Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022

Abstract

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18–67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

Monkeypox caused less worry than COVID-19 among the general population during the first month of the WHO Monkeypox alert: Experience from Saudi Arabia

“…At the time of data collection, it was not clear whether this Monkeypox epidemic was occurring mainly among men who have sex with men, particularly those with multiple recent partners, as was demonstrated in the subsequent research [ 26 , 32 ]. However, we did not collect this data in our survey, as this was not initially communicated in a clear and documented manner in the evolving literature.…”

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022

“…Compared with other patients with monkeypox, those with HIV infection had higher rates of secondary bacterial infection, more prolonged illness (and thereby also longer period of infectiousness), as well as a higher likelihood of having a confluent or partially confluent rash rather than discrete lesions (22). In contrast, recent reports from European countries where most patients are receiving effective ART have noted no deaths or evident excess in hospitalizations among persons with HIV infection and monkeypox to date (3,4,6). In addition, WHO has stated that a more severe disease course has not been reported in persons with HIV infection who are receiving ART and have a robust immune system (23), a finding supported by recent large cohort studies (5,7,8).…”

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

“…Although anyone in close contact with active cases can be at risk of virus acquisition, the current cases appear to be concentrated among men who have sex with men (MSM) [ 18 , 23 , 24 , 25 , 26 ]. This striking pattern was evident in a recent study on HMPX in London which showed that 196 out of 197 (99.5%) reported cases were identified among MSM (gays and bisexual men) [ 20 ].…”