Washington: Ninety-five percent of monkeypox cases were transmitted through sexual activity, according to the largest study to date, which also noted new clinical signs such as single genital lesions.
The research, published in the New England Journal of Medicine on Thursday, came as WHO experts debated whether the outbreak should be classified as a global health emergency, the loudest alarm it could issue.
Led by scientists at Queen Mary University of London, the new paper looked at 528 confirmed infections in 16 countries, between April 27 and June 24, 2022.
“It is important to stress that monkeypox is not a sexually transmitted infection in the traditional sense; it can be transmitted by any type of close physical contact,” first author John Thornhill said in a statement.
“However, our work indicates that most cases of transmission to date have been related to sexual activity – mainly, but not exclusively, among men who have sex with men,” he added.
“This research study increases our understanding of the ways in which it is spread and the groups in which it is spread which will help in the rapid identification of new cases and allow us to offer preventive strategies.”
Overall, 98 percent of those infected were gay or bisexual men, 41 percent had HIV and the average age was 38.
The average number of their sexual partners in the previous three months was five, and about a third of them are known to have visited on-site sex venues such as sex parties or saunas during the previous month.
Although sexual activity was behind most cases, the researchers emphasized in a statement that the virus can be spread by any close physical contact, such as respiratory droplets and possibly through clothing and other surfaces.
Many of those infected showed symptoms not previously associated with monkeypox, including single genital lesions and ulcers in the mouth or anus.
The authors said these are similar to those of sexually transmitted infections (STIs) and could lead to a misdiagnosis.
“The clinical results in this case series were reassuring,” the authors wrote.
“Most cases were mild and self-limiting, and there were no deaths. Although 13 percent of people were admitted to hospital, no serious complications were reported in the majority of those admitted.”
Monkeypox DNA was present in the semen of 29 of the 32 people tested, but it remains unclear whether this substance is able to transmit.
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