Monkeypox is the most recent zoonotic disease to spread around the world. Over the past six months, there have been more than 9,000 reported cases of monkeypox globally.
The study authors mentioned the primary cases in the United Kingdom, Portugal and Spain have been for the most part discovered among men who have sex with other men.
Up to now, the virus spreads mainly through direct contact with lesions on an infected patient's skin. Contact with surfaces contaminated by these lesions can also transmit the virus. It's still not clear whether monkeypox can be transmitted from person to person through bodily fluids like blood and semen. (Related: WHO investigating reports of monkeypox virus in semen)
The latest study investigated several biological samples from 12 patients with a verified case of monkeypox. At the period of their diagnosis, doctors discovered high viral DNA loads in the skin lesions of each patient.
Researchers found that all 12 patients also had virus DNA in their saliva, with many having very high viral loads. Prior to this, only one study has discovered the virus in a single monkeypox patient's saliva. They also discovered virus DNA in rectal (11 of 12 patients), nasal (10 of 12 patients), semen (seven of nine patients) and fecal (eight of 12 patients) samples from the monkeypox group.
"A couple of previous studies had already shown the occasional presence of viral DNA in some samples and in some patients, but here we show that viral DNA is frequently present in various biological fluids, particularly saliva, during the acute phase of the disease, and up to 16 days after the onset of symptoms in one patient," said the study's lead researcher Aida Peiró of the Barcelona Institute for Global Health (ISGlobal).
In the next phase of their examination, researchers are planning to isolate infectious virus particles from the samples. They said higher viral loads in both saliva and semen indicate that they are infectious. This is in line with earlier reports that warn against kissing and having sex with monkeypox patients.
"The results of our study contribute to a better understanding of the mechanisms and dynamics of virus transmission, as well as the possible role of sexual transmission," team leader Mikel Martínez said.
Meanwhile, the Centers for Disease Control and Prevention (CDC) recently reported that there are now 2,323 lab-confirmed cases of monkeypox in the United States.
The virus has spread to 69 nations worldwide, including 63 that rarely or never had cases of monkeypox. As of Monday, July 18, more than 13,300 cases had been verified.
The virus, which is highly infectious and produces painful, itchy lesions, with sometimes-deadly complications, has now been identified in all but seven states. As of Monday, only Alaska, Maine, Mississippi, Montana, North Dakota, Vermont and Wyoming have zero confirmed cases.
A small number of states have each reported a single case, while New York has more than 520 cases. According to reports, Washington, D.C. has the most cases per capita, "prompting public health officials to launch an aggressive vaccination campaign aimed at blanketing the most at-risk communities."
"I do think it’s important to say that U.S. surveillance numbers likely undercount cases," CDC deputy director of the Division of High Consequence Pathogens and Pathology Jennifer McQuiston stated during an interview with the American Medical Association's "Moving Medicine" series.
She added that undercounts happen because "detection really depends on a lot of factors, including patients presenting for care, clinicians thinking about monkeypox when they're seeing patients and then requesting and having access to diagnostic tests."
McQuiston and other public health experts said cases are increasing daily in America.
"Our outbreak curve is in a period of acceleration," said McQuiston, who mentioned the same pattern is seen in the U.K., Spain and Portugal.
McQuiston further said the latest cases displayed day-to-day indicated the community spread and the CDC expects the numbers will continue to increase.
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