Researchers are puzzling as to how the new monkeypox outbreak with a completely new distribution pattern came about. The virus suddenly spreads from person to person, in Europe, the USA, Canada. More than 330 cases in over 20 countries have now been confirmed. They are obviously not related to West and Central Africa, the previous distribution areas. They can also no longer be traced back to contagion in rodents – which was the norm up to now. So what has changed?
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Researchers are pursuing different approaches. The virus could, for example, use other transmission routes than before. It could not only spread through droplets, smear infections and infectious smallpox on the skin, but possibly also through other body fluids – such as blood, semen and vaginal secretions. So far, however, the data is sparse, there are only isolated indications. And it’s not the only theory either.
Monkeypox virus detected in semen
The structure of the virus could also have changed, for example. Similar to the corona virus, it could have become more transmissible with the help of mutations, i.e. infect more people faster. So far, however, monkeypox has actually been considered to be sluggish. “So far we have not seen any groundbreaking changes in the genome,” says Roman Wölfel, who analyzes genome sequences of the first people infected with monkeypox in Germany at the Bundeswehr Institute for Microbiology. The laboratory experiments are not yet complete.
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Studies are also being carried out on conceivable transmission routes, including in Germany. The first sick people in this country have now been examined more closely. “In addition to the classic smear infection and droplets, we were also able to detect the virus in sperm,” reports infectiologist Clemens Wendtner. He is currently caring for two people infected with monkeypox at the Munich Clinic in Schwabing. “We are also dealing with a sexually transmitted disease,” says the chief physician.
In fact, the virus concentration in the semen was higher than in the blood, says microbiologist Wölfel, who is involved in the investigations. It is not yet clear whether and for how long the infectious virus could be detected. The virus has not yet been detected in urine.
Also soon discovered infections in women?
Wölfel also emphasizes: “Sexuality does not only have something to do with the transmission of seminal fluid.” According to everything that is known so far, the monkeypox virus spreads throughout the body. And even if at the moment it is mainly men with monkeypox infections that are appearing – according to Wendtner, it is likely that infections in women will also be discovered in the near future.
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The risk is not limited to people who are sexually active or men who have sex with men.
Robert Koch Institute
The Robert Koch Institute (RKI) states that monkeypox is basically transmitted “through close physical contact”. “The risk is not limited to people who are sexually active or men who have sex with men.” It is currently unknown whether monkeypox can be spread through semen or vaginal fluids.
Transmission of monkeypox through direct skin contact during sex
On the other hand, there is clear evidence that direct skin contact with the rash typical of monkeypox during sexual activity can lead to infection. Monkeypox rashes in the genital area and in the mouth have been noticed in some of the previous sufferers. These are indications that transmissions can take place during sexual intercourse. The pustules themselves contain infectious virus.
Against this background, the European disease control agency ECDC assesses the probability of the spread of the monkeypox virus among people with multiple sexual partners in the EU as high, the overall risk as moderate, and for the general population as low. The World Health Organization (WHO) also currently sees no reason for alarm. She assumes that most cases are mild. However, pregnant women, children and people with weak immune systems have a higher risk of a severe course.
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How do you spot a monkeypox infection?
Anyone who has symptoms that indicate monkeypox should avoid close physical contact and seek advice from a doctor immediately – initially by phone. Sick people report fever, headache, muscle and back pain and swollen lymph nodes. A few days after the onset of fever, skin lesions develop, which simultaneously go through the stages from spot to pustule and ultimately crust and fall off. The rash is usually concentrated on the face, palms, and soles of the feet. The skin and mucous membrane changes can also be found on the mouth, genitals and eyes.
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