Monkeypox, A Suddenly-Widespread Infectious DiseaseAs of May 21, 2022, more than 80 cases of monkeypox have been reported in at least 12 countries in North America, Europe, and Australia.
Confirmed cases have been reported in nine European countries, including the United Kingdom, Spain, Portugal, Germany, Belgium, France, the Netherlands, Italy and Sweden, as well as in the United States, Canada, and Australia.
In general, monkeypox usually occurs in regions such as Central and West Africa, where there are hundreds of cases each year. However, most of these recent cases are not associated with Africa.
In the United Kingdom, for example, the first patient of monkeypox recently traveled to Nigeria in West Africa. However, almost none of the other confirmed cases in the United Kingdom had a history of travel to Africa.
The rash usually starts one to three days after the onset of fever and mainly appears on the face (95 percent), extremities (75 percent), oral mucosa (70 percent), genitalia (30 precent) and conjunctiva (20 percent), and the cornea is also affected. The rash changes through different stages, and it may resemble chickenpox. It eventually crusts over and then peels off.
Complications of monkeypox include bronchopneumonia, sepsis, encephalitis, corneal infections, and loss of vision. The extent to which asymptomatic infections may occur is not known.
Recent Outbreaks of Monkeypox May Have a New Mode of TransmissionWhat worries academics and health officials is not only the large number of cases of monkeypox in non-endemic countries, but also the fact that its current mode of transmission seems to be different from what was previously known.
- Touching an infected person’s lesions (rashes or scabs);
- Touching body fluids or respiratory secretions of an infected person;
- Touching clothes, bedding or towels used by a patient;
- Being in the vicinity of a coughing or sneezing person with monkeypox. However, it takes a long period of face-to-face contact to transmit the disease to others through droplets.
Nevertheless, there has been no previous record of sexual transmission of monkeypox.
Neil Mabbott, a disease expert at the University of Edinburgh, told the Associated Press that the recent cases suggest a potential new mode of transmission, that is, the virus can be transmitted sexually.
Keith Neal, an infectious disease epidemiologist at the University of Nottingham, said that the mode of transmission might not be sexual activity, but the transmission might be through “the close contact associated with sexual intercourse.”
The Risk of Infection is Higher for Gay, Bisexual People?Scientists are still studying whether or not the monkeypox epidemic is actually being transmitted through sexual behavior.
Dr. Agam Rao, a medical official at the Centers for Disease Control and Prevention (CDC), said that research was needed to isolate the virus from semen or vaginal fluid. Therefore, much work still needs to be done before confirming that monkeypox can be transmitted sexually.
Nevertheless, according to previous studies, sexual transmission of viruses is indeed more likely to occur among people who have male-to-male sex. This is consistent with the spread of monkeypox.
These groups are known to be at high risk for the following STDs: human papillomavirus (HPV), HIV, syphilis, chlamydia, gonorrhea, hepatitis B, and genital herpes.
These diseases are transmitted through sexual contact (without condoms) with an infected person, such as oral, anal, and vaginal intercourse, as well as genital skin contact. Other transmission channels include exposure to the patient’s blood or sharing needles with a patient.
The study has also shown that the susceptibility of the human body to viral attack is also related to different epithelial sites. Compared to the epithelium of the female and male genital organs, the anorectal epithelium has the highest probability of HIV transmission at 0.3 percent to 5 percent, while the oral mucosa has a lower probability.
Not only does the mode of sexual activity affect the risk of STDs, but the number of sexual partners is also associated with this risk.
Governmental ActionsAlthough the route of transmission of the new wave of monkeypox is still unclear, health officials in several countries have taken action.
The UK Health Security Agency has advised people, who are gay or bisexual or have sex with men, to be aware of any unusual rashes or lesions on genitalia and any other part of the body.
After the first local case of monkeypox was discovered, the authorities in the United States have also instructed health care providers to be aware of patients with monkeypox rashes, especially physicians who treat patients with sexually transmitted diseases.
Currently, there is no specific vaccine for monkeypox, but the smallpox vaccine provides 85 percent protection, because the two viruses are very similar. In addition, an antiviral drug used to treat smallpox has been approved for use in the treatment of monkeypox.