Background: Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian region accounting for more than 40% of Italian cases. The present study aims to: i) evaluate the presence and the shedding duration of MPXV DNA in different body compartments correlating the MPXV viability with the time to onset of symptoms; ii) provide evidence of MPXV persistence in different body compartment as a source of infection and iii) characterize the MPXV evolution by whole genome sequencing (WGS) during the outbreak occurred in Italy. Material and methods: The study included 353 patients with a laboratory-confirmed diagnosis of MPXV infection screened in several clinical specimens in the period May 24th - September 1st, 2022. Viral isolation was attempted from different biological matrices and complete genome sequencing was performed for 61 MPXV strains. Results: MPXV DNA detection was more frequent in the skin (94.4%) with the longest median time of viral clearance (16 days). The actively-replicating virus in cell culture was obtained for 123/377 (32.6%) samples with a significant higher viral quantity on isolation positive samples (20 vs 31, p < 0.001). The phylogenetic analysis highlighted the high genetic identity of the MPXV strains collected, both globally and within the Lombardy region. Conclusion: Skin lesion is gold standard material and the high viral load and the actively-replicating virus observed in genital sites confirms that sexual contact plays a key role in the viral transmission.
Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy / Piralla, A.; Mileto, D.; Rizzo, A.; Ferrari, G.; Giardina, F.; Gaiarsa, S.; Petazzoni, G.; Bianchi, M.; Salari, F.; Bracchitta, F.; Sammartino, J. C.; Ferrari, A.; Gagliardi, G.; Mancon, A.; Fenizia, C.; Biasin, M.; Rovida, F.; Paolucci, S.; Percivalle, E.; Lombardi, A.; Micheli, V.; Nozza, S.; Castagna, A.; Moschese, D.; Antinori, S.; Gori, A.; Bonfanti, P.; Rossotti, R.; D'Arminio Monforte, A.; Attanasi, F.; Tirani, M.; Cereda, D.; Baldanti, F.; Gismondo, M. R.; Cutrera, M.; Cuomo, M.; De Poli, F.; Campanini, G.; Pitrolo, A. M. G.; Iskandar, E.; Cassaniti, I.; Bruno, R.; Rizzardini, G.; Puoti, M.; Castelli, F.; Corsico, L.; Giacomelli, A.; Pozza, G.; Casalini, G.; Raccagni, A.; Trentacapilli, B.; Bertoni, C.; Bruzzesi, E.; Candela, C.; Tesoro, D.; Mule, G.; Bandera, A.; Bianca Mariani, A. M.; Maffeo, M.; Vecchio, R.; Piccinelli, S.. - In: TRAVEL MEDICINE AND INFECTIOUS DISEASE. - ISSN 1477-8939. - 59:(2024). [10.1016/j.tmaid.2024.102698]
Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy
Bianchi M.;Ferrari A.;Nozza S.;Castagna A.;Tirani M.;Pozza G.;Raccagni A.;Trentacapilli B.;Bertoni C.;Bruzzesi E.;Candela C.;
2024-01-01
Abstract
Background: Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian region accounting for more than 40% of Italian cases. The present study aims to: i) evaluate the presence and the shedding duration of MPXV DNA in different body compartments correlating the MPXV viability with the time to onset of symptoms; ii) provide evidence of MPXV persistence in different body compartment as a source of infection and iii) characterize the MPXV evolution by whole genome sequencing (WGS) during the outbreak occurred in Italy. Material and methods: The study included 353 patients with a laboratory-confirmed diagnosis of MPXV infection screened in several clinical specimens in the period May 24th - September 1st, 2022. Viral isolation was attempted from different biological matrices and complete genome sequencing was performed for 61 MPXV strains. Results: MPXV DNA detection was more frequent in the skin (94.4%) with the longest median time of viral clearance (16 days). The actively-replicating virus in cell culture was obtained for 123/377 (32.6%) samples with a significant higher viral quantity on isolation positive samples (20 vs 31, p < 0.001). The phylogenetic analysis highlighted the high genetic identity of the MPXV strains collected, both globally and within the Lombardy region. Conclusion: Skin lesion is gold standard material and the high viral load and the actively-replicating virus observed in genital sites confirms that sexual contact plays a key role in the viral transmission.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
