Sex between men transmits more monkeypox than skin contact, studies conclude

Fila de vacinação contra varíola de macaco
Monkeypox Vaccination Queue in Los Angeles, California on August 4, 1200 .| Photo: EFE / EPA / ETIENNE LAURENT

18210921Despite an initial focus on transmission by bodily fluids such as saliva and skin contact since the outbreak began in May, there is increasing increasingly clear that the flagship of the transmission of apepox is sex between men.

The first more rigorous suggestion of this was made in July by an article in the medical journal NEJM, which found that 98% of those infected (in a sample of more than 500 in countries) were gay or bisexual men . However, the journal did not directly assess that the mode of transmission was sex, although the authors have expressed suspicion that this was the case in 67% of cases. They found monkeypox orthopoxvirus in the seminal fluid of a small group of men.18210921 This month, another article about it was published in the medical journal The Lancet. The sample was smaller (70 Spanish patients), but the authors were more thorough in the interviews and the assessment of viral load by body area. It is noteworthy that none of the patients traveled to endemic regions where the virus circulates in wild animals. None of the patients had a history that was not compatible with risky sexual activity, and specific lesions were found associated with receptive anal or oral sex. Most have skin rashes caused by the virus concentrated in genital, oral and anal areas.

A third article in the BMJ medical journal, with almost 98 patients in London confirms the pattern: the overwhelming majority are men who have sex with men, and the lesions that transmit the virus were more concentrated in the genital and perianal area.

According to the World Health Organization, three quarters of global monkeypox cases are among men among 18 and 44 years old. This age group is typical for other sexually transmitted diseases among gay and bisexual men. Furthermore, nearly a third of cases are co-occurrence with “classic” sexually transmitted infections. Anogenital and oral lesions, which are more than 70% of lesions , may reflect not a preference of the virus, but the locations where it first entered each organism. Public health policies to contain the outbreak have not yet been updated according to this evidence.

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