What Triggered Monkeypox And Is It Really Spreading Among Gay And Bi Men?

Experts have stressed that anyone can catch monkeypox, regardless of sexual orientation.
There are now more than 50 confirmed monkeypox cases in the UK
VioletaStoimenova via Getty Images
There are now more than 50 confirmed monkeypox cases in the UK

Monkeypox cases have climbed again, with 1,035 confirmed cases in the UK as of Sunday (June 26), and 4313 worldwide.

Although the virus was first detected decades ago, this sudden outbreak has caused some alarm, especially as many cases (but not all) have been reported among men who have sex with men.

As London Pride looks to celebrate its 50th anniversary this weekend, organisers are calling for anyone with symptoms not to attend.

But, it’s important to note that the virus has nothing to do with sexual orientation. Here’s what you need to know.

What is monkeypox?

Monkeypox is a rare virus often compared to smallpox, although it is significantly milder and less deadly.

Endemic in some west and central African countries, monkeypox can cause muscle aches, fever, chills, swollen lymph nodes, exhaustion and weakness, but most notably it usually triggers a rash across the skin.

This then develops into painful sores before scabbing over. The scabs will fall off but may leave a scar behind.

The virus usually starts to clear up on its own, and most people recover from monkeypox within two to four weeks without any long-lasting health implications.

It spreads through close physical contact and sharing infected items such as bedding, clothing and utensils.

The strain which has started to spread across Europe, Australia and North America has a low fatality rate of 1% according to Reuters news agency.

The World Health Organisation has reported one death from this outbreak so far and there is no evidence to suggest this strain had mutated into a more infectious form as yet.

The stages of monkeypox lesions, according to the UKHSA
UK Health Security Agency via PA Media
The stages of monkeypox lesions, according to the UKHSA

So, what has triggered this outbreak?

The exact details surrounding this outbreak’s origins remain uncertain at the moment. As the disease is endemic in animals in Africa, the virus’ spread to other parts of the world has surprised experts.

World Health Organisation (WHO) director for Global Infectious Hazard Preparedness, Sylvie Briand, has suggested it has been driven by a return to socialising as the Covid restrictions are lifted around the world.

A different leading adviser to WHO came up with a more specific idea, speculating that it could be traced back to two large events in Europe.

Dr David Heymann, the former head of WHO’s emergencies department, told the Associated Press that there is a theory the virus spread through sexual transmission at raves in Spain and Belgium.

He said: “We know 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.”

WHO has warned that, as cases have been reported across so many countries at the same time, that the virus may have been silently spreading for a short while – and it could be accelerated by more festivals and parties this summer.

Heymann also speculated that the outbreak could be traced back to a single infection.

“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,” he said.

“And then there were these international events that seeded the outbreak around the world, into the US and other European countries.”

Are men who have sex with men at higher risk?

No – anyone can catch monkeypox.

The majority of known cases so far have been among men who have sex with men who went to sexual health clinics after spotting their lesions, but anyone who is in close contact with an infected individual – and that includes their clothing or bedding – can be infected as well.

Those at a higher risk of contracting monkeypox are actually children under the age of five, pregnant people and the immunocompromised, according to the infection registrar Jamie Murphy, who created a Twitter thread about the disease.

If it’s not an STI, why is it linked to sex?

Experts have also been clear to differentiate that monkeypox spreads through close physical contact (which can include sex) but is not at the moment classified as a sexually transmitted infection.

Mike Skinner, a virologist at Imperial College London, told AP: “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.”

Similarly, the European Centre for Disease Prevention and Control director, Andrea Ammon, said earlier this week: “The likelihood of further spread of the virus through close contact, for example, during sexual activities among persons with multiple sexual partners, is considered to be high.”

Germany previously reported four confirmed cases connected to exposure at “party events” where “sexual activity took place” in Spain’s Canary Islands and in Berlin, according to a government report for lawmakers obtained by AP.

Meanwhile, Spain’s health minister Enrique Ruiz Escudero said the authorities are also looking into links between a Gay Pride event in the Canary Islands where there were 80,000 people, and cases stemming from a Madrid sauna.

Is there wider cause for concern right now?

Heymann reminded AP that “this is not Covid”, as monkeypox does not spread in the air and the smallpox vaccine has been shown to provide 85% protection against it.

This jab is already being offered to healthcare staff looking after monkeypox cases and to those exposed to confirmed cases, according to AP.

But, Heymann suggested that studies should be conducted quickly to find if it could be spread by people without symptoms, and how those at risk of the disease should be protected.

WHO has repeatedly said the virus is “containable”, although Briand said experts were not sure if it was “the tip of the iceberg” or if the peak had already passed.

WHO is closely monitoring the situation, and are looking to understand the incubation period of the virus.

The overall risk level is considered “moderate at a global level”, according to WHO, but “high in the European region”.

If you think you have monkeypox ...

You’ll have to do a PCR test similar to the Covid test. For monkeypox, it involves three swabs, two for the skin, and a throat swab.

You are still allowed to travel on public transport if you suspect monkeypox, but wear a mask and cover any lesions.

If you need to isolate, do not share a bathroom if you can avoid it and isolate in one room. Make sure not to share bedding or towels, avoid contact with your pets and have no sexual contact. Try to avoid other communal spaces, too, like the kitchen.