Sex at two Europe raves may explain unusual monkeypox outbreaks, says WHO expert

A longtime World Health Organization (WHO) infectious disease expert said the recent outbreaks of monkeypox may be explained by sexual transmission from two recent raves in Europe.

David Heymann, who chaired a meeting of the World Health Organization’s advisory group on infectious disease threats on Friday to discuss the outbreak, told The Associated Press that the raves held in Spain and Belgium are the leading theory to explain the disease’s recent unprecedented spread.

“It’s very possible there was somebody who got infected, developed lesions on the genitals, hands or somewhere else, and then spread it to others when there was sexual or close, physical contact,” Heymann said. “And then there were these international events that seeded the outbreak around the world, into the U.S. and other European countries.”

Heymann called the outbreaks “a random event.”

Monkeypox has remained endemic in animals in areas of Africa, a main source of outbreaks in the region that does not usually spread across borders. 

But now, recent cases in the U.S. and Europe have caused concern. Belgium, the site of one of the raves, has implemented a mandatory three-week quarantine for confirmed patients, but President Biden said he doesn’t expect the U.S. to follow suit.

Heymann, who also serves as a professor of infectious diseases at the London School of Hygiene and Tropical Medicine, also pointed to the smallpox vaccine, which is shown to be highly effective against monkeypox infection.

“This is not COVID,” Heymann told the AP. “We need to slow it down, but it does not spread in the air and we have vaccines to protect against it.”

Massachusetts public health officials last week confirmed a case of monkeypox in a person who had recently traveled to Canada, followed by a confirmed case in New York City and a suspected case in Broward County over the weekend.

The cases have left infectious disease experts perplexed as they investigate the sources of the outbreaks. WHO said on Saturday that the cases — which span 12 nonendemic countries — have mainly been identified among men who have sex with men and sought diagnoses in primary care and sexual health clinics.

In total, WHO said it is tracking 92 confirmed cases and 28 possible cases.

“However, the extent of local transmission is unclear at this stage, as surveillance has been limited,” the WHO said in its statement. “There is a high likelihood of identification of further cases with unidentified chains of transmission, including in other population groups.”

Monkeypox is spread through close contact with an infected animal or person, generally through lesions, body fluids, respiratory droplets and contaminated materials, like clothing and bedsheets.

Germany has four confirmed cases linked to exposure at parties “where sexual activity took place” in Spain’s Canary Islands and Berlin, the AP reported.

“Many of these global reports of monkeypox cases are occurring within sexual networks,” said Inger Damon, the director of the Centers for Disease Control and Prevention’s poxvirus research division, which includes monkeypox.

“However, healthcare providers should be alert to any rash that has features typical of monkeypox. We’re asking the public to contact their healthcare provider if they have a new rash and are concerned about monkeypox,” she said.