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HEALTH

Italian monkeypox cases rise to ten

Monkeypox infections have now been confirmed in four Italian regions, Italian health authorities said on Thursday.

Italian monkeypox cases rise to ten
Rome's Lazzaro Spallanzani National Institute for Infectious Diseases, where most of Italy's monkeypox cases are being treated. Photo by Andreas SOLARO / AFP

The total number of Italian monkeypox cases rose to ten on Thursday with the discovery of the first case in the Emilia-Romagna region.

There have now been five cases detected the Lazio region, which are being treated in Rome, plus three in Lombardy, and one each in Tuscany and Emilia-Romagna.

READ ALSO: How is Italy dealing with rising monkeypox cases?

“There is no alarm, but the infection surveillance system is at a state of maximum attention,” Lazio’s regional health councillor Alessio D’Amato told the Ansa news agency after the seventh case was reported on Wednesday.

Researchers at Rome’s Spallanzani hospital for infectious diseases said the new cases are thought to be “part of a pan-European cluster” linked to cases in the Canary Islands, Ansa reported.

The first Italian case of monkey smallpox, or monkeypox, was also found in a man who had recently returned from the Canary Islands, doctors said last Thursday.

On Thursday morning the Italian health ministry published guidance on dealing with outbreaks of monkeypox as case numbers continued to rise across Europe.

More than 250 monkeypox cases have now been reported in at least 16 countries where the virus isn’t endemic, according to the World Health Organization.

They are mostly in Spain, the UK and Portugal, with single-digit cases in Austria, Belgium, France, Germany, Denmark, the Netherlands, Sweden, and Switzerland, as well as Italy.

READ ALSO: What is Spain doing to deal with rising monkeypox cases?

The illness has infected thousands of people in parts of Central and Western Africa in recent years, but is rare in Europe and North Africa.

Monkeypox is known to spread via close contact with an animal or human with the virus. It can be transmitted via bodily fluids, lesions, respiratory droplets or through contaminated materials, such as bedding.

Its symptoms are similar but somewhat milder than those of smallpox: fever, headache, muscle aches, back pain, chills, exhaustion, although it also causes the lymph nodes to swell up.

Within one to three days, the patient develops a rash, often beginning on the face then spreading to other parts of the body. 

Although most monkeypox cases aren’t serious, studies have shown that one in ten people who contract the disease in Africa die from it.

The unprecedented outbreak of the monkeypox virus has put the international community on alert.

On Monday, the European Union urged member states to take steps to ensure positive cases, close contacts, and even pets be quarantined as this is a zoonotic virus (a virus that spreads from animals to humans).

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MONKEYPOX

Semen ‘a vehicle’ for monkeypox infection, say Italian health experts

Researchers in Italy who were first to identify the presence of monkeypox in semen are broadening their testing, saying early results suggest sperm can transmit infection.

Semen 'a vehicle' for monkeypox infection, say Italian health experts

A team at Rome’s Spallanzani Hospital, which specialises in infectious diseases, revealed in a study published on June 2nd that the virus DNA was detected in semen of three out of four men diagnosed with monkeypox.

They have since expanded their work, according to director Francesco Vaia, who said researchers have found the presence of monkeypox in the sperm of 14 infected men out of 16 studied.

READ ALSO: EXPLAINED: How is Italy dealing with rising monkeypox cases?

“This finding tells us that the presence of the virus in sperm is not a rare or random occurrence,” Vaia told AFP in an interview.

He added: “The infection can be transmitted during sexual intercourse by direct contact with skin lesions, but our study shows that semen can also be a vehicle for infection.”

Researchers at Spallanzani identified Italy’s first cases of monkeypox, found in two men who had recently returned from the Canary Islands.

The latest results reported by Vaia have not yet been published or subject to peer review.

Since early May, a surge of monkeypox cases has been detected outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in Western Europe.

More than 3,400 confirmed cases and one death have now been reported to the World Health Organisation from more than 50 countries this year.

The vast majority of cases so far have been observed in men who have sex with men, of young age, chiefly in urban areas, in “clustered social and sexual networks”, according to the WHO.

It is investigating cases of semen testing positive for monkeypox, but has maintained the virus is primarily spread through close contact.

Meg Doherty, director of the WHO’s global HIV, hepatitis and sexually-transmitted infection programmes, said last week: “We are not calling this a sexually-transmitted infection.”

Could antivirals curb the spread of monkeypox?

Spallanzani researchers are now trying to ascertain how long the virus is present in sperm after the onset of symptoms.

In one patient, virus DNA was detected three weeks after symptoms first appeared, even after lesions had disappeared – a phenomenon Vaia said had been seen in the past in viral infections such as Zika.

That could indicate that the risk of transmission of monkeypox could be lowered by the use of condoms in the weeks after recovery, he said.

The Spallanzani team is also looking at vaginal secretions to study the presence of the virus.

A significant finding from the first study was that when the virus was cultured in the lab, it was “present in semen as a live, infectious virus efficient in reproducing itself”, Vaia told AFP.

Vaia cautioned that there remained many unanswered questions on monkeypox, including whether antiviral therapies could shorten the time in which people with the virus could infect others.

Another is whether the smallpox vaccine could protect people from the monkeypox virus.

“To study this we will analyse people who were vaccinated 40 years ago before human smallpox was declared to have disappeared,” Vaia said.

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