Asymptomatic infection can be a cause of concern in Monkeypox infection, reveals study

by Medically Speaking August 16, 2022

Monkeypox virus has been found in anal samples from asymptomatic males who have intercourse with men, presenting another another concern about the current viral outbreak: the likelihood of silent infection. The most recent epidemic of the monkeypox virus, which started in May, mostly impacted guys who had intercourse with other men. A recent publication in Annals of Internal Medicine showed three asymptomatic individuals with no cutaneous manifestations but positive findings, despite the fact that most infections are characterised by cutaneous lesions.

The report suggests that vaccination limited to those with known exposure to the monkeypox virus may not be an effective strategy for preventing infection.

“Whether or not asymptomatic infection will play a role in transmission of monkeypox virus is not known. But the current worldwide monkeypox epidemic and the mode of human-to-human transmission may provide evidence that asymptomatic or preclinical spread can occur,” said the researchers from Bichat-Claude Bernard Hospital in France.

“If so, the practice of ring postexposure vaccination around symptomatic persons with probable or confirmed monkeypox virus infection may not be sufficient to contain spread,” the team added.

All anorectal swabs that were obtained as part of a programme to screen for sexually transmitted infections were retroactively tested for monkeypox virus.

This sort of screening is carried out every three months among males who have sex with numerous partner men who are either taking HIV preexposure prophylaxis (PrEP) or who are HIV positive and undergoing antiretroviral therapy. This is in accordance with French standards.

13 (6.5%) samples from the 200 asymptomatic people who underwent screening but tested negative for the sexually transmitted infections N. gonorrhoeae and C. trachomatis had monkeypox virus in their PCR results. Monkeypox symptoms later appeared in two of the 13 people.

The researchers suggest that the role of an expanded ring vaccination strategy and other public health interventions in the communities at highest risk is likely needed to help control the outbreak.