Monkeypox will not become a pandemic, but many unknowns, says the World Health Organization

In a public session on Monday, Dr. WHO’s Rosamund Lewis said it was important to emphasize that the vast majority of cases seen in dozens of countries worldwide involve gay, bisexual or men who have sex with men so that scientists can further investigate the problem and for vulnerable populations to take precautions.

“It is very important to describe this as it appears to be an increase in a transmission route that may have been under-recognized in the past,” said Lewis, WHO technical director for monkeypox.

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However, she warned that everyone is at potential risk for the disease, regardless of their sexual orientation. Other experts have suggested that it may be coincidental that the disease first caught on in gay and bisexual men, saying it could quickly spread to other groups if left unchecked. To date, 23 countries that have never had monkeypox have reported more than 250 cases, according to the WHO.

Lewis said it was not known whether monkeypox was transmitted through sex or just through close contact between people engaging in sexual activity, describing the threat to the general population as “low”.

“It is not yet known if this virus uses a new mode of transmission, but it is clear that it continues to use its known mode of transmission, which is close, physical contact,” Lewis said. Monkeypox is known to spread through close physical contact with an infected person or their clothing or bedding.

She also warned that among current cases, there is a higher proportion of people with fewer lesions that are more concentrated in the genital area and sometimes almost impossible to see.

“You can have these lesions for two to four weeks (and) they may not be visible to others, but you can still be contagious,” she said.

Last week, a top WHO adviser said the outbreak in Europe, the US, Israel, Australia and beyond was likely linked to sex at two recent raves in Spain and Belgium. This is a marked departure from the disease’s typical pattern of spread in central and western Africa, where humans are primarily infected by animals such as wild rodents and primates, and epidemics have not swept across borders.

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Most monkeypox patients experience only fever, body aches, chills, and fatigue. People with more severe illnesses can develop a rash and lesions on the face and hands, which can spread to other parts of the body. No deaths have been reported in the current outbreak.

The WHO’s Lewis also said that while previous cases of monkeypox in central and west Africa have been relatively contained, it’s not clear whether people can spread monkeypox without symptoms or whether the disease is airborne like measles or COVID-19 could.

Monkeypox is related to smallpox but has milder symptoms. After smallpox was declared eradicated in 1980, countries suspended their mass vaccination programs, a move some experts believe could help spread monkeypox since there is now little widespread immunity to related diseases; Smallpox vaccines also protect against monkeypox.

Lewis said it would be “unfortunate” if monkeypox was able to “exploit the immunity gap” left by smallpox 40 years ago and said there was still a window of opportunity for the outbreak to end in order for it to spread Monkeypox would not establish itself in new regions.