Monkeypox outbreak ‘triggered by sex at raves in Spain and Belgium’

A top adviser to the World Health Organization has described the unprecedented outbreak of monkeypox in developed countries as “a random event” that could be explained by sexual behavior at two recent raves in Europe.

Dr David Heymann, who previously headed the WHO’s emergency department, told The Associated Press that the main theory explaining the spread of the disease was sexual transmission at raves 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 that sexual contact has now amplified this transmission,” Dr 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. .

Health officials say most known cases in Europe are in men who have sex with men, but anyone can become infected through close contact with a sick person, their clothes or their bedding. Scientists say it will be difficult to establish whether the spread is due to sex or just close contact.

“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 Monday, the director of the European Center for Disease Prevention and Control, Andrea Ammon, said that “the likelihood of further spread of the virus through close contact, for example during sexual activity between people with multiple sexual partners, is considered high”.

The WHO has recorded more than 90 cases of monkeypox in a dozen countries including Canada, Spain, Israel, France, Switzerland, the United States and Australia. On Monday, Denmark announced its first case, Portugal revised its total to 37, Italy reported a new infection and Britain added 37 more cases.

According to a government report obtained by the AP, Germany has four confirmed cases linked to exposure at “festive events…where sexual activity took place” in Spain’s Canary Islands and Berlin.

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

So far, cases of monkeypox have been mild, with no deaths reported. Typically, the virus causes fever, chills, rashes, and sores on the face or genitals. Most people recover within a few weeks without requiring hospital treatment.

Vaccines against smallpox, a related disease, are 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.

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

The UN agency said the outbreak was “a very unusual occurrence” and said the fact that cases are being seen in so many countries suggests the virus may have been spreading silently for some time. weather. The agency’s Europe director has warned that festivals and parties could accelerate the spread.

In a town hall on Monday, WHO officials called the outbreak “controllable” and warned against stigmatizing affected groups, saying the disease can infect anyone.

The agency said the cases appeared to be linked to a monkeypox virus first detected in cases exported from Nigeria to Britain, Israel and Singapore in 2018 and 2019.

Authorities in Britain, Spain and Portugal have said most of the cases identified so far have been in young men whose infections were detected when they sought help for lesions at sexual health clinics.

Dr 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’s very possible that someone got infected, developed sores on their genitals, hands or elsewhere, and then passed it on to others through close sexual or physical contact,” he said. -he declares. “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 is 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.”

Dr Heymann said studies should be done quickly to determine if monkeypox could be spread by people without symptoms and that populations at risk of contracting the disease should take precautions to protect themselves.

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