{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:37:41Z","timestamp":1780101461924,"version":"3.54.0"},"reference-count":39,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T00:00:00Z","timestamp":1663372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The ongoing outbreak of the Monkeypox virus (MPXV) is characterized by sustained human-to-human transmission, particularly among men who have sex with men (MSM). The aim of the study was to describe the characteristics of the MPXV infection identified in Southern Italy. Clinical samples for each suspected case identified from 1 June to 1 August 2022 were tested for MPXV, and whole-genome sequencing (WGS) was performed on two strains. Ten cases were identified: eight were young adult males, including six MSMs, and two were female. Nine subjects reported recent sexual exposure. One female subject without sexual exposure only reported attendance at a social gathering. Overall, 7 of 10 skin lesion samples had a high viral load of MPXV DNA, and 6\/9 whole blood samples and 6\/8 nasopharyngeal swab samples also tested positive. The analyzed sequences belonged to Clade 3, lineage B.1, and B.1.5, respectively. Despite this recent multinational outbreak of MPXV cases having revealed a high proportion of cases occurring among MSM, the identification of cases among heterosexual subjects and in a female subject without sexual risk factors should raise awareness among clinicians about the possible spread of MPXV in the general population.<\/jats:p>","DOI":"10.3390\/ijerph191811719","type":"journal-article","created":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T23:39:22Z","timestamp":1663544362000},"page":"11719","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Monkeypox Virus Infections in Southern Italy: Is There a Risk for Community Spread?"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-9745","authenticated-orcid":false,"given":"Daniela","family":"Loconsole","sequence":"first","affiliation":[{"name":"Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sallustio","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-5408","authenticated-orcid":false,"given":"Francesca","family":"Centrone","sequence":"additional","affiliation":[{"name":"Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Casulli","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Accogli","sequence":"additional","affiliation":[{"name":"Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Saracino","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Grandolfo","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Battista","family":"Buccoliero","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giuseppe Moscati Hospital, 74010 Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Prevention, Local Health Authority of Bari, 70100 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"De Nitto","sequence":"additional","affiliation":[{"name":"Department of Prevention, Local Health Authority of Bari, 70100 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Conversano","sequence":"additional","affiliation":[{"name":"Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9255-8893","authenticated-orcid":false,"given":"Francesco","family":"Desiante","sequence":"additional","affiliation":[{"name":"Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Del Sambro","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-9809","authenticated-orcid":false,"given":"Domenico","family":"Simone","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2744-1140","authenticated-orcid":false,"given":"Antonio","family":"Parisi","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Prato","sequence":"additional","affiliation":[{"name":"Hygiene Section, Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Hygiene Section, Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-1256","authenticated-orcid":false,"given":"Maria","family":"Chironna","sequence":"additional","affiliation":[{"name":"Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, July 28). WHO Director-General Declares the Ongoing Monkeypox Outbreak a Public Health Emergency of International Concern, Available online: https:\/\/www.who.int\/europe\/news\/item\/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wang, L., Shang, J., Weng, S., Aliyari, S.R., Ji, C., Cheng, G., and Wu, A. (2022). Genomic annotation and molecular evolution of monkeypox virus outbreak in 2022. J. Med. Virol., epub ahead of print.","DOI":"10.1002\/jmv.28036"},{"key":"ref_3","unstructured":"Centers for Disease Control and Prevention (CDC) (2022, July 28). 2022 Monkeypox Outbreak Global Map, Available online: https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/response\/2022\/world-map.html."},{"key":"ref_4","unstructured":"European Centre for Disease Control and Prevention (ECDC) (2022, July 28). Joint ECDC-WHO Regional Office for Europe Monkeypox Surveillance Bulletin. Produced on 3 August 2022, Available online: https:\/\/monkeypoxreport.ecdc.europa.eu\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/S1473-3099(22)00228-6","article-title":"Clinical features and management of human monkeypox: A retrospective observational study in the UK","volume":"22","author":"Adler","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.3201\/eid2704.203569","article-title":"Reemergence of human monkeypox and declining population immunity in the context of urbanization, Nigeria, 2017\u20132020","volume":"27","author":"Nguyen","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ulaeto, D.O., Dunning, J., and Carroll, M.W. (2022). Evolutionary implications of human transmission of monkeypox: The importance of sequencing multiple lesions. Lancet Microbe, epub ahead of print.","DOI":"10.1016\/S2666-5247(22)00194-X"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/S0140-6736(05)63725-7","article-title":"Re-emergence of human monkeypox in Zaire in 1996. Monkeypox Epidemiologic Working Group","volume":"349","author":"Mukinda","year":"1997","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1056\/NEJMoa032299","article-title":"The detection of monkeypox in humans in the Western Hemisphere","volume":"350","author":"Reed","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_10","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2022, July 28). Risk Assessment: Monkeypox Multi-Country Outbreak, Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/risk-assessment-monkeypox-multi-country-outbreak."},{"key":"ref_11","first-page":"2200503","article-title":"Hospital Clinic de Barcelona Monkeypox Study Group. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022","volume":"27","author":"Fuertes","year":"2022","journal-title":"Euro Surveill."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ogoina, D., Izibewule, J.H., Ogunleye, A., Ederiane, E., Anebonam, U., Neni, A., Oyeyemi, A., Etebu, E.N., and Ihekweazu, C. (2019). The 2017 human monkeypox outbreak in Nigeria-Report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214229"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.idc.2019.03.001","article-title":"Human monkeypox: Epidemiologic and clinical characteristics, diagnosis, and pPrevention","volume":"33","author":"Petersen","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s40265-022-01742-y","article-title":"Prevention and treatment of monkeypox","volume":"82","author":"Rizk","year":"2022","journal-title":"Drugs"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"World Health Organization (2022, July 28). Monkeypox Q&A: What You Need to Know about Monkeypox, Available online: https:\/\/www.who.int\/europe\/news\/item\/10-06-2022-monkeypox-q-a---what-you-need-to-know-about-monkeypox.","DOI":"10.1016\/j.ptdy.2022.10.007"},{"key":"ref_16","unstructured":"Centers for Disease Control and Prevention (CDC) (2022, July 28). About Monkeypox. Signs and Symptoms, Available online: https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/symptoms.html."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2200421","DOI":"10.2807\/1560-7917.ES.2022.27.22.2200421","article-title":"INMI Monkeypox Group. Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022","volume":"27","author":"Antinori","year":"2022","journal-title":"Euro. Surveill."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1099\/vir.0.81215-0","article-title":"A tale of two clades: Monkeypox viruses","volume":"86","author":"Likos","year":"2005","journal-title":"J. Gen. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102402","DOI":"10.1016\/j.tmaid.2022.102402","article-title":"Phylogenomic analysis of the monkeypox virus (MPXV) 2022 outbreak: Emergence of a novel viral lineage?","volume":"49","author":"Luna","year":"2022","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Isidro, J., Borges, V., Pinto, M., Sobral, D., Santos, J.D., Nunes, A., Mix\u00e3o, V., Ferreira, R., Santos, D., and Duarte, S. (2022). Phylogenomic Characterization and Signs of Microevolution in the 2022 Multi-Country Outbreak of Monkeypox Virus. Nat. Med., epub ahead of print.","DOI":"10.1038\/s41591-022-01907-y"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.cell.2012.05.049","article-title":"Poxviruses deploy genomic accordions to adapt rapidly against host antiviral defenses","volume":"150","author":"Elde","year":"2012","journal-title":"Cell"},{"key":"ref_22","unstructured":"Ministero della Salute (2022, July 28). Vaiolo Delle Scimmie, Available online: https:\/\/www.salute.gov.it\/portale\/malattieInfettive\/dettaglioSchedeMalattieInfettive.jsp?lingua=italiano&id=254&area=Malattie%20infettive&menu=indiceAZ&tab=1."},{"key":"ref_23","unstructured":"Ministero della Salute (2022, August 03). Circolare 0034905-02\/08\/2022-DGPRE-DGPRE-P. Focolaio Di Vaiolo Delle Scimmie in Paesi Non endemici: Aggiornamenti Sulla Definizione Di Caso, Segnalazione, Tracciamento Dei Contatti E Gestione Dei Casi. Note Tecniche Per La Diagnosi Di Laboratorio, Available online: https:\/\/www.trovanorme.salute.gov.it\/norme\/renderNormsanPdf?anno=2022&codLeg=88439&parte=1%20&serie=null."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jviromet.2010.07.012","article-title":"Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA","volume":"169","author":"Li","year":"2010","journal-title":"J. Virol. Methods"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e01524-19","DOI":"10.1128\/MRA.01524-19","article-title":"Identification and whole-genome sequencing of a monkeypox virus strain isolated in Israel","volume":"9","author":"Israeli","year":"2020","journal-title":"Microbiol. Resour. Announc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.ijid.2022.06.047","article-title":"Vaccination for monkeypox prevention in persons with high-risk sexual behaviours to control on-going outbreak of monkeypox virus clade 3","volume":"122","author":"Petersen","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2200456","DOI":"10.2807\/1560-7917.ES.2022.27.23.2200456","article-title":"Letter to the editor: Multiple introductions of MPX in Italy from different geographic areas","volume":"27","author":"Ferraro","year":"2022","journal-title":"Euro. Surveill."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s40249-022-01007-6","article-title":"Monkeypox claims new victims: The outbreak in men who have sex with men","volume":"11","author":"Liu","year":"2022","journal-title":"Infect. Dis. Poverty"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Orviz, E., Negredo, A., Ayerdi, O., V\u00e1zquez, A., Mu\u00f1oz-Gomez, A., Monz\u00f3n, S., Clavo, P., Zaballos, A., Vera, M., and S\u00e1nchez, P. (2022). Monkeypox outbreak in Madrid (Spain): Clinical and virological aspects. J. Infect., epub ahead of print.","DOI":"10.1016\/j.jinf.2022.07.005"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Endo, A., Murayama, H., Abbott, S., Ratnayake, R., Pearson, C.A.B., John Edmunds, W., Fearon, E., and Funk, S. (2022). Heavy-tailed sexual contact networks and the epidemiology of monkeypox outbreak in non-endemic regions. medRxiv.","DOI":"10.1101\/2022.06.13.22276353"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ijid.2018.11.008","article-title":"Monkeypox\u2014Enhancing public health preparedness for an emerging lethal human zoonotic epidemic threat in the wake of the smallpox post-eradication era","volume":"78","author":"Petersen","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Bruno, G., Fabrizio, C., Rodano, L., and Buccoliero, G.B. (2022). Monkeypox in a 71-year-old woman. J Med Virol., epub ahead of print.","DOI":"10.1002\/jmv.27993"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.maturitas.2022.05.014","article-title":"Rare monkeypox: Is it really a threat to the elderly?","volume":"163","author":"Chavda","year":"2022","journal-title":"Maturitas"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Karan, A., Styczynski, A.R., Huang, C., Sahoo, M.K., Srinivasan, K., Pinsky, B.A., and Salinas, J.L. (2022). Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022. Emerg. Infect. Dis., epub ahead of print.","DOI":"10.3201\/eid2810.221191"},{"key":"ref_35","first-page":"2200552","article-title":"Paediatric monkeypox patient with unknown source of infection, the Netherlands, June 2022","volume":"27","author":"Fievez","year":"2022","journal-title":"Euro Surveill."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ricc\u00f2, M., Ferraro, P., Camisa, V., Satta, E., Zaniboni, A., Ranzieri, S., Baldassarre, A., Zaffina, S., and Marchesi, F. (2022). When a neglected tropical disease goes global: Knowledge, attitudes and practices of Italian physicians towards monkeypox, preliminary results. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7070135"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/20477724.2020.1743037","article-title":"Knowledge of human monkeypox viral infection among general practitioners: A cross-sectional study in Indonesia","volume":"114","author":"Harapan","year":"2020","journal-title":"Pathog. Glob. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2200422","DOI":"10.2807\/1560-7917.ES.2022.27.22.2200422","article-title":"Community transmission of monkeypox in the United Kingdom, April to May 2022","volume":"27","author":"Vivancos","year":"2022","journal-title":"Euro Surveill."},{"key":"ref_39","unstructured":"Ministero della Salute (2022, August 16). Oggetto: Indicazioni Ad Interim Sulla Strategia Vaccinale Contro Il Vaiolo Delle Scimmie (MPX), Available online: https:\/\/www.quotidianosanita.it\/allegati\/allegato1659727637.pdf."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11719\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:33:18Z","timestamp":1760142798000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,17]]},"references-count":39,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijerph191811719"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191811719","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,17]]}}}