Monkeypox likely spread through sex at two raves in Europe, expert says

LONDON β€” A top adviser to the World Health Organization has described the unprecedented outbreak of the rare disease monkeypox in developed countries as “a random event” that could be explained by sexual or physical contact during two recent mass events in Europe.

In an interview with the Associated Press, Dr David Heymann, who previously headed the emergency department at the WHO, said the main theory explaining the spread of the disease was sexual transmission among gay and bisexual men during two raves organized in Spain and Belgium. Monkeypox has yet to cause widespread epidemics beyond Africa, where it is endemic in animals.

“We know that monkeypox can be spread through close contact with the lesions of an infected person, and it appears sexual contact has now amplified that transmission,” Heymann said.

This marks a significant departure from the disease’s typical spread pattern in West and Central Africa, where people are mainly infected by animals like wild rodents and primates and outbreaks have not spread across borders. .

To date, the WHO has recorded more than 90 cases of monkeypox in a dozen countries including Britain, Spain, Israel, France, Switzerland, the United States and Australia.

Madrid’s top health official said on Monday that the Spanish capital had recorded 30 confirmed cases so far. Enrique Ruiz Escudero said authorities are investigating possible links between a recent Gay Pride event in the Canary Islands, which drew some 80,000 people, and cases at a Madrid sauna.

Heymann chaired an urgent meeting of the WHO’s Infectious Disease Threats Advisory Group on Friday to assess the ongoing outbreak and said there was no evidence to suggest monkeypox could have mutated into a more infectious form.

Monkeypox usually causes fever, chills, rashes, and lesions on the face or genitals. It can be spread through close contact with an infected person or their clothing or bedding, but sexual transmission has not yet been documented. Most people recover from the disease within a few weeks without requiring hospitalization. Vaccines against smallpox, a related disease, are also effective in preventing monkeypox, and some antiviral drugs are under development.

In recent years, the disease has been fatal in up to 6% of infections, but no deaths have been reported among current cases. The WHO said the confirmed cases were the least severe group of monkeypox viruses in West Africa so far and appeared to be linked to a virus that was first detected in cases exported from Nigeria. to Great Britain, Israel and Singapore in 2018-2019.

The UN agency said the outbreak was “a very unusual occurrence” and said the fact that cases are being seen in so many different countries suggests the disease may have been spreading silently for some time. weather. The agency’s European director warned that as summer begins across the continent, mass gatherings, festivals and parties could accelerate the spread of monkeypox.

Other scientists have pointed out that it will be difficult to determine whether it was sex itself or close sex-related contact that led to the recent spread of monkeypox across Europe.

“By nature, sexual activity involves intimate contact, which would be expected to increase the likelihood of transmission, regardless of a person’s sexual orientation and regardless of the mode of transmission,” said Mike Skinner, a virologist at Imperial College London.

On Sunday, the UK Health Security Agency’s chief medical adviser, Dr Susan Hopkins, said she expected more cases of monkeypox to be identified in the country “on a daily basis”.

UK officials have said a “notable proportion” of cases in Britain and Europe have been in young men with no travel history to Africa who are gay, bisexual or have sex with men. Authorities in Portugal and Spain also said their cases involved men who primarily had sex with other men and whose infections were detected when they sought help for lesions at sexual health clinics. .

Heymann, who is also a professor of infectious diseases at the London School of Hygiene and Tropical Medicine, said the monkeypox outbreak was likely a random event that could be traced to a single infection.

β€œIt is very possible that someone was infected, developed sores on their genitals, hands or elsewhere, and then passed it on to others through close sexual or physical contact,” the report said. Heymann’s hypothesis. “And then there were these international events that sowed the epidemic all over the world, in the United States and in other European countries.”

He stressed that the disease was unlikely to trigger widespread transmission.

“It’s not Covid,” he said. “We have to slow it down, but it doesn’t spread through the air and we have vaccines to protect against it.” Heymann said studies should be done quickly to determine if monkeypox could be spread by people without symptoms and that populations at risk of the disease should take precautions to protect themselves.

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