Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022

Abstract

Since May 2022, an outbreak of monkeypox has been ongoing in non-endemic countries. We report four cases in Italy in young adult men reporting condomless sexual intercourse. The patients are in good clinical condition with no need for specific antiviral drugs. Biological samples from seminal fluid were positive for monkeypox viral DNA. For many other viruses found in semen there is no evidence of sexual transmission. The possibility of sexual transmission of monkeypox virus needs to be investigated. Human monkeypox virus (MPXV) is a double-stranded DNA virus of the Orthopoxvirus genus of the Poxviridae family. Two genetic MPXV clades have been characterised: West African and Central African. Outside of Africa, the first cases of monkeypox were reported in 2003 in the United States (US) [1] when an outbreak occurred following the importation of rodents from Africa. Over the past five decades, monkeypox outbreaks have been reported in 10 African countries and four countries outside of Africa [2]. To date, in the ongoing outbreak in 2022, 118 cases of monkeypox have been reported in non-endemic countries [3]. We report four monkeypox cases observed in Italy between 17 and 22 May 2022.