Rossotti Roberto, Calzavara Daniele, Cernuschi Massimo, D'Amico Federico, De Bona Anna, Repossi Roberto, Moschese Davide, Bossolasco Simona, Tavelli Alessandro, Muccini Camilla, Mulé Giovanni, d'Arminio Monforte Antonella
Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
Milano Checkpoint, 20124 Milan, Italy.
Pathogens. 2023 Jun 3;12(6):798. doi: 10.3390/pathogens12060798.
Mpox is traditionally considered a zoonotic disease with endemic circulation in Africa, but the 2022-2023 outbreak reached an unprecedented high number of cases in non-endemic countries, so that it was declared a public health emergency of international concern. The reasons for this extensive global spread, characterized by sexual transmission amongst men who have sex with men (MSM), have not been fully clarified. The existence of asymptomatic carriers with viable viral shedding might be an explanation and is under-debated after retrospective studies suggested that infection without symptoms might have a prevalence of 6.5%. We aimed to prospectively assess the presence of mpox infection in asymptomatic high-risk MSM using HIV pre-exposure prophylaxis and living with HIV. We selected individuals with no signs of active infection nor suggestive symptoms in the previous 21 days. Eligible individuals collected oral and anal swabs to undergo point-of-care testing for mpox and completed a 21-days follow-up. Seventy-two individuals were enrolled, and none tested positive for mpox infection nor developed symptoms during follow-up. We selected a high-risk population with a significant history of sexual exposure, but we failed to detect any asymptomatic infection. This observation might have important consequences in terms of contact management and epidemic control.
猴痘传统上被认为是一种在非洲地方流行传播的人畜共患病，但2022 - 2023年的疫情在非流行国家达到了前所未有的高病例数，因此它被宣布为国际关注的突发公共卫生事件。这种以男男性行为者（MSM）之间性传播为特征的广泛全球传播的原因尚未完全阐明。无症状携带者存在有活力的病毒脱落可能是一种解释，并且在回顾性研究表明无症状感染患病率可能为6.5%之后，这一点正在进行充分讨论。我们旨在前瞻性评估使用HIV暴露前预防药物并感染HIV的无症状高危男男性行为者中猴痘感染的情况。我们选择了在过去21天内没有活动性感染迹象或提示性症状的个体。符合条件的个体采集口腔和肛门拭子进行猴痘即时检测，并完成了21天的随访。72人被纳入研究，在随访期间没有人猴痘感染检测呈阳性，也没有人出现症状。我们选择了有大量性接触史的高危人群，但我们未能检测到任何无症状感染。这一观察结果在接触者管理和疫情控制方面可能具有重要意义。
