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“Sex between men, not skin contact, is fueling monkeypox.” – NBC NEWS, Aug 17, 2022
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“Anal and oral sex spread monkeypox. It’s spreading like an STI through gay men’s sexual networks.” Keren Landman, MD, VOX, Aug 17, 2022
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” It’s possible that, similar to HIV transmission, anal sex increases the risk of monkeypox transmission more than other types of sex.” – STANFORD MEDICINE, Aug 29, 2022
NATURE – A virulent strain of the monkeypox virus has gained the ability to spread through sexual contact, new data suggest. This has alarmed researchers, who fear a reprise of the worldwide mpox outbreak in 2022.
Evidence from past outbreaks indicates that this strain, called clade I, is more lethal than the one that sparked the 2022 global outbreak.
Clade I has for decades caused small outbreaks, often limited to a few households or communities, in Central Africa. Sexually-acquired clade I infections had not been reported before 2023.
But since then, a clade I strain with an apparent capacity for sexual transmission has caused a cluster of infections in a conflict-ridden region of the Democratic Republic of the Congo (DRC), in Central Africa.
A preprint posted on 15 April reports that 241 suspected and 108 confirmed infections are connected to this outbreak — and these numbers are probably a vast undercount because of limited testing capacity. Almost 30% of the confirmed infections were in sex workers.
Adding to the challenges, the region is facing a humanitarian crisis, and the DRC is contending with the aggressive spread of other diseases, such as cholera.
The combination means there is a “substantial risk of outbreak escalation beyond the current area”, says Anne Rimoin, an epidemiologist at the University of California, Los Angeles, who has worked on mpox outbreaks in the DRC since 2002.
Unheeded warnings
Monkeypox virus can cause painful, fluid-filled lesions on the skin and, in severe cases, death. (While the disease was renamed ‘mpox’ in 2022, the virus continues to be called ‘monkeypox virus.’)
The virus persists in wild animals in several African countries, including the DRC, and occasionally spills into people.
The first large reported outbreak with human-to-human transmission, which was in 2017 in Nigeria, caused more than 200 confirmed and 500 suspected cases of the disease.
Researchers warned at the time that the virus might have adapted to spread through sexual contact …
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