Monkeypox can spread by direct skin-to-skin contact; high risk activities you should avoid

India reported its 9th monkeypox case on Wednesday, wherein a 31-year-old Nigerian woman tested positive for the virus. Becoming the first woman in the country to test positive for monkeypox, officials have noted symptoms like fever and skin lesions in her. According to a PTI report, the patient is admitted to LNJP hospital.

Over 75 countries have reported outbreaks of monkeypox, where the viral disease is not endemic. Earlier, the World Health Organization (WHO) declared it as a global health emergency, highlighting the possible dangers associated with it.

That said, given the alarming numbers of monkeypox cases, it is important to stay vigilant and take proper measures against the virus.

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Monkeypox is a rare, viral zoonotic infection that belongs to the same family of viruses as variola virus, the virus that causes smallpox. Fever, headache, muscle/backache, swollen lymph nodes, chills, exhaustion and certain respiratory issues are common symptoms of the viral disease.

Monkeypox transmission can occur through direct contact with a lesion that contains the virus or direct contact with bodily fluids that have the virus in it. That said, it is important to avoid close, direct contact with an infected person.

Below are some of the ways monkeypox spreads and transmits from human to human.

According to the US Centers for Disease Control and Prevention (CDC), monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.

Having said that, activities that include intimate contact such as oral, anal, and vaginal sex or touching the genitals, hugging, massaging, kissing and prolonged face-to-face contact can also increase one's risk of the virus.

Is monkeypox a sexually transmitted disease? This question is currently on the minds of many people.

While experts have no conclusive report on the same, a recent study by The Lancet found that monkeypox virus can persist in semen for weeks after recovery.

Having assessed viral shedding in semen samples collected 5–19 days after symptom onset in a patient, Francesca Colavita, a researcher from the Laboratory of Virology, National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Italy, has said, "Our findings support that prolonged shedding of monkeypox virus DNA can occur in the semen of infected patients for weeks after symptoms onset."

The patient was diagnosed at Italy’s Lazzaro Spallanzani National Institute for Infectious Diseases and had a travel history to Austria during the first two weeks of May. The man self identifies himself as someone who has sex with men and sexworkers. He also self-reported unsafe sexual intercourse with several male partners during his travel.

"The case discussed herein supports that transmission of monkeypox virus during sexual activity might be a viable and recognised route, especially in the current 2022 outbreak of disease," Colavita said, adding that the "prolonged viral DNA shedding, even at low viral copies, might hint at a possible genital reservoir".

However, "since the patient was an HIV-infected, viro-immunological responder, we cannot entirely exclude the possibility of an effect of HIV-associated chronic immune dysregulation on prolonged monkeypox virus shedding in semen," she added.

Health authorities have maintained that the virus is not a sexually transmitted disease and anyone can contract the disease by close contact.

The CDC also warns against touching fabrics and objects that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, clothing.

It is believed that a person with monkeypox can spread the virus to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks, as per the health body.

As per the CDC, enclosed spaces, such as back rooms, saunas, sex clubs, or private and public sex parties where intimate, often anonymous sexual contact with multiple partners occurs, may have a higher likelihood of spreading monkeypox.

Primarily, monkeypox spreads through prolonged skin-to-skin contact with lesions or bodily fluids containing the virus. However, according to the CDC, contact with respiratory secretions can also increase your chances of the disease.

The CDC's "What We Still Don't Know" section reads: "How often monkeypox virus may be spread from respiratory secretions, or at what point during infection a person with monkeypox symptoms might be more likely to spread monkeypox virus through respiratory secretions."

While this does not confirm that monkeypox can spread through respiratory secretions, the health agency does not completely disown the theory.

Health officials have also warned against coming in contact with people who could be showing respiratory symptoms such as coughs, sneezes and sore throats associated with monkeypox.

According to the UK's National Health Services (NHS), if you get infected, it can take between 5 and 21 days for the first symptoms to appear.

Some of the symptoms include:

- A high temperature

- A headache

- Muscle aches

- Backache

- Swollen glands

- Shivering (chills)

- Exhaustion