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Since May 2022, an outbreak of monkeypox has been ongoing in non-endemic countries. We report four cases in Italy in young adult men reporting condomless sexual intercourse. The patients are in good clinical condition with no need for specific antiviral drugs. Biological samples from seminal fluid were positive for monkeypox viral DNA. For many other viruses found in semen there is no evidence of sexual transmission. The possibility of sexual transmission of monkeypox virus needs to be investigated.


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  1. Reynolds MG, Yorita KL, Kuehnert MJ, Davidson WB, Huhn GD, Holman RC, et al. Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis. 2006;194(6):773-80.  https://doi.org/10.1086/505880  PMID: 16941343 
  2. Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2):e0010141.  https://doi.org/10.1371/journal.pntd.0010141  PMID: 35148313 
  3. European Centre for Disease Prevention and Control (ECDC). Monkeypox multi-country outbreak. Situation update, 25 May 2022. Stockholm: ECDC. [Accessed: 26 May 2022]. Available from: https://www.ecdc.europa.eu/en/monkeypox-outbreak#:~:text=As%20of%2025%20May%2C%20118,not%20considered%20to%20be%20endemic
  4. Li Y, Zhao H, Wilkins K, Hughes C, Damon IK. Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. J Virol Methods. 2010;169(1):223-7.  https://doi.org/10.1016/j.jviromet.2010.07.012  PMID: 20643162 
  5. Bankevich A, Nurk S, Antipov D, Gurevich AA, Dvorkin M, Kulikov AS, et al. SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing. J Comput Biol. 2012;19(5):455-77.  https://doi.org/10.1089/cmb.2012.0021  PMID: 22506599 
  6. Li H, Durbin R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics. 2009;25(14):1754-60.  https://doi.org/10.1093/bioinformatics/btp324  PMID: 19451168 
  7. World Health Organization Regional Office for Europe (WHO/Europe). Statement - Monkeypox in the European Region: what we know so far and how we need to respond. Copenhagen: WHO/Europe; 2022. Available from: https://www.euro.who.int/en/media-centre/sections/statements/2022/statement-monkeypox-in-the-european-region-what-we-know-so-far-and-how-we-need-to-respond
  8. Reynolds MG, Damon IK. Outbreaks of human monkeypox after cessation of smallpox vaccination. Trends Microbiol. 2012;20(2):80-7.  https://doi.org/10.1016/j.tim.2011.12.001  PMID: 22239910 
  9. European Centre for Disease Prevention and Control (ECDC). Epidemiological update: Monkeypox multi-country outbreak. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/news-events/epidemiological-update-monkeypox-multi-country-outbreak-0
  10. Moore M, Zahra F. Monkeypox. 2022 May 22. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
  11. Sklenovská N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health. 2018;6:241.  https://doi.org/10.3389/fpubh.2018.00241  PMID: 30234087 
  12. European Centre for Disease Prevention and Control (ECDC). Risk assessment - Monkeypox multi-country outbreak. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/risk-assessment-monkeypox-multi-country-outbreak
  13. Matusali G, D’Abramo A, Terrosi C, Carletti F, Colavita F, Vairo F, et al. Infectious Toscana virus in seminal fluid of young man returning from Elba island, Italy. Emerg Infect Dis. 2022;28(4):865-9.  https://doi.org/10.3201/eid2804.211920  PMID: 35318936 
  14. Le Tortorec A, Matusali G, Mahé D, Aubry F, Mazaud-Guittot S, Houzet L, et al. From ancient to emerging infections: the odyssey of viruses in the male genital tract. Physiol Rev. 2020;100(3):1349-414.  https://doi.org/10.1152/physrev.00021.2019  PMID: 32031468 
  15. Li N, Wang T, Han D. Structural, cellular and molecular aspects of immune privilege in the testis. Front Immunol. 2012;3:152.  https://doi.org/10.3389/fimmu.2012.00152  PMID: 22701457 

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