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 / A. Piralla, D. Mileto, A. Rizzo, G. Ferrari, F. Giardina, S. Gaiarsa, G. Petazzoni, M. Bianchi, F. Salari, F. Bracchitta, J.C. Sammartino, A. Ferrari, G. Gagliardi, A. Mancon, C. Fenizia, M. Biasin, F. Rovida, S. Paolucci, E. Percivalle, A. Lombardi, V. Micheli, S. Nozza, A. Castagna, D. Moschese, S. Antinori, A. Gori, P. Bonfanti, R. Rossotti, A. D'Arminio Monforte, F. Attanasi, M. Tirani, D. Cereda, F. Baldanti, M.R. Gismondo. - In: TRAVEL MEDICINE AND INFECTIOUS DISEASES. - ISSN 1873-0442. - 59:(2024 Mar 29), pp. 102698.1-102698.10. [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

D. Mileto
Secondo
;
M. Bianchi;F. Salari;F. Bracchitta;G. Gagliardi;C. Fenizia;M. Biasin;V. Micheli;S. Antinori;A. Gori;A. D'Arminio Monforte;M.R. Gismondo
2024

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.
Molecular epidemiology; Mpox virus; Multiple samples; Next generation sequencing; Re-Emerging virus
Settore MED/17 - Malattie Infettive
   One Health Basic and Translational Research Actions addressing Unmet Need on Emerging Infectious Diseases (INF-ACT)
   INF-ACT
   MINISTERO DELL'UNIVERSITA' E DELLA RICERCA
   PE00000007
29-mar-2024
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1049192
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