Isolation of viable monkeypox virus from anal and urethral swabs, Italy, May to July 2022

Anal and urethral samples from confirmed cases of monkeypox were screened for monkeypox virus (MPXV) by real-time PCR. Isolation of the virus was subsequently attempted in cell culture. Actively -replicating virus was demonstrated in 13 of 18 and 11 of 15 PCR-positive anal and urethral swabs, respec-tively, collected within 7 days from symptoms onset. Two asymptomatic secondary cases had detectable MPXV genetic material in urethral secretion and for one, MPXV was successfully isolated, supporting a potential MPXV sexual transmission hypothesis.

Automated summary

The study found that the monkeypox virus could be detected in anal and urethral samples from confirmed cases, with actively-replicating virus still present within 7 days from symptom onset. It was also discovered that asymptomatic secondary cases may support a potential sexual transmission hypothesis.