Monkeypox ASymptomatic Shedding: Evaluation by Self-Sampling MPX-ASSESS

Monkeypox ASymptomatic Shedding: Evaluation by Self-Sampling MPX-ASSESS

Monkeypox (MPX) is a viral zoonosis, caused by the Monkeypox virus (MPXV), a DNA virus that belongs to the Orthopoxvirus genus and is closely related to the variola virus, the causative agent of smallpox. Until recently the spread of MPX was mainly confined to the Central African rainforest and to parts of West Africa. However, in May 2022, several cases of MPX were detected throughout Europe and Northern America, albeit with a different presentation than previously seen. Many questions remain on this new presentation of the disease: what the exact mode of transmission is, how contagious the virus really is and whether asymptomatic carriers exist. With this study the researchers aim to perform a close follow-up study of close contacts of MPX confirmed cases. Participants are recruited among high and very high risk contacts of confirmed monkeypox patients that presented to the ITM for diagnosis (index). Contacts that are asymptomatic (for symptoms compatible with MPXV infection according to national case definitions) at the time of recruitment will be enrolled. Contacts of the index case that are symptomatic at recruitment or become symptomatic during follow-up will be invited for sample collection at different timepoints until 21 days after contact as suspect cases.

Inclusion Criteria:

1. Be a high risk or very high-risk contact of a laboratory confirmed monkeypox case, with:

   • Very high-risk contact:

     • Sexual partner(s)
     • Prolonged skin-to-skin contact while the patient had skin lesions

   • High risk contact

     • living in the same household or similar environment (e.g. camping, spending the night, etc.);
     • shared clothing, bedding, utensils, etc., while the patient had skin lesions
     • healthcare workers with unprotected contact (inadequate or no PPE)

2. Last exposure to the monkeypox index case of less than 21 days ago

3. Adult participants (≥ 18 years old) of any gender

4. Written informed consent is obtained from the participant

Exclusion Criteria:

1. Presenting with symptoms compatible with MPX:

   • an unexplained rash on any part of the body AND
   • one or more of the following symptoms: fever, headache, back pain, fatigue, lymphadenopathy (localised or generalised)

2. Inability or unwillingness to comply with the proposed follow-up schedule