Monkeypox virus DNA found in the semen of five men, WHO further investigated

At first glance, these two sets of case reports may suggest that monkeypox may be a sexually transmitted disease (STI).After all, case reports Published in the journal on June 2nd Euro surveillance When It is mentioned in the preprint posted on June 6th. Research Square He explained how monkeypox virus DNA was found in the semen of five different patients. However, calling monkeypox STI based solely on these original reports would be a premature declaration. So far, there is not enough evidence to keep in mind what is known about monkeypox and call it a sexually transmitted disease. However, the World Health Organization (WHO) is further investigating these case reports.

Prior to this current outbreak of monkeypox, which has affected at least 1,285 people in 28 countries so far, According to WHOThere was no convincing evidence that monkeypox could be specifically transmitted to sexually transmitted diseases. As I explained Forbes last monthThe main suspected transmission mode was close contact and handling with contaminated objects. However, as rumors spread that sex rave in Europe could have served as a super-spreading event for this outbreak, people began to scrutinize their genitals.

Speaking of genitals, June 2 sunrise edition Euro surveillance He explained in detail what happened to four men in their thirties who were infected with the monkeypox virus in Italy and developed lesions in the genital and anal areas. Prior to the recent encounter with the monkeypox virus, all four had encounters with other pathogens known to cause STI. Three of them had syphilis. Three had viral hepatitis. Two were HIV positive and were receiving antiretroviral therapy, and the other two were receiving antiretrovirus pre-exposure prophylaxis (PreP) while being HIV negative.

In the first half of May 2022, all four men had condomless sexual intercourse with various male partners during their trip. Three of the men traveled to a mass rally event on Gran Canaria (GCI) and one traveled for sex work. After that, all four ended the onset of monkeypox and lesions appeared in the genital and / or anal regions. Testing of genital or rectal lesions in all four patients revealed the presence of monkeypox virus DNA, which was not surprising. The same was true for testing the nasopharyngeal swabs of two patients, the blood of one patient, and the saliva of one patient. Fecal samples from two different patients revealing the presence of monkeypox virus DNA also had some eerie positives. Oh, but this is the discovery that keeps WHO and others in the ball, so to speak: PCR tests found monkeypox virus DNA in semen samples from 3 out of 4 patients.

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Preprint uploaded to Research Square He explained the same findings as the two German men. One is a 26-year-old male sex worker who was previously HIV positive and had already received antiretroviral therapy. After having sexual intercourse with another man on May 9, the man appeared at a sexually transmitted disease (STD) outpatient clinic in Munich, Germany, complaining of four days of fever, malaise, mild joint pain, and muscle pain. I did. , And his back pain, headache, difficulty swallowing, and white spots on his tongue. Two days later, several papular skin lesions appeared on his trunk, limbs, and head.

The second man, 32, had unprotected sexual intercourse with another man in early May. On May 19, he visited his doctor complaining of fever, fatigue and coughing. Two days later he had a groin problem. The lymph nodes in his groin were getting bigger. He also suffered from anal pain and multiple skin lesions (vesicles) throughout the trunk of his body. In other words, he had some junk in his trunk.

Both men will be transferred to the isolation ward of the Munich Clinic Schwabing. So they tested different body parts and fluids for the presence of monkeypox DNA. Doctors have found such DNA in both oral lesions and blood in patients. And like the three Italian patients, these two also had monkeypox virus DNA in their semen.

Before elaborating on these findings, there are a few things to keep in mind. First of all, the report from Germany is still a preprint, not a peer-reviewed publication. If you can upload a video of a cat planning to hijack your home on the internet, you can also upload a preprint. So take whatever the preprint says with a salt funny pack.

Second, these case reports consist of only a handful of semen cases. It’s a handful in that it’s a relatively small number. It is not clear what percentage of the more than 1285 monkeypox cases in this outbreak had monkeypox virus DNA in their semen. That would require a larger semen study.

Third, finding monkeypox virus DNA in semen is not the same as finding all of Chris Hemsworth there, just as finding the Chris Hemsworth bicep muscle in the semen. Not the same as finding a live monkeypox virus inside. If there is enough virus in the blood, some virus fragments can reach different parts of the body, such as the testicles, so to speak, those derived from the testicles. Moreover, even if some live viruses infect semen, they may not be at a sufficient level to infect other viruses.

Before saying, “But what about sex rave,” keep in mind that just because you get a virus during sex doesn’t mean it’s a sexually transmitted disease. Perhaps during sex, your whole body will be in close physical contact with another person’s whole body at some point. No matter how blessed you claim, it will be difficult to have sex with someone in the room while your head, torso, and limbs remain in another room. To qualify as an STI, the viruses need to go through sexual activity, not just close to each other.

Nonetheless, all of this deserves further investigation and further research, as the monkeypox virus probably increases the likelihood of sexually transmitted infections. Human monkeypox infections are relatively rare from the first case reported in 1971 until the beginning of the year, and are sufficient to understand how the virus behaves under different circumstances or changes over time. It is possible that there were not enough cases over the years to know.

The authors of Preprint show that laboratory studies in mice indicate that vaccinia virus, a virus similar to monkeypox virus, may have some affinity for testicular and ovarian tissue. I paid attention to it. Of course, there is probably a difference between your genitals and the mouse genitals. Moreover, having sex is not the same as experimenting with mice in the laboratory. Beakers, test tubes and cages are usually not part of the gender. Well, at least beakers and test tubes aren’t. So, again, there is not enough evidence to call monkeypox STI. WHO may further investigate the reasons, content, and methods of these case reports.

In the meantime, all of this should not change the monkeypox precautions. “OK, monkeypox is not officially a sexually transmitted disease, so it should be okay to have sex with that person covered with pus-filled lesions.” On the contrary, one should not somehow believe that the virus can be transmitted from person to person only when having sex. For example, unless your intention is sexual, don’t assume that it’s okay to touch someone else’s mysterious fluid-filled lesion directly.