Expert: Monkeypox likely spread through sex at 2 European raves
LONDON (AP) — 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 behavior at risk in 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. .
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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.
FILE – This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows oval-shaped mature monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. A prominent physician who chairs a World Health Organization expert panel has described the unprecedented outbreak of the rare disease monkeypox in developed countries as ” a random event” that could be explained by risky sexual behavior during two recent mass events in Europe. (Cynthia S. Goldsmith, Russell Regner/CDC via AP, File)
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 attracted 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 sores 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.
What is monkeypox and where is it spread?
What is monkey pox?
Monkeypox is a virus that comes from wild animals like rodents and primates, and sometimes jumps to humans. Most human cases have occurred in central and western Africa, where the disease is endemic.
The disease was first identified by scientists in 1958 when there were two outbreaks of a “pox-like” disease in research monkeys – hence the name monkeypox. The first known human infection dates back to 1970, in a 9-year-old boy in a remote region of Congo.
What are the symptoms and how is it treated?
Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.
Most patients experience only fever, body aches, chills, and fatigue. People with more severe illness may develop a rash and sores on the face and hands that may spread to other parts of the body.
The incubation period is about five days to three weeks. Most people recover in about two to four weeks without needing to be hospitalized.
Monkeypox can be fatal for up to 1 in 10 people and is thought to be more serious in children.
People exposed to the virus often receive one of several smallpox vaccines, which have been shown to be effective against monkeypox. Antiviral drugs are also being developed.
On Thursday, the European Center for Disease Prevention and Control recommended that all suspected cases be isolated and high-risk contacts offered the smallpox vaccine.
How many cases of monkeypox are there usually?
The World Health Organization estimates that there are thousands of monkeypox infections in a dozen African countries each year. Most are in Congo, which reports around 6,000 cases per year, and Nigeria, with around 3,000 cases per year.
Patchy health surveillance systems mean many infected people are likely to be missed, experts say.
Isolated cases of monkeypox are sometimes spotted outside of Africa, especially in the United States and Great Britain. Cases are usually associated with travel to Africa or contact with animals from areas where the disease is more common.
In 2003, 47 people in six US states had confirmed or probable cases. They caught the virus from pet prairie dogs that were housed near small mammals imported from Ghana.
How are these cases different?
This is the first time that monkeypox appears to have spread among people who have not traveled to Africa.
In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden. Most cases involve men who have had sex with men.
The UK Health Security Agency has said its cases are not all linked, suggesting there are multiple chains of transmission.
The infections in Portugal were detected at a sexual health clinic, where the men sought help for lesions on their genitals.
On Wednesday, US officials reported a case of monkeypox in a man who had recently traveled to Canada, where authorities are investigating possible infections.
Is monkeypox sexually transmitted?
It’s possible, but it’s not clear at the moment.
Monkeypox has not previously been documented to be spread sexually, but it can be transmitted through close contact with infected people, their bodily fluids, and their clothing or bedding.
Michael Skinner, a virologist at Imperial College London, said it was still too early to determine how men in the UK became infected.
“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,” Skinner said.
Francois Balloux of University College London said monkeypox said sex was the type of close contact needed to transmit the disease.
The UK cases “do not necessarily imply a recent change in the route of transmission of the virus”, Balloux said.
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Barry Hatton in Lisbon, Portugal, contributed to this report.
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.
“It 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.
Barry Hatton in Lisbon contributed to this report.
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