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19 Aug 2022

Research suggests Monkeypox is sexually transmitted.

Further work required but this could be an important step in helping us to minimise transmission.

Several months after community transmission of Monkeypox in non-endemic countries was established, the World Health Organisation has declared that the continuing spread of Monkeypox is now a public health emergency of international concern.
From a World Health Organisation perspective, that’s as serious as things get. It’s a big deal. The last time that the WHO declared a public health emergency of international concern – a PHEIC – was for the outbreak of Covid-19.
A PHEIC is defined by WHO as a public health risk that potentially requires a coordinated international response.
Based on the WHO’s current assessment, the risk globally is assessed as “moderate” while in Europe that risk is “high”.
The current data from WHO indicates over 16K confirmed monkeypox cases, spread across 75 countries. There have been five deaths recorded in connection to this current outbreak. Currently, most cases are in Europe.
As we have seen from the beginning of this outbreak, the WHO has confirmed that the majority of cases continues to be detected within men who have sex with men. Monkeypox is not a Sexually Transmitted Infection but it is spread by close or intimate contact and sex is a really effective way for Monkeypox to spread. There’s nothing about Monkeypox that limits it to men who have sex with men, it’s just that we’re the demographic that it’s made initial contact with.
The general consensus is that health agencies in countries such as the UK – which is pretty much the epicentre of this outbreak – has been slow. It now seems to be accepted that a vaccination programme is going to be the most effective way to navigate this outbreak. Availability of vaccines has been limited but is now ramping up.
Stay in touch with your local sexual health service and get vaccinated when a vaccine is available to you.
What is Monkeypox?
The name “monkeypox” comes from the first documented cases of the illness, in 1958, when two outbreaks occurred in colonies of monkeys kept for research.
But monkeys aren’t major carriers. Instead, the virus is generally spread by squirrels, pouched rats, dormice or another rodent.
How do you catch Monkeypox?
Primarily, from an animal bite, scratch or contact with the animal’s bodily fluid. Then the virus can spread to other people through coughing and sneezing or contact with pus from the lesions.
Symptoms are likely to appear somewhere between 5-21 days after exposure to the virus.
The lesions from monkeypox are similar to those from a smallpox infection.
It’s previously been thought that transmission of Monkeypox between people was a very low risk but this current outbreak appears to be spreading very effectively between people.
Health experts are speculating that the end of vaccination programs against Smallpox has left us vulnerable to a Monkeypox outbreak.
How dangerous is Monkeypox?
Monkeypox can be a nasty illness – it causes fever, body aches, enlarged lymph nodes and, eventually, painful, fluid-filled blisters on the face, hands and feet. One version of monkeypox is quite deadly and kills up to 10% of people infected. The version currently being detected from this cluster is milder. Its fatality rate is less than 1%. A case generally resolves in two to four weeks.
If you have it, you’ll probably need to isolate at home until you’ve recovered.
What should I do if I think I might have been exposed to Monkeypox?
If you notice any unusual rashes or lesions, and you think you might have been exposed to the virus through sexual contact, then contact your local sexual health service for advice.

With over 35,000 confirmed cases across some 92 countries, this outbreak of Monkeypox - first identified in April 2022 - is a global health issue. It's also a health issue that, so far, is primarily presenting in men who have sex with men.

To date, it's been established that a sexual encounter was often the point of transmission, but - given our past experience with Monkeypox - it was throught that this was through skin-to-skin contact or sweat or contact with bedclothes. However, new research suggests that this strain of the virus could be transmitting as a Sexually Transmitted Virus - similar to an STI.

The research has been published by researchers at the University of Southern California. It's not conclusive but does potentially help us to understand how this virus is impacting our community.

One of the key findings of this research is that Monkeypox DNA can be detected in bodily fluids such as semen.

While further studies are required, this latest research does seem to confirm that sexual encounters are where we are most at risk of being exposed to the virus. This seems to emphasise the importance of a comprehensive vaccination strategy that prioritises those most at risk.

What is Monkeypox?

The name “monkeypox” comes from the first documented cases of the illness, in 1958, when two outbreaks occurred in colonies of monkeys kept for research.

But monkeys aren’t major carriers. Instead, the virus is generally spread by squirrels, pouched rats, dormice or another rodent.

How do you catch Monkeypox?

The previous strains of Monkeypox that have been identified have been transmitted through contact with an animal that is carrying the virus - a scratch or a bite would be the most likely cause of someone acquiring Monkeypox. It could then spread to other people through coughing, sneezing, or contact with lesions.

The strain that is driving this current outbreak seems to be very effective at person-to-person transmission. It was clear that a sexual encounter was a highly effective way for the virus to spread - because of the amount of skin contact and body sweat - but evidence now also suggests that the virus could be transmitting as a form of STI.

Symptoms are likely to appear somewhere between 5-21 days after exposure to the virus.

The lesions from monkeypox are similar to those from a smallpox infection.

Health experts are speculating that the end of vaccination programs against Smallpox has left us vulnerable to a Monkeypox outbreak.

How dangerous is Monkeypox?

Monkeypox can be a nasty illness – it causes fever, body aches, enlarged lymph nodes and, eventually, painful, fluid-filled blisters on the face, hands and feet. One version of monkeypox is quite deadly and kills up to 10% of people infected. The version currently being detected from this cluster is milder. Its fatality rate is less than 1%. A case generally resolves in two to four weeks.

If you have it, you’ll probably need to isolate at home until you’ve recovered.

What should I do if I think I might have been exposed to Monkeypox?

If you notice any unusual rashes or lesions, and you think you might have been exposed to the virus through sexual contact, then contact your local sexual health service for advice.

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