Evidence of monkeypox transmission can be found in a few days before the symptoms appear.
The finding would get better if it was replicated. It could help explain how monkeypox got out of control this year and how to combat it.
According to the CDC, people can spread monkeypox to others from the time symptoms start until the rash is completely healed. The CDC states that there is no evidence that monkeypox can be spread from person to person.
The new information was published in the British Medical Association journal.
The paper is important and controversial, according to Dr Esther E Freeman, director of Global Health Dermatology at Harvard Medical School.
Evidence shows that there may be presymptomatic transmission of monkeypox. It needs to be reproduced and validation using other real-world data.
Monkeypox is a disease that is endemic to 11 African nations. During a global outbreak first identified in the UK in May, the virus has mostly been transmitted through sexual contact between men.
According to the CDC, 28,442 people in the US have been found to have monkeypox, which is a disease. The global and US cases have been declining steadily since peaking in August.
There were 2,746 people diagnosed with monkeypox in Britain between 6 May and 1 August and 650 of them completed questionnaires. Most of the men who reported sex with men were from the cohort.
The data in the analysis was adjusted according to the accompanying editorial. They used mathematical models to control the factors that might cause bias.
The investigators used the data from the 54 members of the cohort to estimate the time from when a person was bitten to when they started to experience symptoms. The serial interval is the period between one person's first symptoms and the symptom onset of a person to whom they probably passed the virus.
The median serial interval could be shortened by up to 1.7 days depending on the model used. The proportion of cases that were transmitted preatically was suggested by this.
13 pairs of people between whom monkeypox is likely to have been transmitted were analyzed for validation. Presymptomatic transmission can occur up to four days prior to symptom onset.
Efforts to trace the close contacts of people with monkeypox should not be limited to contacts from the day symptoms began, according to the findings.
Specific types of high intensity interactions, such as sexual contact, may be able to overcome the obstacle of the presymptomatic period and facilitate transmission.
It is possible for people to transmit the virus before they realize they have symptoms.
If presymptomatic transmission is a major driver of the monkeypox outbreak, this calls into question the impact of public health policies requiring people to be symptom free. According to some infectious disease experts, isolation policies might have a limited effect on a virus that doesn't spread through casual contact.
The study made a strong argument that there is some presymptomatic transmission, according to Dr Boghuma Titanji, an infectious disease specialist.
The main finding of the study is that infections that can pass silently like this are harder to control.
The study was limited by the fact that it depended on unreliable recollections of sexual contact and symptoms.
A French study published in October raised the possibility that monkeys could transmit the disease without any symptoms. There were anal samples taken from 200 men who had sex with men who did not have monkeypox. Two eventually developed symptoms.
There is still more work to be done to understand presymptomatic and asymptomatic infections and what that might mean for future policies and management of the monkeypox outbreak.
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