An advisor to the World Health Organisation has said that the unprecedented current outbreak of monkeypox in Europe may have been caused by sexual activity at two raves.
Dr David Heymann, the former head of WHO's emergencies department, told The Associated Press that the leading theory on the spread of the disease was sexual transmission at raves held 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."
The findings are significantly different from the disease's typical spread pattern in central and western Africa.
Here the disease is mainly spread by infected animals such as wild rodents and primates.
Health officials have said that the majority of known cases in Europe have spread among men who have sex with men. However, scientists do not know whether the spread is being driven by sex or close contact, as the disease can infect anyone by being in close proximity to a sick person or their clothing or bedsheets.
The European Centre for Disease Prevention and Control Director Andrea Ammon said on Monday, "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."
WHO has now recorded more than 90 cases of monkeypox in countries including Britain, Spain, Israel, France, Switzerland, the U.S. and Australia.
On Monday, Denmark announced its first case, while Portugal reported a total of 37 cases, and Italy reported one further infection.
Germany now has four confirmed cases linked to exposure at "party events ... where sexual activity took place" in Spain's Canary Islands and in Berlin, according to a government report to lawmakers obtained by the Associated Press news agency.
Madrid's senior health official also confirmed 30 cases.
Enrique Ruiz Escudero said authorities are investigating possible links between a recent Gay Pride event in the Canary Islands, which drew some 80,000 people, and cases at a Madrid sauna.
In humans, the symptoms of monkeypox are milder than the symptoms of smallpox.
Monkeypox begins with fever, headache, muscle aches, and exhaustion.
The main difference between the symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not.
The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.
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