New Delhi: The unprecedented outbreak of monkeypox, the rare disease from Africa, in developed countries could have been caused by "risky sexual behaviour" at two recent mass rave parties in Europe, according to a leader adviser to the World Health Organization (WHO), The Associated Press (AP) reported.
Dr David Heymann, who formerly headed WHO's emergencies department, said in an interview with AP that the leading theory to explain the spread of monkeypox was sexual transmission among gay and bisexual men at two rave parties held in Spain and Belgium. Earlier, the monkeypox virus did not trigger widespread outbreaks behind Africa, where it is endemic in animals, an AP report said.
Monkeypox is a rare zoonotic disease (infectious disease that is transmitted between species from animals to humans or from humans to animals) caused by infection with monkeypox virus, and does not spread easily between people. Most people recover from monkeypox within a few weeks as it is usually a mild self-limiting illness. However, some individuals can suffer from severe illness.
Sexual Contact Has Now Amplified Transmission: Heymann
Quoting Heymann, the report said that 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 fact that sexual contact has now amplified the transmission of monkeypox 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 spread across borders.
The WHO has recorded more than 90 cases of monkeypox in a dozen countries including Britain, Spain, Israel, France, Switzerland, the US, and Australia, to date.
What Do Health Officials Of Different Countries Say?
On Monday, May 23, Madrid's senior health official, Enrique Ruiz Escudero, said that the Spanish capital has recorded 30 confirmed cases so far, according to the AP report. He also said that 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.
Last week, Heymann chaired an urgent meeting of WHO's advisory group on infectious disease threats in order to assess the ongoing epidemic. He said there was no evidence to suggest that Monkepox might have mutated into a more infectious form.
The WHO said the outbreak is "atypical", and stated that the fact that cases are being seen in so many different countries suggests the disease may have been silently spreading for sometime, according to the AP report. Also, WHO's Europe director warned that as summer begins across the continent, mass gatherings, festivals, and parties could accelerate the spread of monkeypox.
According to other scientists, it will be difficult to disentangle whether it is sex itself or the close contact related to sex that has driven the recent spread of monkeypox across Europe.
Quoting Mike Skinner, a virologist at Imperial College London, the report said that by nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person's sexual orientation and irrespective of the mode of transmission.
Dr Susan Hopkins, the chief medical adviser of Britain's Health Security Agency, recently said that she expected more monkeypox cases to be identified in the country "on a daily basis". According to UK officials, "a notable proportion" of the cases in Britain and Europe have been in young men with no history of travel to Africa and who are gay, bisexual, or have sexual intercourse with men.
The cases in Portugal and Spain were in men who mostly had sexual intercourse with other men and whose infections were picked up when they sought help for lesions at sexual health clinics, the countries' authorities said, according to the report.
Monkeypox Outbreak Was Likely A Random Event: Heymann
Heymann said the monkeypox outbreak was likely a random event that might be traceable to a single infection, and that it is very possible there was somebody who got infected, developed lesions on the genitals, hands, or somewhere else, and then spread it others when there was sexual or close, physical contact.
He added that there were international events that seeded the outbreak around the world, into the US, and other European countries, emphasising that the disease was unlikely to trigger widespread transmission.
"This is not COVID. We need to slow down, but it does not spread in the air and we have vaccines to protect against it," the AP report quoted Heymann as saying.
He also said that studies should be conducted rapidly 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.
What Has The WHO Said About Monkeypox?
In a statement dated May 21, 2022, the WHO said monkeypox cases reported so far have no established travel links to endemic areas. Cases have been reported to the WHO from 12 Member States that are not endemic for monkeypox, across three WHO regions, since May 13, 2022.
"Based on currently available information, cases have mainly but not exclusively been identified amongst men who have sex with men (MSM) seeking care in primary care and sexual health clinics," the WHO stated.
As many as 92 laboratory confirmed cases, and 28 suspected cases of monkeypox with investigations ongoing, have been reported to the WHO from 12 Member States not endemic for monkeypox virus, across three WHO regions, as of May 21, 13:00 CET (4:30 pm IST). Also, no associated deaths due to monkeypox have been reported to date.
According to the WHO, the identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area represents a highly unusual event. Human-to-human transmission is occurring among people in close contact with cases who are symptomatic.
Monkeypox endemic countries are: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan. In Ghana, monkeypox virus has been identified only in animals. In the past, Benin and South Sudan have documented importations. Cameroon and Nigeria are countries currently reporting cases of the West African clade. All countries except these four should report new cases of monkeypox as part of the current multi-country outbreak.