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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
Monkeypox is a contagious disease, without remedy, which heals itself, but who can kill if not treated in time.(Photo by CHARLES BOUESSEL / AFP)

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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ENVIRONMENT

REVEALED: These are the most polluted towns in Italy

The northern cities of Milan and Turin were named Italy's 'smog capitals' in a new pollution report on Monday which urged the government to take action over poor air quality.

REVEALED: These are the most polluted towns in Italy
Photo: Pixabay

Smog and pollution are choking Italian cities year-round and many towns are exceeding limits on fine particles and other pollution, according to another report from Italian environmental watchdog Legambiente.

The Mal’aria di città (Air pollution in the city) report for 2023, unveiled on Monday, was the latest to warn about the risks to health posed by pollution in many parts of the country.

It found that 25 of 95 cities monitored had violated clean air ordinances by exceeding daily fine particle (PM10) emission limits, which are currently set at no more than 35 days a year with a daily average of over 50 micrograms per cubic metre.

Turin was ranked as the worst offender, exceeding this level on 90 days, closely followed by Milan (84), Asti (79), Modena (75), and Padua and Venice at 70.

These were followed by Cremona, Treviso, Mantua and Rovigo, all of which exceeded limits to a lesser degree.

All of the most polluted cities were in the northern Italian regions of Piedmont, Lombardy, Emilia Romagna and Veneto, with most within the north-western ‘industrial triangle’.

Some southern cities featured nearer the bottom of the ranking, with Andria (Puglia) and Ragusa (Sicily) exceeding limits on several days, as well as Rome, which overshot the permitted level for one day.

(Photo by Andreas SOLARO / AFP)

The average annual rate of PM10 emissions nationwide dropped slightly, by two percent year-on-year, the report found.

“This, however, is not enough to guarantee the health of citizens,” said Stefano Ciafani, president of Legambiente.

He pointed out that the situation looked even worse if air quality in Italian cities were measured against tighter limits under the new European Directive on air quality, in force from 2030, which lowers the PM10 threshold from 35 to 20 micrograms per cubic meter of air.

“Only 23 out of 96 cities (24 percent) would be under these limits,” Ciafani said, while 84 percent would exceed the threshold for PM2.5 and 61 percent for nitrogen dioxide (NO2).

Italy has repeatedly been reprimanded by the European Union over air quality, and has “persistently and systematically” breached EU recommended limits, the European Court of Justice ruled in 2020.

The north of Italy has long been ranked among the worst areas in Europe for polluted air according to data from the European Environment Agency.

“Air pollution is not only an environmental problem, but also a health problem of great importance,” said Ciafani. “In Europe, it’s the main cause of premature death due to environmental factors.”

“Italy has more than 52,000 deaths per year caused by PM2.5 emissions, equal to a fifth of those recorded throughout the continent,” he said.

The main causes of air pollution in Italian cities are reported to be industry, inefficient domestic heating systems, agricultural practices and, most of all, heavy traffic.

In Italy, cars continue to be by far the most-used means of transport. 65.3 percent of journeys overall are made by car, Legambiante wrote, with the emissions from some 38 million cars choking Italy’s towns and cities.

(Photo by Miguel MEDINA / AFP)

Legambiente said “drastic” measures were required to tackle the problem, including funds for more efficient heating systems in homes and public buildings and a major increase in public transport provision.

The group said Italy must “quadruple the availability of public transit, promoting integrated season tickets as done by Germany in 2022”, triple the number of electric buses, create zero-emission zones in town centres, and “create another 16,000 kilometres of cycle paths”.

It also praised local authorities choosing to bring in 30 km/h speed limits in city centres. Councils in Bologna, Turin, Milan and Cesena have all said they plan to implement these limits, following the lead of European cities including Paris and Madrid, despite fierce criticism from Italian transport minister Matteo Salvini.

Legambiente published a petition urging the government to make clean air and more livable cities a priority, saying Italy should follow Paris in attempting to create ’15-minute cities’, in which everyone lives within a quarter of an hour’s walk of vital amenities such as shops and schools and possibly also workplaces.