2. Transmission of monkeypox virus
The virus is transmitted by large respiratory droplets or by contact with infected body fluids.
For example, you can become ill by:
- Talking to a sick person for a long time and in close proximity
- Direct contact with skin sores or injuries
- Contact with material that has been contaminated by skin sores (e.g. sheets).
As with all viruses, the closer the contact with different people, the greater the risk of being infected by the virus.
The virus is present in the body's biological fluids such as saliva, blood and also in skin sores or lesions. It can enter another person's body through small skin injuries (even if not visible), and mucous membranes (mouth, nose, eyes, anus, vagina, etc.).
Research is underway to find out whether the monkeypox virus is also present in other body fluids such as breast milk, vaginal secretions or semen.
Monkeypox is not considered a sexually transmitted disease. However, the act of sexual intercourse facilitates the transmission of the virus: as the disease is transmitted through prolonged contact with a contagious person, the higher the number of sexual partners, the greater the risk of catching the disease.
A person is contagious from the time of flu-like symptoms and before the appearance of skin sores (which usually appear 1 to 3 days after flu symptoms). He/she remains contagious until these sores disappear (see diagram below).
As a precautionary measure, the UK health authorities and the World Health Organisation (WHO) recommend the use of condoms for several weeks after infection and until the possibility of sexual transmission is definitively ruled out by scientific studies.
Many cases of monkeypox have been reported in communities of men who have sex with men. What is the situation?
During this outbreak, several cases of monkeypox were detected in people who have sex with men (MSM) who were involved in events that put them at risk of contracting the disease (multiple sexual partners). It is important to understand that the risk of monkeypox is not limited to MSM. Anyone who is in close contact with a contagious person is at risk. The assumption is that people who have multiple sexual partners multiply the risk situations and thus the likelihood of contracting the disease. In addition, as the World Health Organisation (WHO) points out, the overrepresentation of people who have sex with men among those diagnosed with monkeypox may also be explained by the positive health-seeking behaviour in this community (i.e. they are aware of health issues, know how to recognise symptoms and have the reflex to seek medical advice if in doubt). Monkeypox rashes can resemble some sexually transmitted diseases, such as herpes or syphilis, which may explain why these cases are detected in sexual health clinics. Currently, there are several signals that there may be under-detection of cases and a silent circulation of the virus. It is likely that the more we learn about monkeypox, the more we will be able to identify cases in the wider community. Stigmatising people because of a disease is never acceptable. Anyone can contract or transmit monkeypox, regardless of their sexuality.