In article <t2g3ot$3jkim$59@news.freedyn.de>
<governor.swill@gmail.com> wrote:
>
> It's a FAGGOT SPREAD DISEASE! Nothing will change that.
>

The claim that skin-to-skin contact during sex between men, not
intercourse itself, drives most monkeypox transmission is likely
backward, a growing group of experts say.

Since the outset of the global monkeypox outbreak in May, public
health and infectious disease experts have told the public that
the virus is largely transmitting through skin-to-skin contact,
in particular during sex between men.

Now, however, an expanding cadre of experts has come to believe
that sex between men itself � both anal as well as oral
intercourse � is likely the main driver of global monkeypox
transmission. The skin contact that comes with sex, these
experts say, is probably much less of a risk factor.

In recent weeks, a growing body of scientific evidence �
including a trio of studies published in peer-reviewed journals,
as well as reports from national, regional and global health
authorities � has suggested that experts may have framed
monkeypox�s typical transmission route precisely backward.

Reconceiving the primary risk factors for transmission is
crucial because of how it may affect guidance on reducing the
risk of infection, including the question of whether demanding
that people with the virus self-isolate has any substantial
impact on transmission.

�A growing body of evidence supports that sexual transmission,
particularly through seminal fluids, is occurring with the
current MPX outbreak,� said Dr. Aniruddha Hazra, medical
director of the University of Chicago Sexual Wellness Clinic,
referring to monkeypox and to recent studies that found the
virus in semen.

Consequently, scientists told NBC News that the Centers for
Disease Control and Prevention and other public health
authorities should update their monkeypox communication
strategies to more strongly emphasize the centrality of
intercourse among gay and bisexual men, who comprise nearly all
U.S. cases, to the virus� spread.

On Aug. 14, Dr. Jeffrey Klausner, an infectious disease
physician at the University of Southern California, and Dr. Lao-
Tzu Allan-Blitz, a resident physician in global health at
Brigham and Women�s Hospital in Boston, published an essay on
Medium in which they reviewed the science supporting the
argument that during the current outbreak, monkeypox is largely
transmitting through anal and oral intercourse between men.

�It looks very clear to us that this is an infection that is
transmitting sexually the vast majority of the time,� Allan-
Blitz said.

This debate, however, is far from settled.

Dr. Rosamund Lewis, technical lead for monkeypox at the World
Health Organization, told NBC News it was �unfortunate but true�
that �we don�t know yet� whether the virus is predominantly
transmitted through intercourse.

�Completely reading the situation as uniquely due to anal or
oral sex is highly likely to be overreach,� she said. �The
correlation may appear to be strong, but that does not explain
the whole picture of disease caused by this virus. So we need to
keep an open mind.�

Some experts in infectious disease see evidence supporting the
argument that monkeypox at least transmits more readily through
intercourse.

�At this point,� said Dr. Paul Adamson, an infectious disease
specialist at the UCLA School of Medicine, �I�m not sure we can
say it is primarily the sexual transmission and not the skin-to-
skin contact that also occurs during sex that is contributing to
the most transmission during this current outbreak. However,
emerging data seem to suggest that monkeypox might be more
efficiently transmitted sexually.�

Parsing the evidence
In an interview, Klausner, who has submitted a version of his
and Allan-Blitz�s essay to a scientific journal for publication,
distilled the evidence that he said supports the hypothesis that
sex itself fuels the global outbreak into four major points.

First, he noted that, according to the WHO, more than three
quarters of global monkeypox cases are among men 18 to 44 years
old. This is a typical age breakdown for diagnoses of sexually
transmitted infections among gay and bisexual men, he said.
What�s more, in recent studies of pooled monkeypox cases among
this demographic, 17% to 32% of those diagnosed with the virus
received a sexually transmitted infection (STI) diagnosis at the
same time.

Second, during the global outbreak, atypical to what has
historically been seen in the 11 African nations where the virus
has become endemic since first being identified in humans in
1970, monkeypox lesions have in the majority of cases occurred
in men�s genital and anorectal areas. This, experts told NBC
News, suggests that these were the sites where the virus first
passed into the body.

In a study of 197 monkeypox cases in London men published July
28 in The BMJ, the British Medical Association�s journal,
researchers found that 56% had lesions in the genital area and
42% had them in their anorectal regions. And in a study
published July 21 in The New England Journal of Medicine, a
global team of researchers pooled 538 monkeypox cases � also all
in men � from around the world and found that 73% had lesions in
the genital or anorectal areas.

Third, researchers have found monkeypox in semen and have been
able to culture that virus, which suggests it could transmit
through ejaculation. Also, the authors of two recent studies
have detected the virus after taking anal swabs among men who
had monkeypox but were asymptomatic, which indicates that the
virus might transmit from the anorectal area during anal
intercourse before people develop symptoms. Experts say more
research is needed on both these fronts.

Referring to bodily fluids such as semen, vaginal fluids and
blood, the WHO�s Lewis said, �Research is underway to find out
more about whether people can spread monkeypox through the
exchange of these fluids during and after symptomatic infection.�

Finally, Klausner noted that scientists have identified an
association between specific sexual acts and the location of
monkeypox lesions.

The authors of a paper published Aug. 8 in The Lancet
documenting 181 cases of the virus in Spain found that 38% of
the men who reported having receptive anal intercourse, called
�bottoming,� developed proctitis, or inflammation of the rectum.
Just 7% of the men who reported sex with men without bottoming
developed this potentially excruciating symptom. Additionally,
95% of the men with tonsillitis reported performing oral sex on
a man.

Dr. Oriol Mitj�, an associate professor in infectious disease at
the University Hospital Germans Trias i Pujol in Spain and the
joint senior co-author of the study in The Lancet, said
monkeypox transmits most efficiently when lesions come into
contact with mucus membranes in the anorectal area, genitals,
mouth and throat.

Monkeypox is more likely to transmit through oral or anal sex
than through contact with external skin, which would need some
sort of defect, such as a wound, to allow entry of the virus,
Mitj� said.

Dr. Dimie Ogoina, a professor of medicine and infectious
diseases at Niger Delta University in Nigeria, acknowledged
Mitj�s research supporting the connection between types of sex
between men and monkeypox outcomes.

�This is not to say that females or heterosexuals are not at
risk of monkeypox or that the female genital mucosa is not prone
to abrasions during sexual activity,� Ogoina said.

Global trends
Some experts, like the WHO�s Lewis, maintain that the main mode
of monkeypox transmission remains skin-to-skin contact �
including during sex. Others, like Klausner and Adamson, say a
number of infectious disease experts may resist believing
intercourse is a predominant driver of the current outbreak
because that is not how monkeypox has tended to spread in past
decades.

�Historically, the primary mode of transmission of monkeypox was
through skin-skin contact, though there might have been some
suggestion of sexual transmission in prior outbreaks. It takes
some time and additional data to overturn our understanding of
transmission,� Adamson said.

Monkeypox has been diagnosed in 38,019 people in 93 countries
during this current global outbreak, according to the CDC. And
the WHO reports that among cases with proper data, 97% have been
diagnosed in gay, bisexual and other men who have sex with men.
The consistency with which cases have remained so overwhelmingly
in this demographic, some experts argue, is further evidence
that the virus transmits among them through a behavior that is
exclusive to the group � anal intercourse and oral sex between
men.

Meanwhile, across the global outbreak, the virus is also
apparently following the same transmission patterns
traditionally seen in Africa. But experts assert that just as in
those African nations, when the virus transmits through
nonsexual means, it does so with dramatically lower efficiency �
and thus at a rate similar to the relatively slow spread seen in
Africa.