LONDON ( Associated Press) — A top adviser to the World Health Organization has described the unprecedented outbreak of the rare monkeypox in developed countries as a “chance event” that could be due to unsafe sex at two recent mass parties in Europe.
In an interview with The Associated Press, Dr. David Heymann, a former director of the WHO emergency department, said the main theory to explain the spread of the disease is sexual transmission between gay and bisexual men at two parties held in Spain and Belgium. Monkeypox has not caused large outbreaks in the past outside of Africa, where it is endemic in animals.
“We know that monkeypox can spread when there is close contact with the lesions of someone who is infected, and it now appears that sexual contact has amplified that transmission,” Heymann said.
That’s a significant change from the usual pattern of virus transmission in central and western Africa, where people are mainly infected by animals such as primates and wild rodents, and outbreaks have not spread across borders.
The WHO has so far recorded more than 90 cases of monkeypox in a dozen countries, including Britain, Spain, Israel, France, Switzerland, the United States and Australia.
Health authorities in Madrid noted that the Spanish capital has registered 30 confirmed cases so far. The regional Minister of Health, Enrique Ruiz Escudero, indicated that possible links between a recent Pride event in the Canary Islands attended by 80,000 people and a sauna in Madrid were being investigated.
Heymann chaired an urgent meeting of the WHO’s advisory committee on infectious disease threats on Friday to assess the epidemic, saying there is no evidence to suggest the virus may have molted into a more infectious form.
Monkeypox usually causes fever, chills, rash, and lesions on the face or genitals. It can be spread by close contact with an infected person, their clothes or their sheets, although sexual transmission has not been documented at this time. Most people recover from the disease in a few weeks without needing hospitalization. Vaccines against smallpox, a related disease, are also effective in preventing monkeypox, and antiviral drugs are in development.
The disease can be fatal in around 10% of infections, but no deaths have been reported in the current outbreak.
The WHO called the outbreak “atypical” and said the fact that cases are being seen in so many different countries suggests the disease may have been circulating undetected for some time. The director of the agency in Europe warned that with the arrival of summer on the continent, massive acts, festivals and parties could accelerate its spread.
Other scientists have pointed out that it may be difficult to tell whether it was sex itself or close contact associated with sex that has driven the recent monkeypox infections in Europe.
“By its nature, sexual activity involves intimate contact, something that one would expect 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.
The chief medical adviser to the British Social Security Agency, Dr Susan Hopkins, said she expected new cases of monkeypox to be identified in the country “every day”.
British authorities have said that “a notable proportion” of the cases in Britain and Europe are young men with no history of travel to Africa and who are gay, bisexual or have had sex with men. Authorities in Portugal and Spain also said their patients were men who had mostly had sex with men and whose infections were identified when they went to sexual health clinics to seek help for their injuries.
Heymann, who is also a professor of infectious diseases at the London School of Hygiene and Tropical Medicine, said the outbreak is likely a chance event that could be traced to a specific infection.
“It is very possible that there was someone who became infected, developed lesions on the genitals, hands or elsewhere, and then spread it to others when there was sexual or close physical contact,” Heymann said. “And then there were these international events that started the outbreak around the world, in the United States and other European countries.”
He noted that the disease is unlikely to cause widespread contagion.
“This is not COVID,” he said. “We have to stop it, but it doesn’t spread through the air and we have vaccines that protect against it.”
Heymann said studies should be done quickly to determine if monkeypox could be spread through asymptomatic people, and the population at risk should take precautions to protect themselves.