Expert: Monkeypox likely spread by sex at 2 raves in Europe
LONDON (AP) — A leading adviser to the World Health Organization described the unprecedented outbreak of the rare disease monkeypox in developed countries as “a random event” that might be explained by risky sexual behavior at two recent mass events in Europe.
In an interview with The Associated Press, Dr. David Heymann, who formerly headed WHO’s emergencies department, said the leading theory to explain the spread of the disease was sexual transmission among gay and bisexual men at two raves held in Spain and Belgium. Monkeypox has not previously triggered widespread outbreaks beyond Africa, where it is endemic in animals.
“We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission,” said Heymann.
That marks a significant departure from the disease’s typical pattern of spread in central and western Africa, where people are mainly infected by animals like wild rodents and primates and outbreaks have not spilled across borders.
A German government report to lawmakers, obtained by the AP, said it expected to see further cases and that the risk of catching monkeypox "mainly appears to lie with sexual contacts among men.”
The four confirmed cases in Germany have been linked to exposure at “party events including on Gran Canaria and in Berlin, where sexual activity took place,” it said.
To date, WHO has recorded more than 90 cases of monkeypox in a dozen countries including Britain, Spain, Israel, France, Switzerland, the U.S. and Australia. On Monday, Denmark announced its first case, Portugal revised its total upwards to 37 and Italy reported one further infection.
Madrid’s senior health official said on Monday that the Spanish capital has 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 WHO’s advisory group on infectious disease threats on Friday to assess the ongoing epidemic and said there was no evidence to suggest that monkeypox might have mutated into a more infectious form.
Monkeypox typically causes fever, chills, rash, and lesions on the face or genitals. It can be spread through close contact with an infected person or their clothing or bedsheets, but sexual transmission has not yet been documented. Most people recover from the disease within several 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 deaths have been reported among the current cases. WHO said confirmed cases have so far been the less severe West African group of monkeypox viruses and appeared to be linked to a virus that was first detected in exported cases from Nigeria to Britain, Israel and Singapore in 2018-2019.
While not considered a sexually transmitted disease, monkeypox is spread through close contact.
BY ALEX COOPER
MAY 23 2022
Spanish health authorities believe that a string of new monkeypox cases is linked to a gay sauna near Madrid and a Pride event in the Canary Islands that drew tens of thousands of people.
Spain announced 23 new cases Friday. Madrid regional health chief Enrique Ruiz Escudero told journalists that health officials have been tracing the cases from an outbreak at the now-closed sauna, Reuters reports.
"The Public Health Department will carry out an even more detailed analysis... to control contagion, cut the chains of transmission and try to mitigate the transmission of this virus as much as possible," Escudero said.
He told the Associated Press that another link may be a Pride event in the Canary Islands that saw around 80,000 people in attendance, the news wire reported Monday.
Elsewhere in Europe, an outbreak of monkeypox in Belgium has been connected to visitors at the Darklands fetish festival in early May, PinkNews reports.
At least three cases have been linked to the festival, according to the organizers.
“There’s reason to assume that the virus has been brought in by visitors from abroad to the festival after recent cases in other countries,” they said in a statement.
While many of the recent cases of monkeypox are among men who have sex with men, Dr. Agam Rao, a medical officer at the Centers for Disease Control and Prevention's Division of High Consequence Pathogens and Pathology, told NBC News that monkeypox isn’t considered a sexually transmitted disease.
“It’s probably premature and potentially even harmful to assume that there are only cases within that community,” she said. “There's going to need to be studies related to trying to isolate virus from seminal fluid or vaginal fluid. There’s really quite a lot of work that would need to be done before we would say that it can be transmitted sexually.”
However, the former head of the World Health Organization told the AP, “We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission.”
The illness is endemic in animals in central and western Africa, according to the news wire.
Last Wednesday, Massachusetts confirmed the first confirmed case of monkeypox in the U.S. this year.
“The Massachusetts Department of Public Health (DPH) today confirmed a single case of monkeypox virus infection in an adult male with recent travel to Canada,” the department said in a statement.
In a statement last week, Dr. Hans Kluge, the WHO regional director for Europe, said that the new cases that have emerged in the U.S., Europe, and elsewhere, have been “atypical.”
“Firstly, because in this instance all but one of the recent cases have no relevant travel history to areas where monkeypox is endemic, in West Africa or Central Africa. Secondly, because most of the initial cases found are being detected through sexual health services and are among men who have sex with men. And thirdly, because of the geographically dispersed nature of the cases across Europe and beyond, this suggests that transmission may have been ongoing for some time,” he said.
Kluge added that the WHO is troubled over the summer season’s festivals and parties.
“I am concerned that transmission could accelerate, as the cases currently being detected are among those engaging in sexual activity, and the symptoms are unfamiliar to many,” Kluge said.
Monkeypox is a zoonotic orthopoxvirus that appears similar to smallpox, although significantly less deadly. Most outbreaks in Europe and elsewhere in the Western Hemisphere are related to the exotic pet trade and international travel.
Initial symptoms of the monkeypox virus include fever, headache, myalgia, fatigue, and swelling of the lymph nodes. After one to two days, lesions may develop in the mouth and later the face and extremities like the palms and soles. The rash may further spread, and the number of lesions can range from just a few to thousands.
Andrew Marquardt
Mon, May 23, 2022
Melina Mara/The Washington Post — Getty Images
Monkeypox, a potentially lethal disease responsible for an alarming rise in cases in North America and Europe over the past three weeks, is primarily spreading through sex between men, according to the World Health Organization.
The disease is spread through close contact with infected people, animals, or materials that are contaminated with the virus. It enters the body through broken skin, the respiratory tract or through the eyes, nose or mouth, according to the CDC.
The virus is not considered a sexually transmitted infection, or spread through semen and vaginal fluids, WHO officials noted. Anyone in close contact with a person who has the virus is considered at high risk of infection, however.
“Many diseases can be spread through sexual contact. You could get a cough or a cold through sexual contact, but it doesn’t mean that it’s a sexually transmitted disease,” Andy Seale, an adviser to the WHO about HIV, hepatitis and other sexually transmitted infections, told CNBC.
In response to the rising number of monkeypox cases worldwide, Bavarian Nordic, a Danish vaccine manufacturer, is ramping up production of its smallpox vaccine to help governments fight the growing outbreak, according to a Wall Street Journal report.
As of May 21, 92 confirmed cases and 28 suspected cases of monkeypox have been reported to the WHO from 12 countries, including the U.S., Australia, Germany, and Spain.
In the U.S., Centers for Disease Control and Prevention officials told Fortune last week that health officials are monitoring six people for suspected cases of monkeypox, all of whom sat next to a person on a May 3-4 flight from Nigeria to London who eventually developed the virus.
Monkeypox is a rare disease related to smallpox and cowpox that causes fever, muscle aches, and lesions. The incubation period, or time between exposure and the onset of symptoms, is usually a week or two but can range from five to 21 days, according to the CDC.
In Africa, where the disease is typically found, monkeypox has proven deadly in as many as 10% of infected persons, the CDC notes. The illness typically lasts anywhere between two and four weeks.
While there is no vaccine that specifically targets monkeypox, smallpox vaccines including the one offered by Bavarian Nordic, can protect against monkeypox infections by at least 85%, according to the CDC.
Known as Jynneos in the U.S., the Bavarian Nordic smallpox vaccine is one of two vaccines currently licensed in the U.S. to prevent smallpox, according to the CDC. It is the only vaccine that the U.S. specifically licenses to prevent monkeypox, however.
Speaking to the Wall Street Journal, Bavarian Nordic CEO Paul Chaplin said the company has received calls from “dozens of countries” in recent weeks asking about Jynneos, which is known as Imvanex in Europe and Imvamune in Canada.
Supply of the vaccine is currently limited, but the company will be increasing its manufacturing in the weeks and months ahead, Chaplin told the Wall Street Journal.
“We feel confident based on discussions that we’ll be able to meet the demand in a relatively short period of time,” Chaplin said.
Speaking to reporters on Sunday, President Biden said the public should be concerned about the rising number of cases in the U.S. and abroad.
“They haven’t told me the level of exposure yet, but it is something that everybody should be concerned about,” Biden told reporters. “It is a concern in that if it were to spread, it would be consequential.”
On Monday, Biden backtracked those comments, saying the country has “vaccines to take care of it.”
"I just don't think it rises to the level of the kind of concern that existed with COVID-19,” Biden said.
According to Chaplin, the U.S. and Canada are the only two countries that have meaningful stockpiles of the Bavarian Nordic vaccines. The CDC says the U.S. has access to enough doses of smallpox vaccine to vaccinate every person in the United States if an outbreak were to occur.
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