Study finds monkeypox virus in anal samples from asymptomatic people

A study conducted at Bichat-Claude Bernard Hospital in Paris (France) detected the monkeypox virus in anal samples from asymptomatic men who have sex with men (MSM).

These results suggest that vaccination limited to people with known exposure to monkeypox virus may not be enough to prevent infection, according to the study published in the Annals of Internal Medicine.

The researchers retrospectively performed PCR tests for monkeypox virus on all anorectal swabs that were collected as part of a screening program for sexually transmitted infections.

According to French recommendations, this type of screening is carried out every 3 months in multipartner MSM taking HIV pre-exposure prophylaxis (PrEP) or living with HIV and on antiretroviral treatment.

Of the 200 asymptomatic people tested who were negative for ‘N. gonorrhoeae’ and ‘C. trachomatis’, 13 samples (6.5%) were PCR positive for monkeypox virus. Two of the 13 people subsequently developed symptoms of monkeypox.

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It is not known whether asymptomatic infection plays a role in the transmission of monkeypox virus. But the current global outbreak of monkeypox and the person-to-person mode of transmission may provide evidence that asymptomatic or preclinical spread may be occurring.

The researchers suggest that “an expanded strategy of ring vaccination and other public health interventions in communities most at risk will likely be needed to help control the outbreak.”

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