Sex with unknown partners making monkeypox contacts hard to trace

Public health officials are struggling to trace contacts of monkeypox cases because many had sexual contact with unknown partners in cruising grounds, sex clubs and during chemsex sessions, it has emerged.

The first technical briefing for the disease included details of interviews with 45 confirmed cases, who were asked about their sexual health.

Nearly all (98 per cent) of the interviewed cases reported sex with other men during the incubation period, with nearly half (44 per cent) reporting more than 10 sexual partners in the previous three months and group sex.

Of those interviewed, 44 per cent (20 out of 45) also reported attending “sex-on-premises” venues in the UK or abroad during the incubation period, such as saunas, dark rooms or sex clubs.

High usage of dating apps

A minority of cases reported sexual activity in international festivals or events. There was high usage of dating apps, with 64 per cent of those interviewed meeting new partners that way

The report, by the UK Health and Security Agency (UKHSA) said the interviews had “highlighted challenges” in controlling the outbreak.

“Traditional contact tracing as a primary control intervention in this specific group will be challenging as most cases reported having sexual contact with new or casual partners, sometimes in the context of cruising grounds or during chemsex, frequently where contact details were unavailable for tracing,” said the report.

A further 43 cases of monkeypox in England, one additional case in Scotland and one additional case in Wales were announced on Friday, bringing the total number to 366 as of June 9.

Same-sex contact

The median age of confirmed cases in the UK was 38 years old. Questionnaires of 152 cases have found that 99 per cent of cases identified as gay, bisexual, or men who have sex with men, or reported same-sex contact.

Recent foreign travel, within 21 days prior to symptom onset, was reported by around half (75 cases), with 59 of these reporting travel within Europe.

The outbreak is currently classified as Level 2meaning that transmission is confined to a subpopulation with close contacts, but the report said health officials were closely monitoring the situation for evidence of Level 3 – the stage before full community transmission.

Sex-on-premises venues

The interviews showed that 36 per cent of people did not report attending any sex-on-premises venues, festivals or events in the three weeks before symptom onset, suggesting the need for wider interventions.

Dr Meera Chand, director of clinical and emerging infections, UKHSA, said: “We are working, both in the UK and together with global partners, to progress the investigations that we need to help us better understand the virus, its transmission and the best use of mitigations such as vaccines and treatments.

“We use the new data rapidly to inform the public health response and we continue to work to reduce transmission.

“We are grateful to all those who have come forward for testing and the patients who continue to help us understand the outbreak through participating in studies and investigations.”

The report authors said it was difficult to put a figure on the reproduction R number, which would give an indication of how fast the disease is spreading.

In recent days, cases appear to have plateaued, which experts believe may be due to a change in behavior from affected populations.

People are advised to contact a sexual health clinic if they believe they have a rash with blisters.

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