Sources of transmission of monkeypox in Madrid and in Berlin

Outbreaks of monkeypox in various countries outside of endemic areas have been ongoing worldwide since early May with Europe as the main affected area.

Germany and Spain are among the European countries with the most reported cases of monkeypox. Two articles published in Eurosurveillance describe the epidemiology of monkeypox and the sources of transmission in the Madrid region of Spain and in Germany, with a focus on Berlin.

Mass gatherings as the main source of contagion in the Madrid region

Martinez et al. [1] analyzed data on 508 confirmed cases of monkeypox in the Madrid region. The majority of reported cases were men who identified themselves as men who have sex with men (MSM) and who had had unprotected sex or had sex with multiple partners in the 21 days prior to the onset of symptoms.

At the start of the Madrid outbreak, many people attended the same sauna in the city center which was temporarily closed by public health authorities as a precaution.

Gay Maspalomas pride in Gran Canaria is also considered a source of contagion for many confirmed cases in Madrid, in the Canary Islands as well as other European countries. [2] based on the high number of sexual partners reported by those attending the event.

Moreover, meeting people on dating apps after private gatherings or parties is also reported from many cases and thus may also play an important role in the transmission of monkeypox.

The authors also speculate that the number of cases will increase over the next few weeks, given the mode of transmission and the fact that most contacts are unknown.

From travel related to local transmission in Germany

Selb et al. [3] analyzed 521 confirmed cases of monkeypox in Germany. At the start of the outbreak, half of the reported cases likely contracted the infection while traveling abroad. However, from 23 May 2022 onwards, cases with locally acquired infections are more common in Germany, with the highest incidence in Berlin.

In Berlin, 353 cases of monkeypox have been reported, 73% identifying themselves as men who have sex with men. The majority of them had no travel history, indicated that they contracted monkeypox in Berlin, mentioned visits to clubs, bars and private parties. For those who have a travel history, Maspalomas Gay Pride on Gran Canaria is the most frequently mentioned destination.

Monkeypox mainly spreads in the MSM community

Neither Martínez et al. and Selb et al. discuss that most of the confirmed cases in Berlin and Madrid were among men identified as MSM. According to Selb et al. it may also explain the shift from travel-related transmissions to local transmissions in Berlin, as the city “has one of the largest MSM populations in Germany and is a major international hotspot of the MSM community”.

In Madrid, sexual activity plays a key role in transmission according to Martínez et al. who stated that “along with the predominant location of the rash in the genital, perineal or perianal area and the presence of lymphadenopathy in the inguinal area, suggest that close physical contact during sexual activity has been strongly involved in the transmission of this infection. extraordinary event.”

Based on their findings, the two articles concluded that in order to minimize and effectively manage ongoing monkeypox outbreaks, it is important to more actively work with at-risk groups and disseminate non-stigmatizing and targeted information and recommendations to at-risk populations, particularly MSM.

/ Public Release. Material from this original organization/author may be timely, edited for clarity, style and length. The views and opinions expressed are those of the author. See more here.

#Sources #transmission #monkeypox #Madrid #Berlin