Asymptomatic Monkeypox Virus Infections Among Male Sexual Health Clinic Attendees in Belgium

Baetselier, Irith De; Dijck, Christophe Van; Kenyon, Chris; Coppens, Jasmine; Bossche, Dorien Van den; Smet, Hilde; Vanroye, Fien; Liesenborghs, Laurens; Ramadan, Kadrie; Platteau, Tom; Looveren, K. Van; Baeyens, Jolien; Hoyweghen, Cindy Van; Mangelschots, Marjan; Coppens, Sandra; Heyndríckx, Leo; Míchiels, Johan; Block, Tessa de; Manoharan-Basil, Sheeba Santhini; Brosius, Isabel; Ariën, Kevin K.; Griensven, Johan van; Laga, Marie; Vanhamel, Jef; Vuylsteke, Béa; Bottieau, Emmanuel; Soentjens, Patrick; Florence, Éric; Vercauteren, Koen; Esbroeck, Marjan Van

doi:10.2139/ssrn.4142074

Cited by 11 publications

(12 citation statements)

References 13 publications

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“…Since recognition of the global outbreak, there has been a rapid scale-up of public health response, including substantial increases in testing and efforts to educate clinicians and the public to mitigate spread 5 . However, surveillance is dependent on practical access to and utilization of testing, limited by awareness of a disease that is novel to the general public and most clinicians, stigma of a disease that has to date primarily been diagnosed in gay, bisexual, and other men who have sex with men, and the potential for asymptomatic cases 6,7 . Alternative public health surveillance approaches independent of individual testing, such as wastewater surveillance, provide an attractive means to detect and track emerging monkeypox transmission and provide situational awareness for public health agencies and clinicians.…”

Section: Introductionmentioning

confidence: 99%

Wastewater Surveillance for Monkeypox Virus in Nine California Communities

Wolfe

Duong

et al. 2022

Preprint

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Background: Wastewater represents a composite biological sample from the entire contributing population. People infected with monkeypox virus (MPXV) may excrete viral DNA into wastewater via multiple ways such as in feces, urine, skin lesions, and/or saliva. We describe results from rapid establishment of wastewater surveillance in selected regions in California within a month of the first reported case of monkeypox in the United States. Methods: PCR assays targeting genomic DNA from MPXV were deployed in an ongoing wastewater surveillance program in California. MPXV DNA concentrations were measured daily in settled solids samples from nine wastewater plants. Results over a four-week period were validated across different MPXV assays, compared using influent and solids samples, and correlated using non-parametric methods (Kendall's tau) with the number of monkeypox cases reported from each sewershed. Results: MPXV DNA was detected at all nine sites between June 19 and August 1, 2022; 5 of 9 sites detected MPXV DNA prior to or within a day of the first case identified in the source sewershed. At the four sites with >10 positive detections, we observed a positive, statistically significant correlation (p <0.001) between MPXV DNA in wastewater solids and incidence rate of reported cases. Conclusions: Our findings suggest wastewater can be used to effectively detect the introduction of MPXV and monitor its circulation in the community to inform public health and clinical response. This flexible wastewater surveillance infrastructure may be rapidly leveraged to monitor other pathogens of public health importance that are shed into wastewater.

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Section: Introductionmentioning

confidence: 99%

Wastewater Surveillance for Monkeypox Virus in Nine California Communities

Wolfe

Duong

et al. 2022

Preprint

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“…One report from Belgium identified asymptomatic cases via rectal testing (12). Additionally, a pre-print report from the Democratic Republic of the Congo reported detection of Human Monkeypox DNA from a throat swab of individuals with prodromal symptoms (13).…”

Section: Discussionmentioning

confidence: 99%

Laboratory Validation and Clinical Implementation of Human Monkeypox Saliva-Based Tests

Allan‐Blitz

Carragher

Sukhija-Cohen

et al. 2022

Preprint

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Background: Improved diagnostic capabilities and accessibility are essential for controlling the outbreak of Human Monkeypox. Methods We developed a saliva-based polymerase chain reaction (PCR) for Human Monkeypox, evaluated in vitro test performance, as well as report on clinical implementation of that assay at three testing sites in Los Angeles. Finally, using pre-specified search terms, we conducted a systematic rapid review of PubMed and Web of Science online databases of studies reporting the performance of saliva-based tests for Human Monkeypox. Results Laboratory evaluation of the assay showed in silico inclusivity of 100% for all (n=97) strains of Human Monkeypox, with an analytic sensitivity of 250 copies/mL, as well as 100% agreement compared to known positive and negative specimens. Clinical testing identified 15 cases of Human Monkeypox among 114 individuals screened (13.2%). Of those, 11 (73.3%) reported symptoms, two of whom had not developed a rash. Our systematic rapid review identified 6 studies; 23 patients had tests performed on oropharyngeal specimens 100% of which were in agreement with the PCR test of a lesion swab. Conclusion: Saliva-based PCR tests are potential tools for outbreak control, and further evaluation of the performance of such tests is warranted.

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“…MPXV infection leads to a wide spectrum of clinical presentation and disease severity, including pauci- or asymptomatic infection as reported within the 2022 outbreak 10 . The majority of the clinical characteristics of human MPXV infection mirror those of smallpox, although with a milder mortality rate varying from 10 % for clade 1 (former Congo Basin clade), to 3.6 % for clades 2 and 3.…”

Section: Main Textmentioning

confidence: 99%

Tecovirimat is highly efficient on the Monkeypox virus lineage responsible for the international 2022 outbreak

Frenois-Veyrat

Gallardo²,

Gorgé³

et al. 2022

Preprint

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The ongoing monkeypox virus (MPXV) outbreak is the largest ever recorded outside of Africa. Genomic analysis revealed a divergent phylogenetic lineage within clade 3, and atypical clinical presentations have been noted. We report the sequencing and isolation of the virus from the first clinical case diagnosed in France in May 2022. We tested the in vitro effect of tecovirimat (ST-246), a FDA approved drug, against this novel strain, showing efficacy at the nanomolar range. In comparison, cidofovir showed activity at micromolar concentrations. These results and the safety profile of tecovirimat strongly support its use in clinical care of severe forms for the 2022 MPXV outbreak.

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Asymptomatic Monkeypox Virus Infections Among Male Sexual Health Clinic Attendees in Belgium

Cited by 11 publications

References 13 publications

Wastewater Surveillance for Monkeypox Virus in Nine California Communities

Wastewater Surveillance for Monkeypox Virus in Nine California Communities

Laboratory Validation and Clinical Implementation of Human Monkeypox Saliva-Based Tests

Tecovirimat is highly efficient on the Monkeypox virus lineage responsible for the international 2022 outbreak

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