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. 2022 Sep 17;19(18):11719.
doi: 10.3390/ijerph191811719.

Monkeypox Virus Infections in Southern Italy: Is There a Risk for Community Spread?

Daniela Loconsole  1 , Anna Sallustio  2 , Francesca Centrone  1 , Daniele Casulli  2 , Marisa Accogli  1 , Annalisa Saracino  3 , Caterina Foti  4 , Mauro Grandolfo  4 , Giovanni Battista Buccoliero  5 , Viviana Vitale  6 , Sara De Nitto  6 , Michele Conversano  7 , Francesco Desiante  7 , Laura Del Sambro  8 , Domenico Simone  8 , Antonio Parisi  8 , Rosa Prato  9 , Domenico Martinelli  9 , Maria Chironna  1
Affiliations

Monkeypox Virus Infections in Southern Italy: Is There a Risk for Community Spread?

Daniela Loconsole et al. Int J Environ Res Public Health. .

Abstract

The ongoing outbreak of the Monkeypox virus (MPXV) is characterized by sustained human-to-human transmission, particularly among men who have sex with men (MSM). The aim of the study was to describe the characteristics of the MPXV infection identified in Southern Italy. Clinical samples for each suspected case identified from 1 June to 1 August 2022 were tested for MPXV, and whole-genome sequencing (WGS) was performed on two strains. Ten cases were identified: eight were young adult males, including six MSMs, and two were female. Nine subjects reported recent sexual exposure. One female subject without sexual exposure only reported attendance at a social gathering. Overall, 7 of 10 skin lesion samples had a high viral load of MPXV DNA, and 6/9 whole blood samples and 6/8 nasopharyngeal swab samples also tested positive. The analyzed sequences belonged to Clade 3, lineage B.1, and B.1.5, respectively. Despite this recent multinational outbreak of MPXV cases having revealed a high proportion of cases occurring among MSM, the identification of cases among heterosexual subjects and in a female subject without sexual risk factors should raise awareness among clinicians about the possible spread of MPXV in the general population.

Keywords: epidemiology; monkeypox virus; southern Italy; surveillance; whole-genome sequencing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Phylogenetic tree of the DNA sequences of samples from patients 1 and 2 in the Apulia region of Italy (red dots), and the sequences of representative Monkeypox genomes downloaded from the GISAID website (https://gisaid.org/, accessed on 17 August 2022); (B) phylogenetic tree of the DNA sequences of samples from patient 1 (red dot) and other sequences of representative Monkeypox genomes belonging to the same lineage of B.1.5. Accession numbers, the country of origin, and years are indicated. Phylogenetic analysis was performed using the Nextstrain web app (https://nextstrain.org/, accessed on 17 August 2022).
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