Collignon Catherine, Kooh Pauline, Ferraris Olivier, Martin-Latil Sandra, Manuguerra Jean-Claude, Haddad Nadia
Risk Assessment Department, ANSES, National Agency for Food Environmental and Occupational Health and Safety, Île-de-France, Maisons-Alfort, France.
Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France.
Microb Risk Anal. 2022 Dec;22:100237. doi: 10.1016/j.mran.2022.100237. Epub 2022 Oct 24.
Monkeypox (MPX) is a zoonotic infectious disease caused by (MPXV), an enveloped DNA virus belonging to the family and the genus. Since early May 2022, a growing number of human cases of Monkeypox have been reported in non-endemic countries, with no history of contact with animals imported from endemic and enzootic areas, or travel to an area where the virus usually circulated before May 2022. This qualitative risk assessment aimed to investigate the probability that MPXV transmission occurs through food during its handling and consumption. The risk assessment used "top-down" (based on epidemiological data) and "bottom-up" (following the agent through the food chain to assess the risk of foodborne transmission to human) approaches, which were combined. The "top-down" approach first concluded that bushmeat was the only food suspected as a source of contamination in recorded cases of MPXV, by contact or ingestion. The "bottom-up" approach then evaluated the chain of events required for a human to become ill after handling or consuming food. This approach involves several conditions: (i) the food must be contaminated with MPXV (naturally, by an infected handler or after contact with a contaminated surface); (ii) the food must contain viable virus when it reaches the handler or consumer; (iii) the person must be exposed to the virus and; (iv) the person must be infected after exposure. Throughout the risk assessment, some data gaps were identified and highlighted. The conclusions of the top-down and bottom-up approaches are consistent and suggest that the risk of transmission of MPXV through food is hypothetical and that such an occurrence was never reported. In case of contamination, cooking ( 12 min at 70°C) could be considered effective in inactivating in foods. Recommendations for risk management are proposed. To our knowledge, this is the first risk assessment performed on foodborne transmission of MPXV.
猴痘（MPX）是一种由猴痘病毒（MPXV）引起的人畜共患传染病，猴痘病毒是一种有包膜的DNA病毒，属于痘病毒科正痘病毒属。自2022年5月初以来，非流行国家报告了越来越多的人类猴痘病例，这些病例没有与从流行和动物疫区进口的动物接触史，也没有前往2022年5月之前该病毒通常传播的地区的旅行史。这项定性风险评估旨在调查猴痘病毒在食品处理和消费过程中通过食物传播的可能性。风险评估采用了“自上而下”（基于流行病学数据）和“自下而上”（沿着食物链追踪病原体以评估食源性传播给人类的风险）相结合的方法。“自上而下”的方法首先得出结论，在有记录的猴痘病毒病例中，丛林肉是唯一被怀疑通过接触或摄入而成为污染源的食物。然后，“自下而上”的方法评估了人类在处理或食用食物后患病所需的一系列事件。这种方法涉及几个条件：（i）食物必须被猴痘病毒污染（自然污染、被受感染的处理者污染或接触受污染表面后污染）；（ii）食物在到达处理者或消费者手中时必须含有活病毒；（iii）此人必须接触到病毒；（iv）此人在接触后必须被感染。在整个风险评估过程中，发现并突出了一些数据空白。“自上而下”和“自下而上”方法的结论是一致的，表明猴痘病毒通过食物传播的风险是假设性的，而且从未有过此类报告。如果发生污染，烹饪（70°C下12分钟）可被认为能有效灭活食物中的猴痘病毒。文中还提出了风险管理建议。据我们所知，这是首次对猴痘病毒的食源性传播进行的风险评估。
