Looking for some good dinnertime conversation? Or perhaps it's your first online date, and there's an awkward silence. Need an icebreaker?
You've come to the right place: ACSH, your provider of multiple forms of information, enlightenment, education, entertainment, and occasionally, tales of the grotesque. Now and then I throw in some fairly gross stuff for no discernible reason (other than the quest for even more puerile humor). But this is only partly true here. It's both gross and scientific. You'll see.
The title gets noticed!
Don't blame me for this one. It absolutely jumped off the page.
Yucky clickbait? Wrong!
Based on the title, one could reasonably conclude that what follows is simply tasteless nonsense with no scientific value. This could not be more wrong. The paper in question is based on a real study that contains very sophisticated science in the form of virology, genetics, and epidemiology. It also addresses a significant public health problem – the spread of monkeypox, aka mpox, especially throughout Africa and Asia.
And it – condoms and all – was published in The Lancet Infectious Disease, arguably the most prestigious microbiology and infectious journal. The article, which is meticulously presented by a team of 30 (!) authors from 14 (!!) countries, discusses how to track the spread of monkeypox, a real and growing public health problem, using some nifty virology and genetics to track the spread of the disease. (Food for thought - Look at the name of the third author and imagine him trying to fill out a form at the DMV.)
To our knowledge, our findings demonstrate for the first time the usefulness of used condoms as an indirect surveillance tool for mpox transmission and community mpox co-occurrence with other sexually transmitted diseases
Wannigama, et.al., Published Online August 21, 2024.https://doi.org/10.1016/ S1473-3099(24)00514-0
Not surprising. It's not like this is the used condom equivalent of the California Gold Rush, where people were shooting it out with muskets over claims.
Why was this study done?
The group had a number of goals in mind, all reasonable:
- Demonstrating, using a novel method, that mpox, which is spreading rapidly, is a sexually transmitted disease
- Studying the patterns of spread of the infection in multiple geographic areas
- Examining viral mutations that may influence how the virus adapts and spreads across regions
- Studying how mpox is co-transmitted with other sexually transmitted diseases (STDs)
- Creating a simple surveillance tool for monitoring the spread of the infection
How was it done?
Here’s how the process worked (if you don't have a strong stomach, now's the time to develop one):
- Condom Collection:
The group enlisted scavengers, public volunteers, and sanitation workers to collect used condoms from brothels and public areas (maybe garbage cans?) in 16 countries. No shortage: a disgusting total of 20,941 used condoms were collected. I don't even want to think about what this might look like or what a volunteer might be thinking about the hideous job they're stuck with.
2. Testing and Genetic Analysis:
Samples from condoms were analyzed in labs using real-time PCR (a standard technique) to detect the presence of monkeypox (MPXV) DNA. The researchers focused on a specific gene, N3R/OPG016, a highly conserved region in the virus's genome. Since this gene remains relatively unchanged across different strains, it is an ideal marker for detecting mpox. The presence of this gene in the condom samples not only confirmed mpox infections but also allowed the team to track viral mutations and study how the virus spread. By using this gene for diagnostic testing, the scientists ensured accurate identification of the virus in samples, helping them map the spread of mpox across different regions.
The study didn’t just focus on mpox—scientists also tested the condom samples for the presence of other sexually transmitted infections, such as HIV, herpes, and syphilis. This allowed the authors to understand whether mpox was being spread in conjunction with other STDs.
Results
A total of 262 (1.3%) of the condom samples from 16 different countries were positive for monkeypox DNA, confirming that the virus was transmitted through sexual contact. Furthermore, geographic analysis revealed regional clustering of cases, indicating that the spread was concentrated in specific areas rather than random.
Understanding clustering is important because it reveals specific transmission patterns, often indicating that the virus spreads within localized networks or communities. This helps public health officials target high-risk areas for interventions such as vaccines or public health campaigns.
Bottom line
Although this may not be the most pleasant topic to discuss, the group's innovative approach provided valuable epidemiological insights and offered a practical tool for regions with limited resources to monitor the spread of mpox and other sexually transmitted infections.
That said, good luck trying to get the images of collecting and sampling out of your mind.
Yuck.
Josh Bloom
Director of Chemical and Pharmaceutical Science
Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.
