Monkeypox spread likely “amplified” by sex at two raves in Europe, says a senior WHO adviser

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A senior adviser to the World Health Organization described the unprecedented outbreak of the rare disease monkey pox in developed countries as a “random event” that could be explained by risky sexual behavior at two recent mass gatherings in Europe.

In an interview with The Associated Press, Dr. David Heymann, formerly head of WHO’s emergency department, said the leading theory to explain the spread of the disease was sexual transmission among gay and bisexual men at two raves in Spain and Belgium. Monkeypox has not yet caused widespread outbreaks outside of Africa, where it is endemic in animals.

“We know that monkeypox can spread when there is close contact with an infected person’s lesions, and it appears that sexual contact has now increased this transmission,” Heymann said.

This represents a marked departure from the disease’s typical pattern of spread in Central and West Africa, where humans are mainly infected by animals such as wild rodents and primates, and outbreaks have not spread beyond borders.

To date, the WHO has registered more than 90 cases of monkeypox in a dozen countries, including the UK, Spain, Israel, France, Switzerland, Australia and the US

According to the CDC, there is one in the USA so far confirmed case in Boston. There are also suspected cases in Broward County, Florida, and New York City.

The virus is spread through body fluids, skin, and respiratory droplets. “It’s important to realize that this virus really requires close personal contact,” said Dr. Anne Rimoin, professor of epidemiology at the UCLA Fielding School of Public Health. She told CBS News senior medical correspondent Dr. Jon LaPook says it’s unusual that we see cases in multiple countries at once: “We’ve never seen that before.”

Madrid’s top health official said on Monday that the Spanish capital had registered 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 about 80,000 people, and cases at a sauna in Madrid.

Heymann chaired an urgent meeting of the WHO advisory group on infectious disease threats on Friday to assess the ongoing epidemic and said there was no evidence monkeypox may have mutated into a more contagious form.

Monkeypox typically causes fever, chills, a rash, 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 being developed.

In recent years, the disease has been fatal in up to 6% of infections, but no fatalities have been reported among the current cases. The WHO said confirmed cases so far had been the less severe West African group of monkeypoxviruses and appeared to be linked to a virus first detected in cases exported from Nigeria to the UK, Israel and Singapore in 2018-2019.

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

Other scientists have cautioned that it will be difficult to distinguish whether it is sex itself or close contact related to sex that drove the recent spread of monkeypox in Europe.

“Sexual activity inherently 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’s Health Security Agency’s chief medical adviser, Dr. Susan Hopkins expects more cases of monkeypox to be identified in the country “every day”.

British officials said “a significant proportion” of cases in the UK and Europe involved young men with no history of travel to Africa who are gay, bisexual or who 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 picked up while seeking 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 fortuitous event that could be traced back to a single infection.

“It’s very possible that someone became infected, developed lesions on their genitals, hands or elsewhere, and then transmitted them to others through sexual or close physical contact,” Heymann suspected. “And then there were these international events that triggered the outbreak around the world, to the US and other European countries.”

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

“This is not COVID,” he said. “We need to slow it down, but it’s not airborne and we have vaccines to protect against it.” Heymann said studies should be done quickly to determine whether monkeypox could be spread by people with no symptoms, and that populations at risk for the disease should take precautions to protect themselves.

dr CBS News’ LaPook agreed.

“This should be taken seriously, and it is taken seriously by public health officials,” LaPook said. “But remember, this is very different from COVID. When the pandemic started, SARS CoV-2, the virus that causes COVID, we didn’t know anything about it, it was a brand new virus. We didn’t have any therapeutics, we didn’t have any vaccines, we didn’t know anything about this disease.

“It’s very different. We have known about monkeypox for more than 60 years. There are vaccines, there are therapeutics, we have a lot of experience with them, certainly in Africa.”

He also noted: “At the beginning of the pandemic, it spread without people realizing it; they were asymptomatic. [Monkeypox] has a characteristic rash. It would be hard for them to spread widely without us knowing about it.”



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