The transmission of monkeypox virus occurs through direct contact, but transmission through saliva or exhaled droplets and aerosols has not yet been investigated. We aimed to assess the presence of monkeypox virus DNA and infectious virus in saliva samples and droplets and aerosols exhaled from patients infected with monkeypox virus. We did a cross-sectional study in patients with monkeypox confirmed by PCR who attended two health centres in Madrid, Spain. For each patient, we collected samples of saliva, exhaled droplets within a mask, and aerosols captured by air filtration through newly developed nanofiber filters. We evaluated the presence of monkeypox virus in the samples by viral DNA detection by quantitative PCR (qPCR) and isolation of infectious viruses in cell cultures. Between May 18 and July 15, 2022, 44 patients with symptomatic monkeypox attended two health centres in Madrid and were included in the study. All were cisgender men, with a median age of 35·0 years (IQR 11·3). We identified high loads of monkeypox virus DNA by qPCR in 35 (85%) of 41 saliva samples. Infectious monkeypox virus was recovered from 22 (67%) of 33 saliva samples positive for monkeypox virus DNA. We also found a significant association between the number of affected cutaneous areas or general symptoms and the viral load present in saliva samples. Droplets exhaled from patients with monkeypox, detected inside a mask, contained monkeypox virus DNA in 32 (71%) of 45 samples, with two of the 32 positive samples showing the presence of the infectious virus. Monkeypox virus DNA in aerosols, collected from the medical consultation room, were detected in 27 (64%) of 42 samples, despite patients wearing an FFP2 mask during the visit. Infectious virus was not recovered from aerosol samples. High levels of monkeypox virus DNA were identified in aerosols collected from a hospital isolation room housing a patient with monkeypox. The identification of high viable monkeypox virus loads in saliva in most patients with monkeypox and the finding of monkeypox virus DNA in droplets and aerosols warrants further epidemiological studies to evaluate the potential relevance of the respiratory route of infection in the 2022 monkeypox virus outbreak. EU, Consejo Superior de Investigaciones Científicas, and Ciberinfec.

The aim of this work was to investigate the phase behaviour and the structure of the n-hexane/water emulsions based on a nonionic, nontoxic and biocompatible surfactant, Tween 80. This system is of interest for new pharmaceutical techniques based on supercritical fluids to form nano- and encapsulated particles. However, it showed a lack of stability denoted by large areas of macroemulsion. For this reason, the effect of additives (alcohols and brine) and external variables (temperature) were explored. The replacement of water by brine caused negligible impact due to the nonionic character of Tween 80. On the contrary, the presence of an alcohol (ethanol or 1-butanol) enhanced the solubility of the surfactant in the oil phase and decreased the mixture viscosity, resulting in improved surface activity. Similar results were obtained by raising the temperature until the cloud point was reached (60°C). With these modifications, microemulsions at relatively low concentrations of surfactant (around 30%) and within a broad interval of compositions could be obtained, widening their possible use in pharmaceuticals manufacturing (such as controlled drug delivery, enzymatic reactions, or excipient processing). The understanding of the surfactant performance could be further used to substitute the n-hexane by a greener solvent, such as supercritical CO₂.

In this study, novel active films made of poly(ε-caprolactone) (PCL) containing a solid dispersion of sage extract (SE) were developed by means of the electrospinning technique and subsequent annealing treatment. Initially, the antioxidant and antimicrobial potential of SE was confirmed. Thereafter, the effect of SE incorporation at different loading contents (5%, 10%, and 20%) on the physicochemical and functional properties of the films was evaluated. The films were characterized in terms of morphology, transparency, water contact angle, thermal stability, tensile properties, water vapor, and aroma barrier performances, as well as antioxidant and antimicrobial activities. Thin, hydrophobic films with good contact transparency were produced by annealing of the ultrathin electrospun fibers. Interestingly, the effect of SE addition on tensile properties and thermal stability of the films was negligible. In general, the water vapor and aroma permeability of the PCL-based films increased by adding SE to the polymer. Nevertheless, a strong 2,2-diphenyl-1-picrylhydrazyl (DPPH^·) free radical scavenging ability, and a strong activity against foodborne pathogens Staphylococcus aureus and Escherichia coli were achieved by SE incorporation into PCL matrix. Overall, the obtained results suggest great potential of the here-developed PCL-based films containing SE in active food packaging applications with the role of preventing oxidation processes and microbial growth.