Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy
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...
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| Veröffentlicht in: | Travel medicine and infectious disease Jg. 59; S. 102698 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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Netherlands
Elsevier Ltd
01.05.2024
Elsevier Limited Elsevier |
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| ISSN: | 1477-8939, 1873-0442, 1873-0442 |
| Online-Zugang: | Volltext |
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| Abstract | 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.
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.
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.
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.
•MPXV detection was more frequent from the skin lesions (289 of 306, 94·4%).•The median clearance time of MPXV DNA was 16 days in the skin, 14 days in the oropharynx.•Higher isolation rate was observed in semen, urine, anogenital, urethral and skin samples.•Higher isolation rate was observed in samples collected between 0 and 7 days (65/158, 41.1%) from the onset of symptoms.•Our 61 genomes are distributed in 37 local subclusters of the outbreak clade. |
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| AbstractList | BackgroundMpox 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 methodsThe 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.ResultsMPXV 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.ConclusionSkin 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. 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.BACKGROUNDMpox 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.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.MATERIAL AND METHODSThe 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.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.RESULTSMPXV 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.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.CONCLUSIONSkin 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. AbstractBackgroundMpox 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 methodsThe 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. ResultsMPXV 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. ConclusionSkin 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. 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. 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. 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. 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. •MPXV detection was more frequent from the skin lesions (289 of 306, 94·4%).•The median clearance time of MPXV DNA was 16 days in the skin, 14 days in the oropharynx.•Higher isolation rate was observed in semen, urine, anogenital, urethral and skin samples.•Higher isolation rate was observed in samples collected between 0 and 7 days (65/158, 41.1%) from the onset of symptoms.•Our 61 genomes are distributed in 37 local subclusters of the outbreak clade. 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. 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. 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. 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. 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. |
| ArticleNumber | 102698 |
| Author | Gaiarsa, Stefano Sammartino, Josè Camilla Pitrolo, Antonino Maria Guglielmo Baldanti, Fausto Percivalle, Elena Candela, Caterina Antinori, Spinello D'Arminio Monforte, Antonella Paolucci, Stefania Lombardi, Alessandra Raccagni, Angelo Giardina, Federica Casalini, Giacomo Ferrari, Guglielmo Micheli, Valeria Rizzardini, Giuliano Giacomelli, Andrea Bertoni, Costanza Maffeo, Manuel Bianchi, Micol Cassaniti, Irene Bandera, Alessandra Vecchio, Riccardo Cuomo, Marianna Piralla, Antonio Attanasi, Federica Bruzzesi, Elena Bracchitta, Fiorenza Gagliardi, Gloria Bonfanti, Paolo Cereda, Danilo Campanini, Giulia Salari, Federica Fenizia, Claudio Castagna, Antonella Tesoro, Daniele Mileto, Davide De Poli, Federica Bianca Mariani, Antonio Muscatello Ferrari, Alessandro Nozza, Silvia Pozza, Giacomo Iskandar, Elizabeth Rovida, Francesca Petazzoni, Greta Mancon, Alessandro Moschese, Davide Biasin, Mara Corsico, Laura Cutrera, Miriam Gismondo, Maria Rita Rossotti, Roberto Mule, Giovanni Tirani, Marcello Puoti, Massimo Castelli, Francesco Rizzo, Alberto Piccine |
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organization: Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy – sequence: 41 givenname: Irene surname: Cassaniti fullname: Cassaniti, Irene organization: Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy – sequence: 42 givenname: Raffaele surname: Bruno fullname: Bruno, Raffaele organization: Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy – sequence: 43 givenname: Giuliano surname: Rizzardini fullname: Rizzardini, Giuliano organization: I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy – sequence: 44 givenname: Massimo surname: Puoti fullname: Puoti, Massimo organization: Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy – sequence: 45 givenname: Francesco surname: Castelli fullname: Castelli, Francesco organization: Department of Clinical and Experimental Sciences, 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University of Milan, Milan, Italy – sequence: 56 givenname: Giovanni surname: Mule fullname: Mule, Giovanni organization: Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy – sequence: 57 givenname: Alessandra surname: Bandera fullname: Bandera, Alessandra organization: UOC Malattie Infettive, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy – sequence: 58 givenname: Antonio Muscatello surname: Bianca Mariani fullname: Bianca Mariani, Antonio Muscatello organization: UOC Malattie Infettive, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy – sequence: 59 givenname: Manuel surname: Maffeo fullname: Maffeo, Manuel organization: Lombardy Region, Milan, Italy – sequence: 60 givenname: Riccardo surname: Vecchio fullname: Vecchio, Riccardo organization: Lombardy Region, Milan, Italy – sequence: 61 givenname: Sara surname: Piccinelli fullname: Piccinelli, Sara organization: Lombardy Region, Milan, Italy |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38556220$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s40506_025_00289_2 crossref_primary_10_1016_j_electacta_2025_147241 crossref_primary_10_1016_j_scitotenv_2025_179706 crossref_primary_10_1021_acsmedchemlett_5c00075 crossref_primary_10_1038_s41598_024_63044_5 |
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| ContentType | Journal Article |
| Contributor | Campanini, Giulia Pitrolo, Antonino Maria Guglielmo Candela, Caterina Tesoro, Daniele De Poli, Federica Bianca Mariani, Antonio Muscatello Raccagni, Angelo Pozza, Giacomo Iskandar, Elizabeth Casalini, Giacomo Corsico, Laura Rizzardini, Giuliano Giacomelli, Andrea Bertoni, Costanza Maffeo, Manuel Cutrera, Miriam Cassaniti, Irene Bandera, Alessandra Mule, Giovanni Vecchio, Riccardo Puoti, Massimo Castelli, Francesco Cuomo, Marianna Piccinelli, Sara Bruzzesi, Elena Trentacapilli, Bendetta Bruno, Raffaele |
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| Copyright | 2024 The Authors Copyright © 2024. Published by Elsevier Ltd. Copyright Elsevier Limited May 2024 |
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| Keywords | Mpox virus Molecular epidemiology Multiple samples Re-Emerging virus Next generation sequencing |
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| Snippet | Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian... AbstractBackgroundMpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely... BackgroundMpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely... Background: Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely... |
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| Title | Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy |
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