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. 2022 Dec:22:100237.
doi: 10.1016/j.mran.2022.100237. Epub 2022 Oct 24.

Risk of Monkeypox virus (MPXV) transmission through the handling and consumption of food

Affiliations

Risk of Monkeypox virus (MPXV) transmission through the handling and consumption of food

Estelle Chaix et al. Microb Risk Anal. 2022 Dec.

Abstract

Monkeypox (MPX) is a zoonotic infectious disease caused by Monkeypox virus (MPXV), an enveloped DNA virus belonging to the Poxviridae family and the Orthopoxvirus genus. Since early May 2022, a growing number of human cases of Monkeypox have been reported in non-endemic countries, with no history of contact with animals imported from endemic and enzootic areas, or travel to an area where the virus usually circulated before May 2022. This qualitative risk assessment aimed to investigate the probability that MPXV transmission occurs through food during its handling and consumption. The risk assessment used "top-down" (based on epidemiological data) and "bottom-up" (following the agent through the food chain to assess the risk of foodborne transmission to human) approaches, which were combined. The "top-down" approach first concluded that bushmeat was the only food suspected as a source of contamination in recorded cases of MPXV, by contact or ingestion. The "bottom-up" approach then evaluated the chain of events required for a human to become ill after handling or consuming food. This approach involves several conditions: (i) the food must be contaminated with MPXV (naturally, by an infected handler or after contact with a contaminated surface); (ii) the food must contain viable virus when it reaches the handler or consumer; (iii) the person must be exposed to the virus and; (iv) the person must be infected after exposure. Throughout the risk assessment, some data gaps were identified and highlighted. The conclusions of the top-down and bottom-up approaches are consistent and suggest that the risk of transmission of MPXV through food is hypothetical and that such an occurrence was never reported. In case of contamination, cooking (e.g., 12 min at 70°C) could be considered effective in inactivating Poxviridae in foods. Recommendations for risk management are proposed. To our knowledge, this is the first risk assessment performed on foodborne transmission of MPXV.

Keywords: CCID50, Cell Culture Infectious Dose50; Food; Monkeypox; Monkeypox virus; PFU, Plaque-forming unit; Poxvirus; Recommendations; TCID50, Tissue Culture Infectious Dose50; Transmission.

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Conflict of interest statement

The authors declare no conflict of interest. This paper was prepared thanks to the collective expertise carried out by the ANSES emergency collective expert appraisal group (GECU) “Monkeypox – Food”. ANSES analyses interests declared by experts before they are appointed and throughout the work, in order to prevent risk of conflicts of interest in relation to the points addressed in expert appraisals. The experts’ declarations of interests are made public via the website: https://dpi.sante.gouv.fr/.

Figures

Image, graphical abstract
Graphical abstract
Fig 1
Fig. 1
Bottom-up risk assessment of MPXV transmission through handling or consumption of food.
Fig 2
Fig. 2
A) Conceptual diagram of the Monkeypox virus transfer routes from animal to human and from human to human. To explore foodborne transmission, two assessment approaches were used: top-down assesment (blue), analyzing epidemiological data, and bottom-up assessment (orange), which explore the persistence of the virus along the food chain. B) Some examples of preventive measures according to different scenarios of MPXV contamination of foods is proposed (on the basis of the situation in France). * The numbers in the column correspond to the arrows in Fig 2A.
Fig 3
Fig. 3
Overview of data on decimal reduction time values (D) observed at different temperatures for three genera of viruses of the Poxviridae family. The associated studies are detailed in Table 2. Example of reading: for Yatapoxvirus (YMTV, pink square symbol), at a temperature of 40°C, a duration of about 2 log10 min (i.e. 100 min) is required to reduce the infectious load of the virus by a factor of 10. The full dataset is accessible (Guillier and Chaix, 2022).
Fig 4
Fig. 4
Observed (dots) and fitted Bigelow model (grey lines corresponding to bootstrap resampling) values of decimal reduction time (logarithmic scale in minutes) as a function of temperature for viruses belonging to the Poxviridae family.

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