Monkeypox Might Spread Several Days Before Any Symptoms Emerge, Study Shows

© ARUN SANKARA technician wearing personal protective equipment (PPE) gestures next to a biohazard sign inside a molecular laboratory facility set up to test for the monkeypox disease.
A technician wearing personal protective equipment (PPE) gestures next to  a biohazard sign inside a molecular laboratory facility set up to test for the monkeypox disease. - Sputnik International, 1920, 03.11.2022
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The guidance from the US Centers for Disease Control and Prevention (CDC) on monkeypox - a rare viral disease that occurs predominantly in Central and West Africa - states that people “can spread it to others from the time symptoms start until the rash has fully healed”.
There is evidence pointing to a “considerable” transmission of monkeypox in the several days before symptoms of the virus emerge, a contact tracing study in the UK has revealed.
Routine surveillance data on 2,746 people diagnosed with monkeypox in Britain between 6 May and 1 August and collected by the UK Health Security Agency (UKHSA) were examined by the research team.
The UKHSA investigators involved in the study, details of which were published in the British Medical Association journal (BMAJ) on 2 November, analyzed questionnaire data to estimate the monkeypox incubation period. They also scrutinized data to estimate the so-called "serial interval" - the time between one individual’s first symptoms and the onset of symptoms in a person to whom they probably passed the virus.
Resorting to various mathematical models, the team found that the average serial interval was 0.3 to 1.7 days shorter than the median incubation period, which was typically a week. Accordingly, the scientists concluded that a “substantial” number of cases (an estimated 53 percent) were transmitted presymptomatically.
After detailed analysis of 13 pairs of individuals between whom monkeypox was probably7 transmitted, 10 appeared to show presymptomatic transmission having occurred. In other words, the virus was likely to have been transmitted from one person to another a maximum of four days before any symptom was displayed.
A person stands in line waiting to register for the monkeypox vaccine at a clinic run by the Mecklenburg County Public Health Department in Charlotte, N.C., Saturday, Aug. 20, 2022.  - Sputnik International, 1920, 06.09.2022
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Meanwhile, the US Centers for Disease Control and Prevention (CDC) guidance on monkeypox says that people “can spread it to others from the time symptoms start until the rash has fully healed”, indicating that to date “there is no evidence that monkeypox spreads from people with no symptoms”.

“It’s an important and potentially controversial paper. It provides evidence that there may be presymptomatic transmission of monkeypox going on. But like any modeling paper, it still needs to be reproduced and validated using other real-world data,” Dr Esther E Freeman, director of Global Health Dermatology at Harvard Medical School and a co-author of an accompanying editorial, was cited as saying by UK media.

  Colorized transmission electron micrograph of monkeypox particles (File) - Sputnik International, 1920, 02.09.2022
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Monkeypox is a rare viral disease that occurs predominantly in Central and West Africa, with most people recovering after a few weeks. Early symptoms include rash, fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. Across the globe, 77,174 people have been found to have contracted the disease in 109 nations, including 28,442 in the US, according to the CDC. Since the first patient tested positive for the disease in early May, 3,439 confirmed and 146 highly probable monkeypox cases were registered in the country up to 16 September 2022. UKHSA has reported a slowing of monkeypox cases in Britain since 15 August.
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