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. 2023 Oct 2;14(1):5998.
doi: 10.1038/s41467-023-40490-9.

Self-sampling monkeypox virus testing in high-risk populations, asymptomatic or with unrecognized Mpox, in Spain

Cristina Agustí  1   2   3 , Héctor Martínez-Riveros  4   5   6 , Àgueda Hernández-Rodríguez  7   8 , Cristina Casañ  7 , Yesika Díaz  4 , Lucía Alonso  4   9 , Elisa Martró  10   5   7   8 , Jordana Muñoz-Basagoiti #  11 , Marçal Gallemí #  11 , Cinta Folch  4   10   5 , Ibrahim Sönmez  4   5 , Héctor Adell  12 , Marta Villar  12 , Alexia París de León  7 , Sandra Martinez-Puchol  5   7   13 , A C Pelegrin  5   7 , Daniel Perez-Zsolt  11 , Dàlia Raïch-Regué  11 , Rubén Mora  12 , Luis Villegas  12 , Bonaventura Clotet  5   9   11   14   15 , Nuria Izquierdo-Useros  5   11   15 , Pere-Joan Cardona  7   8   16 , Jordi Casabona  4   10   5   8
Affiliations

Self-sampling monkeypox virus testing in high-risk populations, asymptomatic or with unrecognized Mpox, in Spain

Cristina Agustí et al. Nat Commun. .

Abstract

The recent monkeypox virus (MPXV) outbreak was of global concern and has mainly affected gay, bisexual and other men who have sex with men (GBMSM). Here we assess prevalence of MPXV in high-risk populations of GBMSM, trans women (TW) and non-binary people without symptoms or with unrecognized monkeypox (Mpox) symptoms, using a self-sampling strategy. Anal and pharyngeal swabs are tested by MPXV real-time PCR and positive samples are tested for cytopathic effect (CPE) in cell culture. 113 individuals participated in the study, 89 (78.76%) were cis men, 17 (15.04%) were TW. The median age was 35.0 years (IQR: 30.0-43.0), 96 (85.02%) individuals were gay or bisexual and 72 (63.72%) were migrants. Seven participants were MPXV positive (6.19% (95% CI: 1.75%-10.64%)). Five tested positive in pharyngeal swabs, one in anal swab and one in both. Six did not present symptoms recognized as MPXV infection. Three samples were positive for CPE, and showed anti-vaccinia pAb staining by FACS and confocal microscopy. This suggests that unrecognized Mpox cases can shed infectious virus. Restricting testing to individuals reporting Mpox symptoms may not be sufficient to contain outbreaks.

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Conflict of interest statement

The authors declare no competing interests. Hoffmann-La Roche Laboratories provided the PCR kits used in the study. The funding body had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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