Asymptomatic monkeypox spread possible, study suggests: 4 updates

Researchers in France have detected monkeypox virus on samples collected as part of routine sexually transmitted infection screenings of aymptomatic men who have sex with men, accoring to findings published Aug. 16 in Annals of Internal Medicine.

Researchers retrospectively performed monkeypox testing on anorectal swabs collected for routine STI screening. Of 200 people who were asymptomatic for monkeypox, 13 samples were positive for the virus. Researchers followed up with those who were initially asymptomatic and found two subsequently developed symptoms. 

The findings raise the possibility that asymptomatic monkeypox spread is contributing to the global outbreak and that vaccination should not be limited to people with known exposure, the American College of Physicians said in a statement about the new research. 

"The practice of ring post-exposure vaccination around symptomatic persons with probable or confirmed [monkeypox] infection may not be sufficient to contain spread," if asymptomatic transmission is occuring, researchers said

Three more updates: 

1. The CDC has added dogs to the list of animals that can be infected with the monkeypox virus after researchers in France reported evidence of the first case of a dog that may have contracted an infection from its owners in France. The CDC advises that people infected with monkeypox avoid contact with pets. It advises that people who "did not have close contact with their pets after symptom onset," ask friends or family outside their homes to take care of their pet until they have fully recovered. 

2. At least seven children in the U.S. have tested positive for monkeypox, ABC News reported Aug. 15.  A child under the age of 4 in Marin County, Fla., and a child in Maine are the latest pediatric cases health officials have confirmed in the U.S. Five other children since July had previously tested positive. The Jynneos monkeypox vaccine is available to children determined to be at high risk of contracting monkeypox under an emergency use authorization from the FDA. 

3. Fifty-four percent of U.S. cases are among Black and Hispanic men, CDC data shows. This is based on 1,195 case reports the agency received as of  July 27, according to a report published Aug. 12. Of those cases, 99 percent were among men. Forty-one percent were among white individuals; 28 percent were among Hispanic individuals; and 26 percent were among Black individuals. "Although the largest proportion of cases have occurred in white persons, Black and Hispanic persons, who represent approximately one-third of the general population, accounted for more than half of monkeypox cases," the CDC said. "Ensuring equity in approaches to monkeypox testing, treatment, and prevention is critical." 

Tom Frieden, MD, former CDC director, in an Aug. 12 tweet wrote, "[Seventy percent] of monkeypox cases detected in North Carolina are among Black men and 19 percent are in white men, but less than a quarter of vaccines have gone to Black recipients while 67 percent have gone to White recipients. We have to do better." 

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