MPXV DNA kinetics in bloodstream and other body fluids samples

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• The global epidemiology of monkeypox virus (MPXV) shifted significantly in spring 2022 with an unprecedented rise in human clade II cases.
• This increase raised global concerns regarding the emerging zoonotic disease and its transmission dynamics.

Purpose of the Study:

• To analyze positivity rates, viral loads, infectiousness, and MPXV DNA persistence in various biological samples from confirmed MPXV cases.
• To identify key biological samples for MPXV diagnosis, monitoring viral shedding, and understanding transmission routes.

Main Methods:

• Analysis of positivity rates, viral loads, and MPXV DNA persistence up to 4 months in biological samples from 89 MPXV-confirmed patients.
• Viral culture from respiratory samples, semen, and stools.
• Comparison of MPXV DNA detection rates and viral loads in plasma, serum, and whole-blood samples.

Main Results:

• Higher viral loads and positivity rates were observed in all sample types during the first two weeks of symptoms.
• Respiratory specimens exhibited higher MPXV DNA levels and longer viral clearance times compared to other non-skin samples.
• Infectious MPXV was cultured from respiratory samples, semen, and stools collected within the first 10 days of symptoms.
• Blood plasma demonstrated the highest MPXV DNA detection rate and viral loads during a 3-week follow-up compared to serum and whole-blood.

Conclusions:

• Respiratory specimens are valuable for MPXV diagnosis, investigating asymptomatic cases, and monitoring viral shedding.
• Blood plasma is a sensitive sample type for MPXV detection.
• Understanding MPXV DNA persistence and infectiousness in various samples is crucial for diagnostics and mitigating transmission.